Diaper rash is a skin inflammation that, in its initial days, is harmless. However, if not properly managed, it could potentially progress into a more serious condition. How should one respond to severe diaper rash? Let's explore this together.
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Severe Diaper Rash: How to Treat It?
Summary
- How does a severe case of diaper rash present itself?
- What to do in case of severe diaper rash?
- Sources
Published March 12, 2025,
updated on March 12, 2025,
by
Pauline, Chemical Engineer
—
4 min read
How does a severe case of diaper rash present itself?
Primarily affecting infants, diaper rash is a skin inflammation that occurs in the buttocks, thighs, and groin area due to a combination of mechanical, irritative, and infectious factors. More specifically, it arises in response to prolonged exposure to moisture and urine and feces trapped in diapers, which contain skin-irritating agents. In response, the skin turns bright red and sensations of burning and itching may occur. If the diaper rash is not addressed, it can spread beyond the initially affected area and reach the genital parts. The onset of fever, rapid skin swelling, as well as oozing and/or foul-smelling blisters can also indicate that the diaper rash is becoming severe. At this stage, the skin is usually very painful, making any contact with diapers or underwear particularly difficult.
The worsening of the diaper rash is often due to an infection by pathogenic microorganisms.
What to do in case of severe diaper rash?
If you are dealing with a severe case of diaper rash, it is crucial to consult a doctor.
This can guide you towards a treatment that quickly soothes the skin. Most often, in cases of severe diaper rash, corticosteroids are prescribed for two weeks. Hydrocortisone at 1% is one of the standard treatments for babies, as stronger corticosteroids can lead to serious side effects in this vulnerable population, such as skin atrophy, intracranial hypertension, growth delay, or Cushing's syndrome. If the diaper rash affects an adult, other corticosteroids are possible, such as desonide, triamcinolone, and betamethasone.
However, dermocorticoids alone are typically not sufficient to curb severe diaper dermatitis. Often associated with colonization by microorganisms, severe diaper rashes require more extensive medical intervention. In the case of a fungal infection, agents such as nystatin, clotrimazole, miconazole, ketoconazole, or sertaconazole can be applied with each diaper change. In the presence of bacterial colonization, the doctor may prescribe antibiotics. Applying mupirocin twice a day for five to seven days is usually enough to effectively curb the infection in most cases.
How to prevent diaper rash from worsening?
Even though a severe diaper rash can be relatively easily treated, the ideal is to prevent it from worsening. To do this, it is primarily necessary to keep the buttocks area clean, by regularly changing diapers and clothes soiled with urine or feces. It is also recommended to clean it twice a day with warm water and a mild soap, and to thoroughly dry the skin with a clean towel, gently patting. Additionally, you can apply an emollient cream designed for this purpose after each diaper change, in order to strengthen the skin barrier.
Sources
SCHEINFELD N. Diaper dermatitis: a review and brief survey of eruptions of the diaper area. American journal of clinical dermatology (2005).
TIERNEY N. & al. Diaper Dermatitis: Etiology, Manifestations, Prevention, and Management. Pediatric Dermatology (2013).
NIU G. & al. Safety evaluation for ingredients used in baby care products: Consideration of diaper rash. Regulatory Toxicology and Pharmacology (2017).
HASANPOOR-AZGHADI S. B. & al. A Review Study of Diaper Rash Dermatitis Treatments. Journal of Client-Centered Nursing Care (2018).
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