From the FDA Drug Label
Active ingredient Miconazole nitrate 2% The alternative antifungal cream that can be used for diaper rash if Nystatin (nystatin) is ineffective is Miconazole.
- Miconazole is an antifungal cream that can be used as an alternative treatment option. 1
From the Research
If nystatin isn't working for diaper rash, try an over-the-counter antifungal cream containing clotrimazole, as it has been shown to be superior to nystatin in reducing symptom scores and achieving clinical cure rates 2. This recommendation is based on a randomized, controlled study that compared the efficacy and safety of two antifungal pastes, one containing clotrimazole and the other containing nystatin, in infants with diaper dermatitis. The study found that clotrimazole was superior to nystatin in reducing symptom scores and achieving clinical cure rates, with a higher clinical cure rate of 68.1% compared to 46.9% for nystatin.
Some key points to consider when using clotrimazole for diaper rash:
- Apply a thin layer to the affected area 2-3 times daily for 7-14 days
- Change diapers frequently to prevent further irritation
- Clean the area gently with warm water, avoiding wipes that can irritate the skin
- Allow the skin to dry completely before applying cream and a new diaper
- Use a barrier cream like zinc oxide after each diaper change to protect the skin
It's also worth noting that other antifungal creams, such as miconazole and sertaconazole, have also been shown to be effective in treating diaper rash 3, 4. However, based on the most recent and highest quality study, clotrimazole is the recommended alternative to nystatin. If symptoms persist or worsen after 7 days of treatment, it's essential to consult a pediatrician to rule out other causes of the rash or to prescribe a stronger antifungal medication.