Diaper rash cure– revealed!

A diaper rash question from Kelly: “Dr. Roy – My one year old and I are struggling to get rid of a persistent diaper rash. We’ve tried various creams and antifungal meds (both over the counter and prescription). We’re trying to change diapers every 2 hours. Is it possible that some kids are allergic to diaper creams? If so, do you have any suggestions about what else to do or try? Thank you!”

Any child could be allergic to just about any sort of cream, but I can’t say I’ve run into diaper rash cream allergy. If it seems like that might be going on, switch to plain Vaseline (petroleum jelly.) It has just about nothing in it to be allergic (no protein, just fats.)

As for the best overall approach to diaper rash: every pediatrician has their own secrets. We like to pretend that there’s some super-magical formula for getting rid of diaper rash. In truth, there are really only a few simple techniques that work. You can use any of these in combination:

1. Keep the skin cool and dry. Going naked is by far the best “medicine” for diaper rash, and the cutest too. After a diaper change, let Junior scoot around bare for a little while. Maybe not so good for the carpet, but it’s great for the rash.

2. To further keep skin cool, use a COLD hair dryer after changes (never, never use a hot or warm setting.) Bonus: very young babies love the noise.

3. Bland diaper rash creams protect and soothe. There is no reason to pay more for any kind of fancy-pants (get it?) diaper cream—they’re all going to do the same thing, and none are magic. I like generic zinc oxide paste (anywhere from 20-40%). You can buy store brands in big 1 pound tubs. Good brands of zinc oxide are Balmex and Desitin. Plain Vaseline or generic petroleum jelly works well, too. Use this after the cooling-off naked time. Apply a nice thick layer with a gloved hand (use a glove or it’s hard to get it out from under your nails.)

4. You can add a low-potency steroid, like over-the-counter strength hydrocortisone 1% ointment. Use this twice a day instead of the bland cream if a diaper rash seems like it’s irritating or painful. It will help soothe the skin, though it will not really help it heal faster. There is absolutely no need to use any sort of higher-potency steroid on this area of the body. Some doctors prescribe this stuff, and they’re asking for trouble. Stick with OTC strength and you and your baby will be fine.

5. Yeast sometimes appears in a diaper rash, usually on skin that’s been raw and red for more than three days. Also suspect yeast if your child has been on antibiotics. Though yeast can have a characteristic appearance of little satellite red dots outside of the main rash, it doesn’t always look like this. If you’ve got a diaper rash for more than three days or with dotty satellites, add in an anti-yeast cream twice a day. Over-the-counter generic Lotrimin (clotrimazole 1%) works well. Do this in addition to steps 1-3 above, and add step 4 also if the skin is uncomfortably irritated.

For any diaper rash that doesn’t respond to the above, go see your pediatrician. It’s rare, but sometimes a “diaper rash” can be something different from ordinary. Those cases need additional evaluation.

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10 Comments on “Diaper rash cure– revealed!”

  1. Shannon Says:

    We tried the naked trick (per Dr. Roy’s suggestion) with our newborn son because he has the most sensitive skin in the world. It worked wonderfully. After that, when in flared up again (not as bad) Desitin worked better than any of the other diaper creams.

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  2. Maggie Says:

    Dr. Roy, my 15 month son is(and has been) battling a yeast diaper rash. Every time it clears up it seems to come back within days. We have tried diaper rash creams, yeast medicine(over the counter and prescription), time without diapers, I use wash clothes instead of wipes and basically everything I can think of. A friend suggested cloth diapers instead of disposable ones. Will this help clear up my son’s yeast if we switch to cloth ones? We are pretty desperate but we don’t want to switch if its a waste of time. Thanks!

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  3. Kelly Says:

    Wow – thank you for the thorough response. You even answered my question about what to put on first!

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  4. Dr. Roy Says:

    Maggie, from what I understand speaking w/ older docs who were in practice when cloth diapers were in common use, the disposable diapers are much better at preventing diaper rashes. They absorb far more urine. I suppose if using cloth diapers forces parents to change the child ASAP after urine or stool, that would be good.

    I did a brief looksee w/ Google, and certainly the pro-cloth diaper sites sure claim that they’re great for diaper rashes. I don’t have any first hand experience, and I have very few patients in cloth diapers. So I just don’t know.

    If you give it a try, let us know how it goes!

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  5. Beth Says:

    I don’t think all diaper creams are created the same. My youngest daughter would break out with Desitin, and my finger tips would dry and crack. I asked my mother about it, and she had the same problem with my older brother when he was an infant. The culprit was balsam of peru (which is also in Oil of Olay). My mom found out about 13 years ago she had this allergy. We never had a problem if we used Balmex.

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  6. Ona Westermark Says:

    when my baby gets diaper rashes, i always use zinc oxide cream to treat it.`

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    Liked by 1 person

  7. Amanda Says:

    My daughter has been having diarrhea which flared the rash up so bad she could barely sit down. I tried everything from Destin to A&D, nothing worked. Called my pediatrician and he told me try using a warm cloth instead of wipes to clean her up after a wet diaper, air dry, and a good layer of vasoline. It worked almost over night. My daughter is now comfortable again and her rash is practically gone.

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  8. jeff Says:

    We just emerged victorious from a 3-week battle with diaper rash, and I would have to agree with Amanda. We tried zinc oxide based products like Boudreaux’s to no avail, as well as others, but once we switched to Vaseline/Petroleum Jelly, it went away almost over night. We gave him a bath, made sure the area was dry, then switched to petroleum jelly and it was almost like a small miracle occurred.

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  9. NewMom Says:

    Great advice! Baby boy had a pretty bad diaper rash the last two days to the point where I thought I needed to take him to see his pediatrician. Did all the steps including the Lotrimin and it worked like a charm. 24 hours later the rash is barely noticeable. We had a pee puddle or two on the hardwood from all the “airing out” and got pretty indignant looks for drying Junior with the hair dryer but totally worth it!
    Thank you!!!

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  10. Rosalia Rodriguez Says:

    Is safe to use lotrimin or monistat while wearing disposable diapers? My son has a yeast infection and his not potty trained.

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