Diaper Rash Treatments: What Works and What Doesn’t

Diaper rash can happen fast — and it hurts. Effective treatment needs to work fast, too. A baby suffering from diaper rash can make life miserable for everyone. Fortunately, there are many options available for treating diaper rash, and some of the most effective ones are available over the counter. 

Keep reading to learn more about treating diaper rash, including which products to look for, how to use them, and how to know when it’s time to talk to a medical professional.

Good skin care can help prevent diaper rash

The cause of most diaper rashes is irritant contact dermatitis. That means something that touches the skin also irritates it. Poop and pee are very strong irritants. But some things that you might not think of — like soap, the detergent residue in cloth diapers, or the chemicals in packaged baby wipes — can also be irritants for some babies.

Fortunately, healthy skin care habits can go a long way toward preventing diaper rash. To keep the diaper area healthy you’ll want to:

• Change diapers as soon as they are wet or soiled.

• Clean the skin thoroughly after the baby poops.

• Use clear water for washing (no soaps).

• Allow the skin to dry completely before applying a cream or ointment.

• Avoid products with chemicals that could irritate the baby’s skin.

The more time your baby’s skin has contact with an irritant, the worse the rash will be. Checking a baby’s diaper often, and changing it quickly when it’s wet or soiled, can make a big difference.

3 steps to treat diaper rash in babies and young children

Once a diaper rash starts, you’ll want to act fast to make it go away. If your baby is uncomfortable because of their diaper rash, consider giving a dose of acetaminophen (Tylenol) to help with pain.

1. Wash

It may help to fully bathe the baby in clear water to make sure you’ve completely removed all the irritants. If a full bath isn’t practical, try soft paper towels or washable cloths soaked in warm water to get the skin very clean. If you prefer packaged baby wipes for their convenience, rinse them in warm water to remove chemicals before using them.

2. Dry

Allow the diaper area skin to dry completely after washing. This is an important step: The skin has natural protective features, but they can’t work well when the skin is wet. Moist skin is also more vulnerable to yeast, which can make a diaper rash worse. Pat the diaper-area skin dry, then leave it open to the air. Set your baby on a towel and let them go without a diaper for as long as possible. 

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3. Protect

When it’s time to dress your child, first choose a thick, waterproof barrier cream and apply it generously to the irritated skin. Dress them in a clean diaper. When the diaper becomes wet or soiled, remove it immediately and repeat the cleaning process.

If the diaper rash continues to be difficult to treat, talk to your healthcare provider about adding a prescription medication.  

Best barrier creams for diaper rash

It makes sense to be choosy when you’re picking a diaper cream. The most important characteristic of a diaper cream is how well it works as a barrier. That is, how well it blocks moisture, germs, and irritants to keep them away from the skin.

For everyday use, zinc oxide is often a good place to start. Zinc oxide works well as a barrier, and it also gently moisturizes, decreases inflammation, and stops the growth of germs on the skin. 

Petroleum jelly (Vaseline) is a more affordable and very effective option for everyday use.

When a diaper rash first starts, or when a baby has diarrhea, you might want to take your diaper cream up a notch. On those days you’ll still need a good barrier cream — so a product that includes zinc oxide or petroleum jelly still makes sense. But you might want to look for a combination product that contains other active ingredients as well.

Other ingredients that can be helpful in an over-the-counter diaper cream include:

• Silicone/dimethicone to create an additional barrier against moisture

• Dexpanthenol to help repair the skin surface

• Taurine to decrease inflammation and to strengthen the skin’s own oil barrier

• Vitamins A and D to condition and heal the skin 

• Zinc gluconate to stop the growth of germs

• Mineral oil, lanolin, or glycerin to help moisturize, protect, and soften irritated skin

• Menthol to help with pain

Keep in mind that some babies can be sensitive to certain chemicals on their skin. Creams with long lists of ingredients or fragrances might not be the best idea for these babies. 

Alternative treatments for diaper rash

If you’re looking to try alternative approaches to ease diaper rash, you’ve got options. There are plenty of products on the market that you can use in place of, or in addition to, the usual barrier creams for preventing and treating diaper rash.

Plant-based ingredients

Many barrier creams contain traditional, plant-based ingredients. Evidence-based natural ingredients to look for include: 

• Aloe vera for skin protection and healing

• Calendula officinalis (marigold) to fight inflammation

• Olea europaea (olive oil) as a natural moisture barrier and to fight inflammation

• Lawsonia inermis (henna) for its anti-inflammatory properties

• Citric acid for its natural antimicrobial effects

Probiotics

Probiotics contain cultures of healthy bacteria that may naturally protect skin from the effects of harmful yeasts and other microorganisms. 

Healthy bacteria change the chemical environment on the skin, making it more difficult for yeast and harmful bacteria to grow. They also compete directly with yeast and other troublesome germs, stopping them in their tracks. The goal of probiotics is to help a baby develop a healthy microbiome. That means growing a healthy population of good bacteria on the skin — quickly. 

Probiotics that fight diaper rash usually come as an oral liquid or as a powder that you can dissolve in water or milk. Researchers are studying topical creams, and they may be available soon. Look for probiotics that contain a bacterial strain called “B. infantis EVC001.”

Prescription treatments for diaper rash

Most of the time, diaper rash doesn’t require prescription treatment. But there are times when the situation needs stronger medication. After all, there are different causes of diaper rash, and sometimes several can happen at the same time.  

Prescription medications that your provider may recommend for diaper rash include:

• Antifungal creams, such as nystatin or miconazole 

• Antibacterial ointments, such as mupirocin (Bactroban)

• Steroid creams, such as hydrocortisone or desonide

• Oral antibiotics, such as cephalexin (Keflex)

Diaper rash treatment myths (what doesn't work)

There’s a myth that you don’t need to change superabsorbent disposable diapers when they get wet. That’s not true. They sure can absorb lots of liquid. But the environment inside the diaper stays humid after the baby pees, and that leaves the skin vulnerable to irritants. Plus, the chemicals in those fancy diapers can be irritants, too.

It turns out that experts don’t recommend powder for diaper rash, including baby powder and talc. For one thing, powder just doesn’t work as a barrier against moisture. On top of that, the powder itself can get into the air and cause damage to a baby’s lungs. 

Treatments for adult diaper rash 

Adult diaper rash is very similar to the diaper rash that babies get. To prevent it, make sure vulnerable skin is fully clean and free from chemicals, adhesives, soaps, and other irritants. Allow the skin to air dry completely, and keep it uncovered for as long as possible. 

Use a thick layer of a non-irritating barrier cream or ointment to protect the skin before you cover it again. When the area becomes soiled, clean it thoroughly as soon as possible.

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Written by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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