Definition Nappy rash is a rash in the area of the body covered by a nappy.
What is going on in the body? Most infants develop a nappy rash at one time or another. Nappy rash is a very common condition in infants because their skin is very sensitive. A nappy rash is most often due to a reaction of the infant's skin to moisture and irritants.
What are the signs and symptoms of the condition? The symptoms of nappy rash include:
redness in the area covered by the nappy
itching
pain, especially when urine or stools come in contact with the rash
irritability
If the rash is caused from a yeast infection, the rash often has bright red spots that form a solid area, which is surrounded by red dots. This rash typically covers a large area.
What are the causes and risks of the condition? There are many causes of a nappy rash. Most nappy rashes are due to prolonged contact with wetness, bowel movements, and irritants in urine. Nappy rash may also develop if an infant is on antibiotics and develops a yeast infection of the skin. Infants with a history of skin disorders, such as eczema, or cradle cap, may be more likely to develop a nappy rash.
Nappy rash does not usually present a health risk. However, if it is not properly treated, a bacterial infection may develop in the affected skin. A bacterial infection can lead to more serious problems such as:
an infection in the blood, which can be life threatening.
scarring of the tube, called the urethra, which carries urine out of the body. This is quite rare.
What can be done to prevent the condition? Nappy rash is difficult to prevent. However, the following steps may decrease skin irritation in the nappy area:
frequent nappy changing to decrease contact between the skin and urine or stools.
cleaning of the nappy area with water, a bland cream and drying of the skin with each nappy change.
loosely fastening the nappy to allow for more air circulation.
Using good quality disposable nappies
How is the condition diagnosed? To diagnose a nappy rash a doctor will take a history and examine the rash. A rash caused by an irritant is tends be a spotty, pinkish-red rash that is itchy. If the rash is caused from a yeast infection, the rash often has bright red spots that form a solid area. In this case, the rash is often surrounded by red dots. This rash typically covers a large area.
What are the long-term effects of the condition? Nappy rashes usually have no long-term effects. It is possible that chronic rashes or those that become severely infected could lead to scarring.
What are the risks to others? Nappy rash presents minimal health risks to others. If a yeast infection is involved then it is possible that this can be passed on by direct hand contact.
What are the treatments for the condition? Prevention is the first measure for nappy rashes. When a nappy rash develops, treatment may include:
frequent nappy changing.
leaving the infant's bottom exposed to air as much as possible each day.
rinsing the skin with warm water. If the rash causes raw skin, warm water soaks in a tub can be used a few times a day.
changing the nappy during the night until the rash heals.
applying an ointment, such as zinc oxide paste. This ointment, when applied to the affected areas, helps to keep stool and urine off the skin until it heals.
applying an antifungal cream, such as nystatin or clotrimazole, for rashes due to yeast infections. If the skin is quite inflamed, it may also help to apply a mild hydrocortisone ointment. The baby's doctor should evaluate a rash before this is done. Stronger cortisone preparations should be avoided. These may cause thinning of the skin of the genital area, which is very sensitive to cortisone.
antibiotics, if bacterial infection of the skin occurs.
What are the side effects of the treatments? There are usually no side effects to changing a nappy and cleaning the infant's skin frequently. There are possible side effects to ointments and cortisone creams including further rash. Strong hydrocortisone creams can cause thinning and scarring of the genital area. If an antibiotic is used, there may be side effects from the antibiotic. These include stomach upset and allergic reaction. A doctor should be contacted if side effects develop.
What happens after treatment for the condition? After a nappy rash is treated and goes away, there is no further treatment needed. If an infant has a nappy rash that persists despite treatment, the baby's doctor should be consulted.
How is the condition monitored? The parents can often monitor the rash at home to make sure it is getting better. If a rash does not improve, the caregiver should consult a doctor for further evaluation and monitoring.
Author: Eileen McLaughlin, RN, BSN Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
