Nappy Rash: Causes, Symptoms, & Relief for Your Baby

Watching your baby develop a red, sore-looking bottom can be worrying, but nappy rash is one of the most common skin issues in babies, and in most cases it clears up quickly with simple care at home. Whether your little one has a mild patch of redness or reactive, sensitive skin that flares up easily, the right combination of gentle cleaning, frequent nappy changes, and skin-friendly products can make a real difference to their comfort.

Choosing the right nappy also matters - especially for babies whose skin reacts to fragrances, dyes, or lotions. In this article, you'll learn how to spot the signs of nappy rash, what causes it, how to treat and prevent it, which nappy features help protect sensitive skin, and when to seek advice from your GP or health visitor. You can also learn more about the common types of rashes in newborns and babies to help tell nappy rash apart from other skin conditions.

5 Quick Tips for Nappy Rash Prevention

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Change your baby’s nappy regularly

It’s much easier to keep nappy rash at bay by making sure your baby’s skin stays clean and as dry as possible. Regular nappy changes can prevent baby nappy rash from starting.

Keep your baby’s skin fresh

Stick to alcohol-free, fragrance-free wipes, or whatever gentle option suits you best to help reduce nappy rash symptoms.

Get the right nappy fit

Double check the nappy isn’t too tight, isn’t rubbing, and isn’t leaking. If your little one already has a nappy rash, going up a size can help things heal.

Pick nappies with super-absorbent layers

Choose nappies that pull moisture away from your baby’s skin, helping them stay dry and comfy.

Let your baby’s skin breathe

Opt for nappies that let air in, so there’s less moisture and irritation. You can even opt for short periods of nappy-free time.

What Is Nappy Rash?

Nappy rash is a common condition that typically forms when the sensitive skin on and around your newborn or older baby's nappy area becomes irritated, for example if it remains in contact with urine or poo for too long.

Nappy rash can make your baby's skin red, hot or sore in patches, and sometimes it can cause spots or blisters. With proper treatment, nappy rash usually clears up within three or four days, but if the rash doesn't noticeably improve within a couple of days, or if it gets worse, see your midwife or doctor for advice.

An important way of protecting your little one against nappy rash is changing your baby's nappy frequently.

What Does Nappy Rash Look Like?

Nappy rash usually looks like red, sore-looking patches on your baby's bottom or across the nappy area, and it may be accompanied by spots, blisters, or general fussiness. Common signs include:

• Red blotches or patches on your newborn or older infant's bottom, or across the whole nappy area

• Pimples, spots or blisters

• Hot, sore-looking skin

• An irritable or fussy baby

On brown or black skin, redness may appear as a darker discolouration, or the skin may look shiny or feel rough rather than obviously red.

What Causes Nappy Rash?

Even with frequent nappy changes, nappy rash can still happen. In the next sections, we'll explore some causes of nappy rash and situations in which it might occur.

Nappy Rash Caused by Irritants

Skin irritation is the most common cause of nappy rash, and often it is a result of:

• Your baby's skin being in contact with wee or poo for too long

• Chafing from a nappy that's too tight and rubbing against your baby's skin

• Not cleaning the nappy area or changing the nappy often enough

• A reaction to detergents, soaps, bubble baths or some alcohol-based baby wipes

• Certain types of medicines, such as antibiotics or laxatives

You may notice red patches on your baby's bottom, or the whole area may be red. Most of the time, babies don't feel sore if they experience mild nappy rash. However, if the rash is severe your little one may feel uncomfortable and be distressed.

Make sure to change your baby's nappy regularly, keep the nappy area clean and apply nappy cream. It's also a good idea to use highly absorbent nappies and make sure they fit correctly without being too tight to avoid chafing.

Fungal Nappy Rash in Babies

If the nappy rash doesn't clear up within two or three days, your little one may have a fungal infection. In this case, your health visitor or doctor can advise you on the best treatment.

If your baby's nappy rash is caused by a fungal infection you might see more severe nappy rash symptoms, such as:

• Pus-filled blisters in the folds of the skin or other areas

• Bright red, moist patches

• Distress

Your doctor may prescribe an antifungal cream or medicine. This will usually clear up the infection within a week or so, but you may be advised to keep using it for longer to prevent reinfection.

