What is the treatment for diaper rash?

Treatment of Diaper Rash

The most effective treatment for diaper rash is using a barrier cream containing zinc oxide and/or petrolatum with each diaper change, keeping the area clean and dry, and allowing for diaper-free time. 1, 2

First-Line Treatment Approach

Cleansing and Drying

• Clean the diaper area with each diaper change using:
  • Gentle cleansing with emollient ointment rather than water or commercial wipes 3
  • Avoid soaps and detergents as they remove natural lipids from skin surface 3
  • Pat dry gently rather than rubbing to avoid further irritation 3

Barrier Protection

• Apply a barrier cream containing:
  • Zinc oxide (protects against wetness and helps treat existing rash) 2
  • Petrolatum (seals out wetness and protects chafed skin) 1
  • Apply a thick layer with each diaper change, especially at bedtime 1

Diaper Management

• Change wet and soiled diapers promptly 1
• Use well-fitted disposable diapers 3
• Consider trimming the inner elastic of disposable diapers to reduce friction 3
• Line the diaper with a soft cloth liner coated with emollient or paraffin-impregnated gauze 3

Air Exposure

• Allow for periods without diapers to air the skin 4
• This helps dry the area and reduce moisture-related irritation

For Moderate to Severe Diaper Rash

If Signs of Infection Are Present

• For bacterial infection (crusting, weeping):
  • Topical antibiotics may be necessary 3
  • Flucloxacillin is appropriate for treating Staphylococcus aureus, the most common pathogen 3
• For fungal infection (bright red rash with satellite lesions):
  • Add antifungal agents to the treatment regimen 5

For Persistent or Severe Cases

• Consider hydrocortisone 1% cream for short-term use to reduce inflammation 3
• For severe cases that don't respond to first-line treatment, referral to a specialist may be necessary 3

Common Pitfalls to Avoid

1. Overuse of topical corticosteroids - Use only for short periods and with the least potent preparation required 3

2. Using alcohol-containing products - These can dry and irritate the skin further 3

3. Neglecting frequent diaper changes - Prolonged exposure to wet diapers is a primary cause of diaper rash 6

4. Using occlusive plastic pants - These trap moisture against the skin

5. Vigorous rubbing during cleansing - Pat dry instead of rubbing to avoid further irritation 3

6. Using fragranced products - These can cause additional irritation to sensitive skin

The evidence strongly supports that consistent use of barrier creams containing zinc oxide and/or petrolatum, combined with proper cleansing and diaper management, effectively treats and prevents diaper rash by protecting the skin from moisture and irritants 7, 6.