Diaper rash can be caused by many things, such as skin conditions, allergies, or infections. If your child has a rash for more than a few days, they need to see a healthcare professional.

Is your baby’s bum looking beyond angry these days? If they’re between 4 and 15 months old, they might have a diaper rash. It’s nothing you did wrong. At least half of babies this age have had a diaper rash at least once in the last two months.

Diaper rashes can come on quite suddenly and make you and your little one miserable. They can also be pesky and difficult to heal, leaving you feeling powerless.

The key to effective treatment is understanding what type of rash your baby has. That’s right — there are several of these monsters you may encounter. Don’t worry, though, we’ve got you covered — from A+ identification to zinc oxide diaper creams.

Preventing this type of rash is all about keeping your baby’s skin dry and protected. Here are some tips for clearing up irritant dermatitis diaper rash:

  • Change your baby frequently throughout the day: Every 2 to 3 hours or more often if your baby has diarrhea. Be sure to continue these diaper changes at night.
  • Apply a barrier before the rash starts: Creams and ointments help shield the skin from moisture and irritants. Consider adding this to your diaper-change routine.
  • Size up or loosen the diaper a bit to give the skin more space: Again, this is particularly important overnight when your little one is in their diaper the longest.
  • Give your sweet babe some diaper-free time to let the skin breathe: If you’re worried about accidents, place a towel underneath them.
  • Watch what your baby is eating: What causes a rash in one baby may not in another. You may want to avoid juices, which are acidic and may cause diarrhea.

So many babies experience diaper rash, but there are actually only a few main causes. Here are the most common causes, and what you can do to help your baby feel better fast:

Your baby’s skin encounters a lot under a diaper. Baby’s bottom is in contact with pee and poop at many points day and night. If you consider all rubbing and chafing as your baby moves throughout the day, you’ll understand why it’s so easy for them to develop diaper rash.

Rashes caused by irritants—urine and feces—are the most common type doctors see. The area may look red and shiny and feel warm to the touch.

This type of rash is focused on the genitals, buttocks, thighs, and stomach, but it’s not usually found in the creases or folds of the skin between these areas.

Acidic poop is possible

Yeah, acidic poop. Diaper rashes may increase when your baby starts eating solid foods. When certain foods are eliminated from the body, they may make your baby’s poop particularly irritating. Eating foods may also make your baby poop more often, leading to even more rashes.

And if you’re nursing, keep an eye on your diet as well. Some nursing parents feel that certain foods they eat bother their baby’s bottom.

Treatment

You can treat most rashes caused by irritation with over-the-counter (OTC) creams and ointments. Look for creams with zinc oxide or thick petrolatum-based ointments that can protect the skin while it heals. If the rash is particularly severe, you may need prescription cream to help clear it up.

Candida rashes, more commonly referred to as yeast, have a deep red color. They show up as patches or plaques inside the diaper area, in the folds and creases of the thighs, and even outside the diaper area. There may be red dots just outside the main area of discoloration.

Baby girls may also have a white or yellow discharge from the vagina and itching. Baby boys may have scaling, redness, or discoloration on the penis.

If you suspect yeast, take a look at your baby’s mouth as well. They may have thrush, which is a yeast infection in the mouth. This type of rash can happen when your baby is taking antibiotics for an illness. Nursing moms may even pass along yeast infections after taking medications.

Treatment

Some people have had good luck with OTC antifungal creams. But you’ll probably need to make an appointment with your pediatrician, who will likely prescribe some type of antifungal ointment or cream for yeast infections.

Your baby may need oral antifungal medications, but your topical creams or ointments usually do the trick.

Prevention

Yeast diaper rashes are common. They aren’t always related to antibiotic use, so they’re hard to prevent, so it’s best just to keep following healthy diapering practices.

Research on probiotics use in infants is slim, but you might consider asking your pediatrician about giving your baby probiotics while they’re on antibiotics. Probiotics may encourage good gut bacteria to help keep yeast at bay.

Though rare, your baby might be allergic to something in their diaper or wipes. With repeated exposure, they may develop a nasty rash.

Allergic reactions may take between 1 and 3 weeks to show up after the first exposure, so if you’re trying to identify a cause, you might have to think back a few weeks.

Diaper rashes caused by allergic reactions are red, shiny, and can show up on large areas — on the genitals, buttocks, abdomen, thighs, and in the creases. Basically, you’ll see it anywhere and everywhere diapers and wipes touch their skin or where other products are applied.

Treatment

Your baby’s rash won’t clear up until you figure out what they’re allergic to. Even then, it may take between 2 and 4 weeks after you eliminate the allergen for the rash to clear.

OTC diaper creams can help with symptoms. Try formulas that are fragrance-free and hypoallergenic. If the rash is particularly severe, you may want to speak with your doctor about prescription medications.

Prevention

You’ll need to figure out what’s causing the reaction. Try looking at each step in your diapering routine individually.

