What Is a Diaper Rash?

What are the symptoms of a yeast diaper rash?

Verywell / Cindy Chung 

What Is a Diaper Rash?

Diaper rash, or diaper dermatitis, is a general term to describe inflammation in the diaper area. A diaper rash is very common, occurring in 16% to 65% of children under age 2, and can be caused by irritation to the skin, yeast or bacterial infections, and skin allergies.

Here's how to spot telltale symptoms, as well as how to treat diaper rash.

How It Happens

Several factors may increase your infant's risk of developing a diaper rash, including: 

  • Having frequent stools or diarrhea
  • Not being kept clean and dry
  • Wearing too-tight diapers that rub the skin
  • Teething, which causes extra saliva to be passed through the gut
  • Having had thrush, a yeast infection in the mouth
  • Taking antibiotics (or if you're breastfeeding and on antibiotics, they can pass through your breast milk to your baby)

Types of Diaper Rashes

The majority of diaper rashes can fall under the category of “irritant dermatitis,” which is a rash that occurs from skin over-hydration, friction, and frequent and prolonged contact with urine and stool. It is also possible for your infant to develop a rash from the following:

Allergic Reaction

In some cases, a diaper rash can be caused by an allergic reaction to specific chemicals, including:

  • Dyes or elastics in diapers
  • Fragrances or preservatives in wipes
  • Fragrances or preservatives in creams or ointments

If your baby has sensitive skin and is having an allergic reaction, the rash will likely show up everywhere the product is applied and can easily be treated by switching brands or products.

Bacterial Infection

Although rare, a diaper rash can be caused by a bacterial infection, including staph and strep. Bacteria can also make an existing diaper rash worse. If you notice any of the following signs of an infection in your baby’s diaper area, you’ll need to visit the pediatrician for proper treatment:

  • Bright red skin around the anus (which might indicate a strep infection)
  • Yellow crusting, weeping, or pimples (which might indicate a staph infection)

Yeast Infection

A stubborn diaper rash that refuses to go away despite typical treatment with diaper rash cream may actually be a yeast infection. Diaper rashes that are caused by infection with a yeast (fungus) called Candida can happen to any child and can occur if an infant takes an antibiotic. Candida grows best in warm, moist places, so under a diaper is a perfect environment for it.

Also, if your baby has another type of untreated diaper rash for two days or more, it can turn into a secondary yeast infection. Signs of a diaper rash caused by a yeast infection include:

  • A dark red rash within a slightly raised, distinct border
  • Pimples, blisters, ulcers, or sores filled with pus 
  • Rash that hangs around after two days of diaper rash treatments
  • Scaly or flaky areas
  • Small red bumps or pimples outside the border

Your doctor will usually diagnose a yeast diaper rash just by looking at it. They can further confirm the diagnosis by doing a KOH test, which uses a microscope on a scraping of skin to see whether the typical Candida yeast is present.

Other Types

Some of the less common conditions that can cause or mimic a diaper rash include:

  • Acrodermatitis enteropathica: a genetic cause of zinc deficiency
  • Psoriasis: which may also involve a child's scalp and nails
  • Scabies: caused by Sarcoptes scabiei, a mite that can burrow under the skin
  • Seborrheic dermatitis: greasy, yellow or salmon-colored scales that also occur on a baby's face, behind their ears, and on their scalp and armpits

What to Look For

Take a peek under your baby’s diaper. If it's a diaper rash, you may see areas of redness, scaling, pustules, and/or sores on the skin covered by the diaper. You'll also notice that the skin folds in the groin area, which have greater protection from urine and stool, look normal.

Tips for Treating Diaper Rash

If your baby has a diaper rash, you may not necessarily need to see a doctor right away. In fact, experts say that most diaper rashes clear with two to four days of management using a plan with the simple acronym ABCDE:

  • A: Air out skin
  • B: Barrier ointments
  • C: Clean skin
  • D: Disposable diapers
  • E: Educate yourself on diaper rash prevention

Here's a closer look at the ABCDEs of diaper rash, as well as a few more steps to keep your baby's skin clean and dry under the diaper:

  • Air out the skin. Give your baby some time out of their diaper so their skin can have a break. Place your baby on a towel without a diaper (or any creams or ointments) several times throughout the day for as long as possible.
  • Coat the skin with a thick barrier. Once the skin is dry, use a barrier ointment such as petroleum jelly or an over-the-counter ointment that contains zinc oxide, petrolatum, cod liver oil, dimethicone, lanolin, dexpanthenol, or Burow solution. This will help protect your baby's skin.
  • Keep the area clean. Regularly bathe your baby to help keep their skin clean. Make sure to wash your hands after every diaper change to reduce the chances of spreading the infection to other people or to other parts of your baby's body.
  • Switch to disposable diapers. If you're using cloth diapers, consider using breathable disposable diapers while the rash heals. If you must use cloth diapers, be sure to wash them with a gentle soap that won't irritate your baby's skin. Never use dryer sheets or fabric softeners because the chemicals and fragrances in these can make any existing rash worse or cause a new one.
  • Change diapers frequently. Change your baby's diaper every two or three hours and as soon as it gets wet or soiled.
  • Avoid irritants. Skip the baby wipes when your infant has a rash, since the ingredients in them can sting the sensitive skin. Instead, use a soft washcloth or wet cotton balls with warm water.
  • Leave some breathing room. Keep diapers loose for a while so there's airflow around the area. One way to do this is to put them in the next size up until the rash has gone away.
  • Use anti-fungal creams. Apply over-the-counter yeast infection treatments and antifungals, like Mycostatin (nystatin), Monistat (miconazole), and Lotrimin (clotrimazole), three times a day to the affected area underneath the barrier ointment. Using a thin layer of a mild over-the-counter corticosteroid cream like hydrocortisone may also help if the infection is severe.

Don't use talcum powder or cornstarch in your baby's diaper. It can get into their lungs and can also actually make the infection worse.

When to Call Your Pediatrician

If it's your first time treating your baby for a diaper rash, you may want to talk to your pediatrician or nurse first to see what they recommend. They might ask about the diapers, lotions, detergents, and other household items used on your baby, so be prepared to discuss the types of brands you typically are using.

Other reasons to call your pediatrician include:

  • The rash isn't going away or gets worse.
  • The rash spreads to your baby's abdomen, back, arms, or face.
  • Your baby is less than 6 weeks old.
  • You notice signs of infection such as lesions, blisters, or large sores that are filled with pus.

If your baby develops a fever or the rash begins oozing or has open sores, be sure to reach out to your health provider. This could be a sign of a bacterial infection that requires medical attention and possibly an antibiotic.

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Article Sources
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Additional Reading
  • Seattle Children's Hospital. Diaper rash. Schmitt Pediatric Guidelines LLC. Updated May 7, 2017.