Nappy Rash: Causes, Prevention and Treatment
Few things upset parents more than seeing their baby’s skin looking red, sore, and uncomfortable.
The good news is that nappy rash is extremely common and, in most cases, improves quickly with the right care.
However, not all nappy rashes are the same.
Understanding what is causing the rash is often the key to treating it successfully.
What Is Nappy Rash?
Nappy rash is irritation and inflammation of the skin in the nappy area.
It commonly appears as:
Redness
Soreness
Inflamed skin
Small spots or patches
Most babies will experience nappy rash at some point during infancy.
Why Does Nappy Rash Happen?
The skin inside a nappy is exposed to:
Moisture
Friction
Urine
Stools
Heat
All of these can irritate delicate skin.
Some babies have naturally more sensitive skin than others and may develop rashes more easily.
The Most Common Causes Of Nappy Rash
Common causes include:
Prolonged contact with urine or stools
Frequent bowel movements
Diarrhoea
Sensitive skin
Friction from the nappy
Antibiotic treatment
Fungal infections
Reactions to wipes or skincare products
Sensitivity to particular nappy brands
Not All Baby Wipes Are The Same
One of the things I have noticed over the years is that some babies have very sensitive skin and can react to certain wipes.
Many standard wipes contain:
Fragrance
Preservatives
Cleansing agents
Additional ingredients that some babies find irritating
For babies with sensitive skin or persistent nappy rash, I generally prefer simple water-based, fragrance-free wipes with minimal ingredients.
During severe flare-ups, some parents find cotton wool and warm water to be the gentlest option.
In my experience, reducing irritation often helps more than adding additional products.
Could It Be The Nappy?
One of the most overlooked causes of persistent nappy rash is sensitivity to a particular nappy brand.
Occasionally, a baby who continues to develop redness despite frequent nappy changes and good skincare may be reacting to:
The nappy material
Fragrances
Dyes
Elastic components
Over the years, I have seen babies whose skin improved dramatically after switching to a different nappy brand.
If a rash repeatedly returns despite good care, it is worth considering whether a product sensitivity may be contributing.
When The Rash Is Mainly Around The Anus
The location of a rash can provide important clues.
If the redness is concentrated mainly around the anus, I often start thinking about irritation from stools rather than the nappy itself.
Diarrhoea, frequent stools, or particularly acidic stools can irritate the skin very quickly.
Parents may notice:
Bright redness around the anus
Soreness that develops rapidly
Skin that worsens after bowel movements
Improvement when stools become less frequent
In these situations, treating the skin is important, but understanding why the stools are irritating the skin can be equally important.
Is It Really Diarrhoea?
This can be surprisingly difficult to answer in young babies.
Breastfed babies often have stools that are:
Very soft
Mustard coloured
Seedy
Frequent
This is completely normal and not diarrhoea.
Diarrhoea is usually a noticeable change from your baby’s normal pattern.
Parents may notice:
More frequent stools than usual
Much more watery stools
Stools soaking into the nappy differently
Signs that their baby is unwell
If you are unsure, it is always worth seeking advice.
Can Mum’s Diet Affect A Breastfed Baby’s Bottom?
Most breastfed babies tolerate their mother’s diet extremely well.
However, some mothers notice that certain foods seem to coincide with changes in their baby’s stools.
In my experience, some parents report that after eating particularly spicy, rich, or greasy meals, their baby may temporarily have looser or more frequent stools.
If those stools become frequent enough, they can sometimes contribute to irritation around the anus.
This does not mean breastfeeding mothers need to avoid these foods routinely.
Rather than eliminating foods unnecessarily, it can be helpful to look for patterns.
For most babies, occasional spicy or rich meals cause no problems at all.
Fungal Nappy Rash: When Barrier Cream Isn’t Enough
Not all nappy rash is caused by moisture and friction.
Some rashes are caused by a fungal infection, most commonly Candida (thrush).
A fungal nappy rash often looks different from ordinary nappy rash.
You may notice:
Bright red skin
Rash extending into the skin folds
Small red spots surrounding the main rash
A rash that is not improving despite good nappy care
In these situations, barrier cream alone is unlikely to solve the problem.
A fungal rash usually requires specific antifungal treatment recommended by a healthcare professional.
Barrier Creams
Barrier creams work by creating a protective layer between the skin and irritants.
They can be extremely effective when used correctly.
A common mistake is trying to remove every trace of barrier cream at each nappy change.
Gentle cleaning is usually sufficient.
The aim is to protect the skin, not scrub it.
Air Time
Allowing babies some nappy-free time can be helpful.
Air exposure allows the skin to remain dry and reduces the constant contact between skin, moisture, and irritants.
While not always practical, even short periods of nappy-free time can be beneficial.
Cultural Advice And Home Remedies
One of the wonderful things about working with families from different backgrounds is seeing how many traditions are passed from one generation to the next.
These suggestions usually come from a place of love.
However, not all traditional remedies are safe for newborn skin.
Over the years, I have heard parents advised to use:
Egg whites
Cornflour
Talcum powder
Toothpaste
Herbal preparations
Various food-based products
While well intentioned, these remedies can sometimes worsen irritation, increase the risk of infection, or trigger allergic reactions.
As a general rule, I encourage parents to keep nappy rash management simple and evidence-based.
When Should I Seek Medical Advice?
Please seek medical advice if:
The rash is worsening
The skin is broken or bleeding
Your baby appears uncomfortable or distressed
The rash is spreading
You suspect a fungal infection
The rash is not improving despite appropriate treatment
There are signs of infection such as pus or swelling
A Persistent Rash Is Telling You Something
One of the most important lessons I have learned over the years is that a persistent nappy rash is often your baby’s way of telling you that something deserves a closer look.
Sometimes it is moisture.
Sometimes it is friction.
Sometimes it is a fungal infection.
Sometimes it is a product sensitivity.
Sometimes it is irritation from frequent stools.
The answer is not always more cream.
Sometimes the answer is understanding what is causing the skin to become irritated in the first place.
A Final Thought
Most nappy rashes improve quickly once the underlying cause is identified and addressed.
Frequent nappy changes, gentle cleaning, appropriate barrier creams, and seeking advice when needed will solve the majority of problems.
If your baby’s bottom is looking sore, try not to panic.
Nappy rash is common.
It is usually temporary.
And with the right approach, most babies are comfortable again very quickly.
About The Author
Solange Martins is a mentor, coach, and former maternity nurse with over 20 years of experience supporting women through every season of motherhood. Based in the UK, she works with mothers at all stages — from the newborn haze to rediscovering their identity in later chapters — offering compassionate guidance, practical tools, and a steady, non-judgmental space to find their footing again.