A nappy rash (diaper rash) is not a reflection on the mother or a sign of neglect, but a very common problem. The baby develops an angry red area of skin under the nappy due to excess moisture on the skin from wet nappies, pilchers and plastic over-pants that can cause skin damage, eczema and fungal infections (tinea cruris). Over-bathing, soap and detergents left in nappies may also irritate the skin.
Red, pealing, irritated skin appears on the buttocks. If the skin folds are spared, it is probably a pure dermatitis, but if the rash extends to the skin folds and there are red satellite lesions beyond the edge of the rash, it probably has a fungal component. Uncommonly bacterial infections may occur.
Zinc cream, lanolin or petroleum jelly applied to the bottom will protect it against moisture, and fungal infections will settle with antifungal creams, but eczema may require a mild steroid cream. The results of treatment are good, and even the most resistant cases settle once the child is toilet trained.