One of the functions of our skin is to act as a barrier between the world and the rest of our body. To do this, our skin needs to be functioning in a healthy way, with the dead and dying cells being constantly replaced. Naturally, anything that significantly interferes with this process threatens the ability of our skin to act as a barrier. Any skin that is either too dry or too wet has trouble maintaining good health. Therefore, the warm and moist areas hidden beneath our children's nappies need special care.
Why do babies get nappy rash?
The main causes of nappy rash are wet skin and the chemicals produced from stale urine. These can leave your baby's skin sore, red, raw and inflamed. Bacteria and fungus can also invade the area which will cause the rash to worsen. Modern nappies (either cloth or disposable) that help to draw moisture away from baby's skin will help reduce the incidence of nappy rash, as will changing your baby's nappy more frequently. When such rashes are seen today, it is often because the baby has been unwell with frequent diarrhoea. Food allergies and teething may also produce such a rash.
What about other rashes in the nappy area?
Reactions to products
Some mild rashes can be caused by the use of different brands of cleansing wipes, oils, creams or nappies - everybody is unique and it is simply a process of elimination to find out which products suit your baby. These rashes are pink or red in appearance, and may have small spots or scaly bits. They are less defined than the redness and rawness described above, and are usually dry rather than wet. While these are not frequent, skin can react to anything at any time. This is not the fault of the product, just an individual reaction. The best advice is to simply stop using the product.
Thrush
An overgrowth of thrush is frequently the cause of, or a contributing factor to, nappy rash. Nappy rash caused by thrush is red, a bit shiny, and may have raised spots around the edge. Thrush in some skin fold areas can also look a bit grey and soggy.
Often thrush in the nappy area is associated with oral thrush, but it can occur by itself. These rashes need specific care, such as an anti-fungal powder or cream. As thrush enjoys warmth and moisture, the use of normal barrier creams should temporarily be stopped, since they may inadvertently promote the growth of thrush by providing a protective ‘blanket’ under which the organism can flourish. Oral antibiotics can also promote thrush, although some babies are simply more prone to it than others.
Eczema
Scaly rashes such as eczema and psoriasis can also be seen in the nappy area. See your GP as these uncommon rashes require specialist treatment.
What can I do to minimise nappy rash?
Good hygiene is essential each time a nappy is changed. Wipe the nappy area with water or a wipes wash and carefully pat dry;
Change nappies sufficiently often that they don't become completely soaked and change pooey nappies immediately;
Use a barrier cream or rash powder if necessary. A simple drying agent such as cornflour will also work well. Dab it on with a cotton ball after each cleansing and soon the area will be dry and comfortable;
Nappy-free time at least once a day will also help to keep baby's bottom healthy. A few minutes with the bottom in a patch of sun is also okay, but be wary of leaving them any longer than this;
Do not forget that diet is a factor too - as skin is constantly being replaced it requires good nutrition and adequate rest.