Bacterial Nappy Rash in Babies

While rare, nappy rash may be caused by a bacteria called impetigo, a skin infection that's very contagious but not usually serious. Impetigo typically starts with red sores or blisters, which may be harder to see in brown or black skin. The sores or blisters burst quickly leaving behind crusty, golden-brown patches.

If you believe your baby's nappy rash may be due to a bacterial infection, contact your baby's GP for diagnosis and treatment. Avoid using an over-the-counter antibiotic cream to treat the nappy rash unless advised to do so by your child's GP.

Nappy Rash Caused by Allergens

You may find that your baby is sensitive or allergic to certain substances or ingredients, such as:

• Dyes in soap or laundry detergent

• The elastic band in nappies

• Fragrances in soap, laundry detergent, fabric softeners, or nappy wipes

• Preservatives in creams

• Ingredients found in baby powder, lotions and oils

• Food – allergens can be passed on to your baby through breast milk or other solid foods your baby eats once they start on solids

A rash may show up shortly after your little one is exposed to an allergen. If you notice a rash, consider switching to another type of nappy, wipe or cream for two weeks to see if that helps it clear up. If you suspect a food allergy, try removing that food from your baby's diet.

If a reaction is suspected, look for nappies labelled hypoallergenic, fragrance-free, and lotion-free. Pampers Harmonie nappies are fragrance-free, lotion-free, and hypoallergenic, with dermatological testing by the Skin Health Alliance. It's also worth switching to fragrance-free, alcohol-free wipes such as Pampers Sensitive Wipes at the same time you change nappy brand, so you can more easily isolate the cause of the reaction.

Visit your child's GP for a detailed diagnosis, any necessary tests and treatment recommendations.

Nappy Rash Treatment and Prevention

Treating and preventing nappy rash comes down to the same core routine: keep the nappy area clean and dry, change nappies frequently, and use gentle, skin-friendly products. If you want to know how to get rid of nappy rash as well as help prevent it, try these remedies:

• When your baby has a wet or dirty nappy, change it as quickly as possible. This is probably the very best way to treat or prevent nappy rash. Keep in mind that newborn babies may need around 8 to 12 nappy changes a day.

• Gently clean your baby's bottom with each nappy change. Rinse the skin with warm water or use unscented, alcohol-free wipes - Pampers Sensitive Wipes are alcohol-free and fragrance-free, and are hypoallergenic and suitable from birth.

• Gently pat your baby's skin dry with a clean towel or – even better – leave the nappy off for a little while before putting on a new one to let the skin air-dry.

• Apply a very thin layer of barrier cream just before putting the nappy on.

• If your baby seems distressed or uncomfortable, ask your health visitor, pharmacist or doctor to recommend a nappy rash cream or ointment.

• Give your little one a bath daily until the nappy rash clears up. Once a day is enough though – bathing your baby more often than that could dry out their skin.

• Make sure your baby's nappy fits properly – for example the tapes should fasten symmetrically, the nappy should cover the buttocks and the nappy should fit snugly under the belly button.

• During a nappy rash episode, choose highly absorbent nappies that pull moisture away from the skin. Super-absorbent nappies help keep the nappy area drier, reducing the time skin is in contact with wetness.

• When you can, let your baby go without a nappy. For example, you could spread out a towel during playtime and keep your baby's nappy off for a while.

• If your baby has nappy rash, don't use soaps with fragrances, bubble baths, lotions or talcum powder as these can further irritate the skin.

When choosing wipes during a nappy rash episode, opt for fragrance-free, alcohol-free wipes. Avoid wipes containing preservatives or strong cleansers, as these can aggravate already-irritated skin.

If symptoms persist or worsen, speak with your GP or health visitor.

What Nappy Features Help Prevent Nappy Rash in Babies with Sensitive Skin?

Nappies that help prevent nappy rash in babies with sensitive skin combine high absorbency with breathability, softness, and skin-friendly materials. The right combination reduces moisture, friction, and exposure to potential irritants - the three main triggers of nappy rash in sensitive skin.

