How to Recognize and Treat Every Type of Diaper Rash (with Pictures)

Contrary to popular belief, diaper rash is NOT a right of passage into parenthood.

In this post I'll cover questions like...

• How do I know what kind of diaper rash I have?
• How many types of diaper rash are there?
• What does a bacterial diaper rash look like?
• What does eczema diaper rash look like?
• How can I stop diaper rashes from ever occurring?

  

• My promise to you

I am a mom of four that had the "privilege" of diapering 4 babies (2 boys and 2 girls) - and that came with a lot of mistakes and lessons learned. So in this blog I share the diapering tips and strategies that worked really well for me. My hope is that these tips make your diaper journey super easy - so that you can spend less time online reading articles like this, and more time on the things that matter most - like your sweet little one. So let’s dive in!

 

• Quick answers

I would love for you to read this full blog, but if you just want to cut to the chase, here’s the quick answers to the questions that are top of mind for you.

1. How do I know what kind of diaper rash I have? Mostly by looking at it. Below are pictures to help you quickly identify the type of rash your little one has.
2. How many types of diaper rash are there? There are 5: contact, eczema, ammonia burn, acidic poop rash, and yeast rash.
3. What does a bacterial diaper rash look like? It looks like a yeast rash. See pictures below.
4. What does eczema diaper rash look like? Often cracked, broken, red, and dry skin.
5. How can I stop diaper rashes from ever occurring? Keep your baby's bum clean and dry, change every 2 to 3 hours, and apply rash cream at every diaper change.

 

• The 5 Types of Diaper Rash 

Below are the pictures of severe diaper rash. I included them so you could get a good idea of how the rash will look. Yours may appear smaller – although the yeast diaper rash pictures are pretty spot it. That rash appears almost overnight.

1. CONTACT RASH
   

A red, flat and blotchy rash. This one kind of looks like your cheeks do when you’ve gotten really hot or severely embarrassed.  It usually appears all over the bum and if you see it, it’s a clear indication that you didn’t get all of the detergent out of your diapers when you washed them.  Or, in my case, you used a tad bit too much Biokleen Bacout and didn’t rinse it out very well in the wash, so the live enzymes are just happily chewing away at your little one’s bum.  Yep – not a great mommy-moment for me.  To get rid of a contact rash, do these 4 things. 

1. Take all of your diapers (even the ones you just cleaned) and throw them all in the washing machine. 
2. Wash them like you normally do, but reduce the amount of detergent you’re using. 
3. When your wash cycle is done, rinse the hell out of them in the washing machine.  Seriously.  Run like a gazillion wash cycles until you no longer see suds when the load is agitated.  Some people might call this stripping.  I just call it “rinse like hell”. 
4. Line dry, or toss them in the dryer. 

You should also see the rash go away very quickly, like in a day or two, or in some cases, almost immediately. Keep track of how much detergent you used.  If it took a ton of cycles to rinse them out, you’re using way too much detergent.  Try cutting the amount in half.

 

2. ECZEMA

This one is pretty easy to spot.  It will appear red, cracked, and scaly looking.  If it’s really bad, the cracked areas will bleed and may even ooze with puss. Some babies will also scratch it, but some won’t so don’t necessarily use that as a gauge.  The main thing you’ll want to look for here is the location of the rash. Eczema tends to occur in the folds of the skin – so places like in the crack of the bottom and the crease between the groin and thigh are common.  There’s also a type of eczema that appears as tiny, raised bumps on the rump (I could have said “bottom” but “bumps on a rump” seemed pretty funny while I was writing this).  These bumps may or may not be scaly looking, but they will appear close together like a rash (even a heat rash if you’ve ever seen one of those).  Eczema can be a little tricky to get rid of.  While no one knows the true cause of it, at the highest level its an allergic reaction to something internal.  So the good news is that there is nothing wrong with your diapers.  The bad news is that getting rid of it requires a bit of trial and error.  Most physicians will want to prescribe a topical steroid cream to get rid of it.  And, in my case, also suggest giving your baby an antihistamine to “suppress the immune system”.  Honestly, that freaked me out so I sought out more natural alternatives.  Natural things that have helped me, and other moms, clear up eczema include the following:

• Eliminating dairy and soy from baby’s diet. This also includes you mom if you’re nursing.  The dairy and soy you consume is passed to the baby.
• Eliminating gluten from baby’s diet. This was insanely hard for me to do because it seems like gluten is in nearly everything these days, but honestly, eliminating the dairy and soy cleared up nearly 90% of my son’s eczema.
• Bathing using a gentle castile soap. I personally like Dr. Bronner's Baby Unscented Pure-Castile Liquid Soap, but really, any castile soap will do.  I don’t know all the ins and outs of soap products except to say, castile soap is gentler on the skin and won’t over dry the skin. When the skin is dry, eczema gets worse, so you’ll want to make sure you’re always keeping the skin moisturized and not over-drying it with soap or wipes.
• Bathing infrequently. Most babies stay fairly fresh for a few days. I think it’s God’s way of giving us a little sanity in the midst of the little shit storm we call being a mother of adolescent. So, if possible, try bathing your little one every other day, or every 2 days. This also helps with keeping the skin moisturized and not dry out.
• Apply coconut oil. As I mentioned earlier, once I eliminated dairy and soy from my son’s diet, most of his eczema cleared up. To get rid of the remaining eczema I applied coconut oil to the area twice a day – once in the morning and once at night after his bath. I will say that coconut oil can be quite messy, and shiny.  Depending on your child’s skin tone, it can make them look like a “greased up stripper” – hubby’s words, not mine.  So I add a few things to mine to help reduce the greasiness and shine and soothe the itching.  You can find the ingredients here.