  • If you have changed diaper brands, try changing back or look for a brand of diapers that doesn’t include chemicals or dyes.
  • Look for wipes that are similarly stripped of alcohol, fragrances, and other chemical additives. Or just use a soft cloth with warm water.
  • If you’re using cloth diapers, examine the detergent you’re using. Your best bet is a free and clear formula.

Maybe baby has a skin infection down there. What starts as a tiny area of infection may quickly spread in the moist, warm conditions under the diaper. The most common culprits are group A Streptococcus (strep) and Staphylococcus aureus (staph) bacteria.

  • Strep: The rash may be bright red and focused around the anus, though it can spread to the genitals. You may even notice blood in your baby’s poop.
  • Staph: You might see pus-filled bumps with a red base. These blisters may rupture with a yellow-brown fluid and leave behind scales.

Bacterial infections can get serious if they aren’t treated promptly. So, you’ll need your pediatrician’s help. Look out for other symptoms, such as:

  • fever of 100.4°F (38°C) or higher
  • bleeding
  • weeping wounds
  • pustules
  • lethargy (fatigue and listlessness)

Treatment

This type of rash can’t be treated with OTC creams. Instead, you need to make an appointment with your baby’s doctor to get prescription antibiotics, like amoxicillin and penicillin. Infections, like strep, tend to recur, so it’s a good idea to make a follow-up appointment as well.

Prevention

Infections can’t always be prevented, but you can keep an eye out for early signs so the infection doesn’t become severe. Infections may also be more likely if there is persistent irritation, like small cuts or scratches, in and around the diaper area.

Wash the area gently and pat dry so you don’t accidentally scratch or cut your baby’s delicate skin. Be sure to treat other types of diaper rashes, as they have the potential to turn bacterial the longer the skin is damaged.

There are a number of other issues that can affect your child’s skin and cause a rash. If your child’s condition seems long lasting, your best bet may be getting a referral from your pediatrician to a dermatologist who specializes in children’s skin.

Eczema

This may look like a typical diaper rash at first, but it can become purple and crusty. Sometimes, blisters or weeping may appear.

Eczema is usually dry and itchy. Though it occasionally causes diaper rash, it is more common on other parts of the body. It can often be managed by bathing and moisturizing with mild soaps, creams, or ointments.

It’s important to avoid irritation, which means using fragrance-free products, diapers, and wipes. Keeping the skin breathing and cool is also helpful.

Your doctor may prescribe medicated ointments or bleach baths. Some babies and young children may outgrow their eczema, but it is unclear why. Many children have a period of remission from eczema symptoms in later childhood, but symptoms may recur in adulthood.

Psoriasis

This can very closely resemble a diaper rash or yeast infection. Doctors often misdiagnose the condition at first. And even if you do see a pediatric dermatologist, it can be hard to distinguish between eczema and psoriasis in babies.

The treatment course is similar for both conditions. To keep the skin happy, use gentle products and consider prescription ointments.

Seborrheic dermatitis

This can cause diaper rashes and impact skin on other parts of the body, like the scalp, face, and neck. While this type of rash is red, you may also see yellow or oily patches under the diaper and in the skin folds.

Treatment involves topical medications. While doctors don’t totally know what causes it, there’s good news. Seborrheic dermatitis tends to go away on its own by the time your baby reaches 6 months to 1 year in age.

Impetigo

Impetigo is a contagious skin infection caused by the same bacteria (group A Streptococcus and Staphylococcus aureus) that cause general bacterial dermatitis.

Impetigo, however, looks like sores instead of a rash. These lesions may rupture and ooze on different parts of the body. They typically focus on the nose, mouth, hands, and feet, but you can also find them in the diaper area or anywhere else that has been exposed.

Treatment requires topical or oral antibiotics to heal. Until your little one has treatment for 24 hours, they may pass the infection on to others.

Heat rash

This type of rash is made up of tiny bumps. In fact, it’s sometimes called “prickly heat” for this reason. It happens when the skin — anywhere on the body — is hot and can’t breathe. In the diaper area, you may see it particularly in the creases. The sweat ends up blocking the pores and creates redness, discoloration, bumps, and itching.

Thick creams and ointments may make matters worse. So, if you suspect heat rash, don’t slather on diaper creams. Treatment involves cooling the area and promoting good air flow.

Disposable diapers may be better at preventing diaper rash since they keep more moisture away from the baby’s skin, and when a baby in cloth diapers gets diaper rash, they may be advised to use disposable diapers until it clears up.

However, there’s not enough evidence to suggest that either type is better for treating or preventing diaper rash. Choose what works best for your family and your budget. This simply means finding a brand of diaper that doesn’t irritate (if you use disposables) and finding a laundry soap that doesn’t irritate (if you use cloth).

Either way, change your baby frequently to keep their bottom clean and dry.

If you feel like you’ve tried every diaper cream under the sun, and your child’s rash is still raging, pick up the phone. You don’t need to do all this detective work alone.

Rashes that don’t respond to home treatment after 2 to 3 days are a reason to visit your doctor. Make an appointment sooner if you see pus-filled sores, blisters, or any other worsening symptoms, like fever.

Once you get the right treatment for your baby’s rash, you’ll both feel a whole lot better.