Look for these key features:

• Super-absorbent core: Nappies that draw moisture away from the skin immediately reduce the time the skin spends in contact with urine and faeces, which is the primary cause of nappy rash.

• Breathability: Nappies with micropores or breathable outer layers allow air circulation, reducing the warm, moist environment in which skin irritation and fungal infections thrive.

• Soft inner layer: A gentle, non-abrasive topsheet reduces friction and chafing, particularly around the legs and waist.

• Correct fit: A snug but not tight fit prevents rubbing. Use the Nappy Size Calculator as a helpful starting point.

• Fragrance-free and lotion-free materials: For babies with reactive skin, nappies free from added fragrance and lotion reduce the risk of an allergic-type reaction.

What Are the Best Hypoallergenic Nappies for Sensitive Skin?

When choosing a nappy for a baby with sensitive skin or one prone to nappy rash, look for options that are hypoallergenic, dermatologically tested, fragrance-free, and lotion-free. Dermatologists and independent skin-safety bodies typically recommend nappies that have been tested and certified for skin safety, rather than singling out one absolute "best" brand.

Pampers Harmonie nappies are a good option for babies with sensitive skin. They are hypoallergenic, contain 0% perfume and 0% lotion, feature a soft outer cover paired with a super-absorbent core, are dermatologically tested and approved by the Skin Health Alliance, and are OEKO-TEX Standard 100 certified - an independent standard that confirms textiles have been tested for harmful substances.

Pampers Premium Protection is another dermatologically tested option worth considering. It features a Dermacomfort layer with more than 1,000 micropores designed to draw moisture away from the skin instantly, along with breathable materials and an ultra-soft construction that helps keep the nappy area comfortable.

To compare both ranges side by side and find the right fit for your baby, see the Pampers guide on which nappy to choose.

How Can I Tell If a Nappy Is Suitable for My Baby's Sensitive Skin?

You can tell whether a nappy is suitable for sensitive skin by checking the packaging for specific claims and certifications, and by observing how your baby's skin responds when the nappy is introduced. The most important markers are hypoallergenic status, dermatological testing, and independent safety certification.

Use this practical checklist:

• Look for the terms "hypoallergenic" and "dermatologically tested" on the packaging.

• Check for a Skin Health Alliance (SHA) or OEKO-TEX Standard 100 certification - these independent standards confirm the product has been tested for skin safety.

• Opt for nappies labelled fragrance-free and lotion-free if your baby has shown reactions before.

• Use the two-week switching test: if a rash develops or persists, switch nappy brand and/or wipes brand for two weeks to identify whether the product is the trigger - an approach in line with NHS guidance.

• If you're uncertain, consult a pharmacist or health visitor before trialling a new product.

What Do Paediatricians Recommend If a Nappy Rubs a Baby's Skin?

If a nappy is rubbing your baby's skin, the first recommendation is usually to check the fit - chafing from an ill-fitting nappy is one of the most common causes of nappy rash. NHS guidance advises that nappies should fit snugly at the waist and legs without being too tight, and that the tapes should fasten symmetrically.

If rubbing is occurring at the legs or waist, it may be time to move up a nappy size. You can use the Nappy Size Calculator to check the correct size for your baby's current weight. Applying a thin layer of barrier cream at each change can also help protect the skin from friction while it recovers. If the rash caused by rubbing does not improve within two to three days, consult a pharmacist, health visitor, or GP for further advice.

Can Cloth Nappies Cause Nappy Rash? How to Prevent It?

Yes, cloth nappies can cause or worsen nappy rash. NHS-affiliated sources note that approximately 50% of babies using traditional cloth nappies experience nappy rash, compared with around 25% of babies using disposable nappies, because cloth nappies are generally less effective at drawing moisture away from the skin.

To reduce the risk of nappy rash when using cloth nappies:

• Avoid fabric conditioner or fabric softener when washing cloth nappies - NHS guidance notes that fabric conditioners reduce absorbency, which can increase the risk of nappy rash.

• Change cloth nappies more frequently - ideally every 1.5 to 2 hours - and use a nappy liner to help keep moisture away from the skin.