 

3. AMMONIA BURN

This one looks similar to the contact rash but tends to be isolated to a certain area – usually the butt or the groin area.  In mild cases it will just appear red and blotchy.  In more severe cases it will actually look like the skin has been burned and have a white, opaque area in the center of red, irritated skin.  This happens when baby’s bum has been in contact with urine for an extended time.  I’m purposely vague here because “extended time” varies by the child.  For some kids, “extended time” could mean 2 hours.  For others, “extended time” could mean 8 hours like in the case of an overnight / nighttime diaper.  

• If your child showed this type of rash after only being in a diaper for 2 – 3 hours, I highly recommend putting a fleece liner inside of your diaper, or switching to a diaper that already has fleece on the inside.  The fleece fabric will wick the urine away from your baby’s skin so it stays dry. 
• If this rash showed up after an overnight rest in a diaper, first check to see if the diaper smells like urine (ammonia).  I use the word “check” loosely because if it’s bad, you’ll smell the diaper before you even get around to changing your baby.  If your diaper wreaks of ammonia, that’s a clear sign it wasn’t washed well.  You’ll need to modify your cloth diaper routine.  Either add more detergent to get it clean, or add more rinse cycles at the end of your wash routine to make sure you’re rinsing all of the urine out of the diaper.  If you want to get super fancy with it, you can use a pool chlorine pH checker like I did. Urine typically has a pH of 6.  Most water will have a pH of 7 (neutral).  I used a kit like this one and just placed a few drops in the center of my diaper.  I kept rinsing my diapers until the color matched a neutral pH.  Going forward, I highly recommend rinsing your nighttime diapers in fresh water before tossing them in your diaper pail.  This greatly helps to reduce the ammonia issue.  I personally just rinse them in the tub, wring them out and toss them in the pail. It saves me a ton of headaches and I don’t ever have to strip them.
• As for the rash, apply a cloth-diaper safe cream until it goes away.  It should take 3 - 5 days to disappear.

 

4. ACIDIC POOP RASH 

This one looks similar to the ammonia rash but tends to be isolated to the buttocks area, and around the anus.  A rash here is a clear indication that your child has eaten something way to acidic like citrus fruit, dairy or tomatoes. Or in my case, vitamin C gummies when they were just 18 months old even though the container said not to give it to a child under 2.  Yep, I did that.  In any case, this one is fairly easy to get rid of.

• Stop giving your kid the acidic food (or Vitamin C gummy in my case)
• Give your kid an infant probiotic (this helps to readjust the pH in their intestinal tract)
• Apply a cloth-diaper safe cream to the area until the rash disappears (usually 3 – 5 days)

 

5. YEAST RASH

This last one is my favorite.  Not really.  It should be called the “yeast beast” because this thing is truly a beast to get rid of.  It looks like really bad acne all over the bum.  And while it is similar in appearance to the bumps that appear from HFMD (hand, foot and mouth disease), the cause is entirely different.  First, a little bit about the birth of yeast.  All along our GI tract (from the roota to the toota as my mom would say) there is good and bad bacteria – a “force” if you will.  Taking an antibiotic kills both the good and bad bacteria, creating a “disturbance in the force”, leaving room for all kinds of germs to flourish.  One such “germ” is yeast, a gnarly little fungus that grows whenever there is moisture and warmth – and what better place for that, than the bum. To eliminate a yeast rash you must do 2 things:

• Kill the yeast
• Kill the yeast spores. 

Say it with me… “Yeast spores, if not destroyed, will simply create more yeast.”   

So what’s a parent to do?

1. Apply a yeast-rash diaper cream, anti-fungal cream like Lotrimin, or a 50-50 diluted mix of Bragg's apple cider vinegar (ACV) and water at every diaper change for up to 7 days
2. Bring balance back to the GI tract by giving baby a daily dose of an infant probiotic
3. Add 1 cup of bleach to every cloth diaper load up to 5 days after the rash has disappeared to prevent the spores from spawning off more yeast.

 

• The Bottom Line (pun-intended :-) 

And that’s it – the most common types of diaper rash you’ll see on a baby. In most cases if you just apply a diaper rash cream at every diaper change, it’s very likely that you’ll never see a diaper rash.

 

 

---

Related Links:

• A list of good and bad diaper rash creams for cloth diapers
• 3 steps to cure yeast diaper rash
• How to remove rash cream from your cloth diapers