How to Recognize and Treat a Yeast Diaper Rash

Spotting the Signs of Candida

newborn crying during diaper change
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All diaper rashes are not created equal. Besides the garden-variety type, babies can develop a rash caused by yeast. It's not always easy to tell the difference, but it does matter when it comes to treating a sore, red, little bum and preventing future infections. Here's a guide to yeast diaper rash. 

Overview

The strain of yeast that's responsible for diaper rash is a fungus called Candida. It grows best in warm, moist places—such as under a wet diaper. Infants who are taking antibiotics, or whose mothers are taking antibiotics while breastfeeding, are more likely to have a yeast diaper rash.

Other common causes of yeast diaper rash include frequent bowel movements, acids in the stool, too-tight diapers, and reactions to soaps or products used to clean cloth diapers.

Symptoms

The symptoms of a yeast diaper rash include:

  • The bold red rash is contained within a slightly raised border.
  • The rash is still hanging around after two days of diaper rash treatments.
  • Red or scaly areas (for boys on the scrotum and penis, for girls on the labia and vagina)
  • Pimples, blisters, ulcers, or sores filled with pus 
  • Satellite lesions, or smaller red patches that blend with the other patches
  • Typically, the rash is only under the diaper and has not spread to other areas.

Over-the-Counter Treatments

You may not need to take your baby to the doctor in order to treat yeast diaper rash. In many cases, such infections can be cleared up with the simple application of some over-the-counter topical treatments. Three easy-to-find anti-fungal creams are Mycostatin (nystatin), Lotrimin (clotrimazole), and Monistat-Derm (miconazole micatin). Ask your pediatrician if she has a preference if you aren't sure which to use. 

If the infection does not subside after the four to seven days of treatment often prescribed on the label, it's important to contact your doctor. A 1-percent hydrocortisone cream may also be recommended for severe rashes.

When to Call the Doctor

Reach out to your pediatrician if your infant develops a fever or the rash begins oozing or has open sores. This could indicate a bacterial infection that requires medical attention.

Contact your pediatrician if:

  • Your baby is less than 6 weeks old
  • The rash gets worse or doesn't subside 
  • The rash spreads to the abdomen, back, arms or face
  • The rash is accompanied by a fever 
  • You notice pimples, blisters or large sores filled with pus

If your doctor recommends an office visit, she will often diagnose the rash just by looking at it. There is also a simple test she may do to confirming that it is yeast. Called the KOH test, it involves scraping the area and looking at it under a microscope to see if yeast is present.

Prevention

Keeping your baby's bottom clean and dry is the best prevention and treatment for yeast diaper rash.

  • Let your baby "air out" by going diaper free for half an hour several times a day. 
  • Change your baby's diaper as soon as he urinates or passes stool. 
  • Gently clean the diaper area with water with every diaper change. 
  • Pat the area dry or allow to air dry.
  • Place the diaper on loosely. If it's too tight, it can irritate the baby's skin.
  • Wash your hands before and after changing a diaper.
  • Use absorbent diapers that keep moisture off your baby's skin.
  • Don't use baby wipes that have perfumes or alcohol.
  • If you use cloth diapers, don't use plastic or rubber pants over the diaper. Use breathable diaper covers instead.
  • If you use cloth diapers, don't use fabric softeners or dryer sheets and be sure the diapers are rinsed two or three times in the washer, especially if your child has already had diaper rash.
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