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Severe diaper rash treatment. What to do when a diaper rash won't go away?


severe diaper rash

What to do when your baby's severe diaper rash won't go away with the usual over the counter creams and ointments?

It may be that it is not a regular rash that every baby at some point will get.

A standard diaper rash appears when the skin comes in contact with irritating substances in the diaper or from the diaper itself.

Especially diarrhea is often the cause of a bad diaper rash because the skin is longer exposed to irritating watery stool. But even a extreme diaper rash from diarrhea will usually clear up in a few days with standard home remedies.

What should you do when home remedies to treat a baby's diaper rash fail? And how do you distinguish the rash and find the source of the problem?

To start with, you need to know more about the different types of diaper rash.

Check out our list of the most common rashes and how one treats such a problematic diaper rash.


Irritant dermatitis

baby with severe diaper rash

Irritant dermatitis is a common diaper rash that develops when the skin gets irritated. This happens when babies are too long in contact with urine or stool or by the rubbing of a too tight diaper.

Typical for this diaper rash is, that it usually does not affect the skin folds. In the beginning this skin rash appears red and inflamed, but when the rash becomes severe you may get a diaper rash that is raw and bleeding.


Allergic diaper rash

We often see that a diaper rash won't go away because the baby is allergic to the diaper material or to the fragrance used in baby wipes.

Allergic contact dermatitis (eczema) causes itchy red, raised, scaly skin in the diaper area. Sometimes simply changing the brand of disposable diapers will help to clear this rash on its own.

But it is also possible, that baby's who wear cloth diapers, are sensitive to the laundry detergent.


A yeast infection diaper rash

Your baby has a yeast diaper rash when he is infected with the fungus Candida Albicans. This is often a severe diaper rash with red and raw patches, fluid filled pustules (satellite pustules) and it covers large areas.

The rash may spread to the skin outside the diaper area, like on baby's thighs or belly. Yeast loves warm and moist areas and infections usually start around baby's anus or in the skin folds between the thigh and body.

A breastfeeding mom that takes antibiotics needs to know that her baby is vulnerable to a yeast diaper rash. Antibiotics kill the beneficial bacteria on baby's skin that normally help to keep fungus infections at bay. At the same time there may also be a yeast infection in baby's mouth or on the mothers nipples (thrush).

A fungal infection can easily be spread either through direct contact of baby's mouth on the nipple or through baby's intestines into his stool.


How to treat diaper rash caused by Candida Albicans?

If a diaper rash won't go away with the usual creams and ointments it is most of the time a yeast diaper rash. For yeast infections you get a prescription for anti fungal treatment from your pediatrician.  Even though there are diaper rash creams for yeast infections that you can buy without a doctor's prescription, like nystatin, miconazole and clotrimazole, it is better to ask your doctor for the proper treatment.

Carefully read the labels of barrier creams because some contain cornstarch, like the well-known triple paste cream. Cornstarch can actually make a yeast infection worse. For yeast infections you better use the triple paste anti fungal ointment with 2% miconazole nitrate. Though a bit pricy, this stuff has quit a few happy customers!



The following two rashes are not typical for the diaper area, and will not go away by just changing your diapering routines.

A bacterial diaper rash

Another reason babies get a severe diaper rash is because bacteria have found their way through the damaged skin. A bacterial skin infection in the diaper area caused by Staphylococcus Aureus will give red patches and fluid filled blisters. When these blisters start leaking, they will form a honey colored scab.

This infection, known as impetigo, is very contagious and can easily be spread to other body parts when baby scratches it. For this diaper rash to go away it needs treatment with an antibiotic ointment. When the infection is severe or has spread, your doctor may decide topical treatment  is not enough and prescribe oral antibiotics.


Seborrhea Dermatitis in the diaper area

Most of us are well familiar with baby cradle cap, the thick yellow greasy patches on a baby's scalp. But Seborrhea can also appear on the face, in the arm pits, gentitalia and buttocks area.

Seborrheic dermatitis responds well to treatment with a mild steroid like hydrocortisone 1% cream. You may apply it twice a day but be careful not to use this steroid cream for more than one week.


Other conditions causing a severe diaper rash

There are other conditions not mentioned above because they are very rare. When a severe diaper rash won't go away after weeks or months and seems not to responsd to any treatment there may be another underlying condition.

Your doctor may do some tests to exclude highly unusual causes like, Psoriasis, scabies, congenital syphilis, Langerhans cell histiocytosis, human immunodeficiency virus (HIV) and Granuloma gluteal infantum.



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