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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Small Child, Nappy Rash, Recurring Condition. Using Anti Fungal Creams With Steroids. Suggestions?

My 22 month old boy has awful nappy rash and has done on and off for about 6 months. He s been prescribed anti fungal creams and is currently using one containing steroids. It doesn t seem to making any difference and nappy changes and bathing is a tearful experience to say the least! Us there anything you can suggest?? Greatly appreciated!
Tue, 6 Nov 2012
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Pediatrician, Neonatology 's  Response
Hi
Nappy rash occurs due to skin contact by moisture of urine and stool of your baby. Even the best absorbent diaper cannot remove all the moisture.

The way to prevent and treat Nappy rash is to keep the skin area dry. And you know how difficult it is with kids. These are the general steps to be followed.

1. Try to give your baby a nappy free time as much as possible. His skin need to get air. Air keeps the area dry. Air acts as healing aid of affected area.

2. Change diapers with fresh one as soon as possible after it get wet.

3. When he get dirty, clean your baby's bottom with plain water ( with pH neutral soap). Pat dry with soft towel. Then use fresh diaper [ If possible, after some diaper-free time].

4. Don't fasten the nappy tight. Allow some air to flow between. This will keep the area dry.

5. Use gentle pH neutral Soap for bathing.

6. Select the proper nappy. Some nappies are rough and cause skin irritations. Cloth nappy or disposable one - both will work.

7. Allergic dermatitis, though very rare, could be a cause. Change the nappy brand / type if some material in the nappy itself is causing dermatitis.

8. Do not apply powder to keep the area dry. It may cause skin irritation.

9. A thin film of cream / oil / petroleum jelly may be applied before putting fresh nappy. But, keep in mind, the amount of cream should be very little, and to be applied after properly drying the area.

10. Do not use any perfumed / alcohol containing wipe to clean your baby's bottom.

Above managements usually prevent and cure most cases of Nappy rash. Application of medicated ointments may be necessary to treat more severe cases.Nappy rashes may get worse by skin erosion and fungal infection, and that is why steroid and antifungal ointment is prescribed. Zinc oxide ointment is also good for protecting (and treating ) nappy rash, and it could be an alternative in your case.

However, get your baby examined by doctor, if there is extensive rashes.

Hope I could make it clear. Post if you have further queries.
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Small Child, Nappy Rash, Recurring Condition. Using Anti Fungal Creams With Steroids. Suggestions?

Hi Nappy rash occurs due to skin contact by moisture of urine and stool of your baby. Even the best absorbent diaper cannot remove all the moisture. The way to prevent and treat Nappy rash is to keep the skin area dry. And you know how difficult it is with kids. These are the general steps to be followed. 1. Try to give your baby a nappy free time as much as possible. His skin need to get air. Air keeps the area dry. Air acts as healing aid of affected area. 2. Change diapers with fresh one as soon as possible after it get wet. 3. When he get dirty, clean your baby s bottom with plain water ( with pH neutral soap). Pat dry with soft towel. Then use fresh diaper [ If possible, after some diaper-free time]. 4. Don t fasten the nappy tight. Allow some air to flow between. This will keep the area dry. 5. Use gentle pH neutral Soap for bathing. 6. Select the proper nappy. Some nappies are rough and cause skin irritations. Cloth nappy or disposable one - both will work. 7. Allergic dermatitis, though very rare, could be a cause. Change the nappy brand / type if some material in the nappy itself is causing dermatitis. 8. Do not apply powder to keep the area dry. It may cause skin irritation. 9. A thin film of cream / oil / petroleum jelly may be applied before putting fresh nappy. But, keep in mind, the amount of cream should be very little, and to be applied after properly drying the area. 10. Do not use any perfumed / alcohol containing wipe to clean your baby s bottom. Above managements usually prevent and cure most cases of Nappy rash. Application of medicated ointments may be necessary to treat more severe cases.Nappy rashes may get worse by skin erosion and fungal infection, and that is why steroid and antifungal ointment is prescribed. Zinc oxide ointment is also good for protecting (and treating ) nappy rash, and it could be an alternative in your case. However, get your baby examined by doctor, if there is extensive rashes. Hope I could make it clear. Post if you have further queries.