Nearly every baby gets nappy rash at some point, and most of it clears in a few days with changes and a barrier cream. The useful distinction to learn is between ordinary irritant nappy rash and thrush, because they look different, and barrier cream alone will not shift the second one.
Irritant nappy rash comes from skin sitting against wet or soiled nappies. It shows as red, sore patches on the areas the nappy touches — buttocks, genitals, the tops of the thighs — and characteristically spares the skin folds, because urine does not reach into the creases.
Treatment is straightforward:
Most rashes improve within three days on this routine.
Candida (thrush) looks different: bright red, often with a clearly defined edge, small red spots scattered beyond the main patch, and — the key difference — it does go into the skin folds and creases.
Suspect thrush if the rash has not improved after three days of good nappy care, if it looks like the description above, or if your baby also has oral thrush — white patches inside the mouth that do not wipe away.
Thrush needs an antifungal cream rather than barrier cream alone. Come and speak to us; we can look and advise on what is suitable for your baby’s age.
See a GP or health visitor if:
A rash in a baby under one month old is always worth having looked at rather than treating at home.
Nappy rash is more likely during teething, illness, courses of antibiotics and around the introduction of solid foods, when stools change. Being a bit more vigilant with changes at those times heads a lot of it off. Some babies react to particular wipes or nappy brands — if a rash follows a switch, switch back.
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