• If your baby shows signs of sensitivity, consider avoiding bio or enzymatic washing powders. NHS guidance notes there is no general evidence that bio powders irritate skin, but individual babies may react.

• During an active nappy rash episode, the NHS advises temporarily switching to disposable nappies, as their absorbent gelling materials help keep the baby drier and more comfortable.

If symptoms persist or worsen, speak with your GP or health visitor.

Other Skin Conditions You Might Mistake for Nappy Rash

A rash can sometimes be a symptom of something other than just irritated skin. It's a good idea to familiarise yourself with the symptoms of other common skin conditions so you'll be able to tell them apart from a simple nappy rash.

Some common baby skin conditions include:

• Cradle cap. Crusty or flaky patches of skin could be a sign of cradle cap. It's most common on the scalp, but cradle cap can also appear in the nappy area so you might mistake it for nappy rash if that's where you notice it first.

• Oral thrush. One possible cause of a fungal nappy rash is oral thrush. This yeast infection of the mouth is common in newborn babies, because their immune systems are still developing. The candida yeast that causes it can end up in your baby's poo, spreading the infection to the nappy area. This is why, if your little one has a nappy rash caused by a fungal infection, it's a good idea to check their mouth as well. The symptoms of oral thrush can include a white coating on the tongue or white spots in or around your baby's mouth.

• Eczema. Itchy, sore or cracked skin could be eczema. Sometimes it can get inflamed, causing redness. Eczema is most common on the face, scalp, hands, insides of the elbows and backs of the knees, but it can also appear anywhere on the body. If you suspect your little one has eczema, see your doctor for advice on how best to treat it.

If you're not sure precisely what might be causing nappy rash or any other rash on your newborn or older baby's skin, ask your health visitor or doctor for advice. Get more tips on how to care for your little one's delicate skin.

Severe Nappy Rash and Treatment

Severe nappy rash is nappy rash that has progressed to include blisters, swelling, or broken and raw skin, and it usually calls for prompt medical advice rather than home treatment alone. As mentioned in the sections above, severe nappy rash may sometimes be caused by an underlying fungal infection.

If your baby is distressed and the rash doesn't improve after a few days of the usual home care, seek advice from your GP or health visitor. For severe cases, a GP may prescribe a mild steroid cream to reduce redness and soreness, an antifungal cream if thrush is suspected, or antibiotics if a bacterial infection is identified. It's important not to self-prescribe steroid or antifungal creams - always follow your GP's advice, as using the wrong treatment can make some rashes worse.

Remember, even bad and severe nappy rash can be managed and your baby can feel comfortable again with the right care, remedies and treatment.

When to See the Doctor

Check in with your health visitor or doctor if you think your newborn or older baby's nappy rash may be caused by a fungal or bacterial infection – this could be the case if the rash lasts longer than a couple of days, especially if it seems severe.

Also let your doctor or health visitor know if your baby has a rash along with a fever or if your little one seems very uncomfortable or distressed.

Seek urgent medical attention if your little one has a rash anywhere on their body that doesn't fade when you press a glass against it. This could be a sign of meningitis, which needs to be treated immediately. On brown or black skin, the rash may appear as purplish spots or patches rather than clearly red, and the glass test still applies.

Other symptoms of meningitis include if your baby seems confused, is breathing rapidly, shaking uncontrollably, seems over-sensitive to light and/or has unusually cold hands and feet.

If you're unsure whether your baby's symptoms need urgent attention, you can call NHS 111 at any time of day for advice.

The Bottom Line

Even when you're careful to frequently change your little one's nappies, there's still a good chance that they will get a nappy rash at some point. You can do your best to prevent them by following the above tips, some of which aren't just great for warding off nappy rash, but for your baby's overall skin care.

The good news is that most mild cases clear up within a few days with simple treatment and your little one's skin will soon return to being as smooth and soft as, well... a baby's bottom!

If the rash doesn't clear up with these measures, your baby's GP will be able to recommend suitable treatment. For example, if your little one's nappy rash is caused by fungus or bacteria, a special cream or medication may be required.