Noticed some redness in the diaper area and started to worry?
Diaper rash, also called diaper dermatitis, is very common in babies. Most of the time, it is a mild irritation that improves with a few simple measures.
The diaper area combines exactly the conditions that make skin more vulnerable: moisture, heat, friction and frequent contact with urine and stool. Since a baby’s skin is still delicate, staying in this environment for a long time can make irritation more likely.
The good news is that a few habits during diaper changes help a lot, both in preventing rash and in helping the skin recover.
How to recognize diaper rash?
It can look different from baby to baby, but a common diaper rash usually causes:
- redness in the area covered by the diaper;
- irritated or sensitive skin;
- drier or peeling areas;
- discomfort during cleaning;
- fussiness or crying during diaper changes.
In more intense cases, the skin can become very red and sore.
Not every change in the diaper area is just a common rash, though. Fungal or bacterial infections, dermatitis and other skin conditions can cause similar symptoms.
Why does diaper rash happen?
One of the main factors is prolonged contact of the skin with urine and, above all, stool.
Moisture weakens the skin’s natural barrier. Friction from the diaper and certain substances in stool can make the irritation worse.
Other factors can also contribute, such as:
- bouts of diarrhea;
- a diaper that is too tight;
- excessive cleaning or cleaning with a lot of rubbing;
- scented or irritating products;
- wipes containing alcohol;
- some medications, such as antibiotics;
- secondary fungal infection, mainly *Candida*.
That’s why preventing diaper rash isn’t just about using an ointment: it involves caring for everything that comes into contact with the skin.
Change diapers often
This is probably one of the most important measures.
Wet or soiled diapers should be changed as soon as possible, especially after a bowel movement.
The less time the skin is in contact with these residues, the less irritation there tends to be.
Modern diapers can absorb a lot of liquid, but that doesn’t mean the baby should stay in the same diaper for long periods.
And if you have twins, a little organization can save your sanity: having diapers, cotton, hygiene items and a change of clothes set aside near the changing area avoids that treasure hunt with two babies waiting.
How to clean the baby’s skin
During a diaper change, more force doesn’t mean cleaner.
The ideal is gentle cleaning, avoiding rubbing the skin over and over.
Warm water can be used to clean the area. If you use wet wipes, choose products suitable for babies, especially ones that are fragrance-free and alcohol-free.
After cleaning, pat dry gently, without rubbing.
Irritated skin + hard rubbing is a duo nobody invited to this party.
Does diaper-free time help?
Yes.
Whenever it is possible and safe, leaving the baby diaper-free for a few minutes helps reduce moisture and lets the skin get some air.
Exposure to air is one of the measures mentioned by the Brazilian Society of Pediatrics (SBP) for both preventing and caring for diaper dermatitis.
Place the baby on a protected, easy-to-clean surface and enjoy a few minutes of freedom.
Just keep in mind that newborns have an impressive knack for choosing exactly that moment to pee.
The diaper also needs to be the right size
Diapers that are too tight increase friction and reduce airflow in the area.
Watch for very deep marks on the waist or legs and follow the manufacturer’s weight recommendations.
If the diaper keeps getting tight or there are lots of leaks, it may be time to try the next size up.
Barrier ointment: what is it for?
Barrier creams or ointments create a layer between the skin and the irritating substances in urine and stool.
Products based on zinc oxide, for example, are used for this purpose and appear in the recommendations of the Brazilian Society of Pediatrics.
One important detail: you don’t need to scrub hard to remove every bit of the cream at each change.
Aggressive cleaning can further irritate skin that is trying to recover.
When in doubt about which product to use — especially for newborns or premature babies — it’s worth talking to the pediatrician.
What to avoid when the baby has a diaper rash?
Some products can make the irritation worse.
Avoid using on your own:
- talcum powder;
- products with alcohol;
- heavily scented products;
- harsh soaps;
- antiseptics on the area;
- medications or ointments containing corticosteroids;
- antifungal or antibiotic ointments without professional guidance.
Corticosteroids, antifungals and antibiotics may be needed in specific situations, but they should not be used as the standard treatment for every diaper rash. The choice depends on the cause of the irritation.
When could it be a fungal infection?
A diaper rash that doesn’t improve isn’t always just irritation.
*Candida*, a type of fungus, can overgrow in the diaper area, especially when the skin is already damaged or after certain situations, such as antibiotic use.
It can look different from common irritant dermatitis and may involve more intense redness and small spots near the main area. Skin folds can also be affected.
But don’t try to diagnose it just by comparing photos on the internet.
If an infection is suspected or the rash is persistent, the pediatrician can examine the skin and recommend the right treatment.
When to see the pediatrician?
A mild diaper rash can usually be cared for at home at first.
Seek medical evaluation if the irritation:
- is getting worse;
- shows no improvement after about two to three days of proper care;
- spreads beyond the diaper area;
- has blisters;
- has open sores;
- has discharge, pus or crusts;
- bleeds or is very raw;
- causes the baby a lot of discomfort;
- comes with a fever.
These signs may indicate more intense dermatitis or an infection that needs specific evaluation and treatment.
If the baby seems very unwell, shows a significant change in behavior, or the family feels something isn’t right, there is no need to wait a few days before seeking care.
A rash that keeps coming back deserves attention
If the skin improves and then soon becomes very irritated again, it’s worth talking to the pediatrician.
Contact dermatitis, infections, skin conditions and even products used during diaper changes can cause recurring rashes.
The doctor can look at where the lesions are and other signs to tell a common irritant dermatitis apart from other causes.
Most of the time, care can be quite simple:
1. change the diaper when it is wet or soiled;
2. clean the skin gently;
3. avoid rubbing;
4. let the area dry;
5. allow a few minutes without a diaper when possible;
6. use the barrier cream recommended for the baby;
7. put on a clean diaper without making it too tight.
There’s no need to turn every change into a 14-step ritual.
Being gentle with the skin is usually one of the best strategies.
Most of the time, it clears up
Finding the baby’s skin very red can be scary, especially in the first weeks.
But diaper rashes are extremely common and, in most cases, improve with simple measures: frequent changes, gentle cleaning, dry skin, exposure to air and protecting the skin barrier.
The most important thing is to keep an eye on how it evolves.
If it’s getting better, keep up the care. If it’s getting worse, not going away, or signs different from a common irritation appear, seek professional advice.
Unsure about your baby’s skin?
In Nilu, you can also talk to Luna to organize your questions about diaper changes, skin care and the baby’s routine.
She can help you understand what to look out for and when to see a health professional — without replacing the pediatrician’s evaluation.
> Important: this content is educational and does not replace evaluation, diagnosis or treatment by a health professional.
Sources and references
- Brazilian Society of Pediatrics — *Cuidados com a pele e anexos do recém-nascido: da higienização e hidratação ao tratamento* (Newborn skin and adnexa care: from cleansing and hydration to treatment, 2024).
- Brazilian Society of Pediatrics — *Dermatite de fraldas: diagnósticos diferenciais* (Diaper dermatitis: differential diagnoses).
- Brazilian Society of Pediatrics — guidance on preventing diaper dermatitis.
- American Academy of Pediatrics / HealthyChildren.org — *Common Diaper Rashes & Treatments*.
- NHS — *Nappy rash*.