Diaper Rash Treatment: Creams, Alternatives, Antibiotics (2024)

Diaper dermatitis, known as diaper rash, is common among babies and adults who wear diapers. About 50% to 65% of all babies get a diaper rash at some point in their lives, despite their parents' best efforts to prevent it. Treatment involves preventive measures and topical (on the skin) treatments, including:

  • Proper sanitary care
  • Fragrance-free topical treatments with zinc oxide or petrolatum (commonly called petroleum jelly)
  • Hydrocortisone cream
  • Anti-yeast (antifungal) cream
  • Natural alternatives, such as witch hazel or breast milk

This article lists diaper rash treatments for mild to severe rashes, alternative therapies, and what to do when treatment doesn’t work.

Diaper Rash Treatment: Creams, Alternatives, Antibiotics (1)

Complete List of Diaper Rash Treatments

Mild diaper rashes begin as pink skin in the diaper area. Moderate rashes get more red but do not include open sores or bleeding. Severe rashes involve red skin that can become raw or cause sores and bleeding.

Mild diaper rashes typically clear up within two to three days (or less) with the following methods.

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Keep the Area Clean and Dry

Change the diaper frequently, allowing the skin to air dry for a few minutes (or as long as possible) before putting on a fresh diaper.

Use breathable and loose-fitting diapers, and avoid plastic diaper covers. Doing so allows for air circulation and prevents rubbing against the skin.If you typically use cloth diapers, consider using disposable diapers until the rash heals.

Breathable Diapers

Breathable diaper fabrics have tiny pores that allow air movement. Studies show that breathable diapers decrease the risk of diaper rash by 50% in babies and 62% in adults.

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Avoid Irritants

Certain dyes, fragrances, and chemicals can be irritants or allergens. Products that may contain irritants include wipes, soaps, diapers, lotions, and laundry detergents. Try to use mild products that are free of alcohol, fragrance, and dye.

Apply a Diaper Rash Cream, Ointment, or Paste

A diaper ointment, cream, or paste protects the skin from moisture, irritation, and infection by creating a barrier.

The brand is less important than the ingredients. Look for fragrance-free products with zinc oxide (an antioxidant that provides a barrier to water and infection) or petroleum jelly.

Diaper rash ointments typically include petrolatum. They are best for everyday use, prevention, or mild rashes. Examples include:

  • Vaseline petroleum jelly
  • Aquaphor
  • Triple Paste Medicated
  • A+D Originalointment

While adults can use baby products, they can also use the following petrolatum products for adults:

  • Calmoseptine
  • Aloe Vesta
  • PeriGuard

For moderate diaper rashes, consider Aquaphor advanced therapy ointment.

Diaper rash creams contain zinc oxide and are good for prevention. They also treat mild to moderate rashes, typically within two to three days. Examples of products with zinc oxide include:

  • Desitin Daily Defense
  • Triple Paste
  • Honest
  • Cetaphil
  • Mustela
  • Aveeno
  • Weleda
  • Balmex Adult Advantage (for adults)
  • Baza Protect (for adults)

The following treatment application tips may also help diaper rashes heal more quickly:

  • Apply to dry skin with each diaper change.
  • Apply a thick layer.
  • Don’t rub it in.
  • Do not wash it off after every diaper change (once a day is sufficient).

Soothing Diaper Rash Overnight or Quickly

Diaper rash paste can help moderate to severe diaper rashes heal quickly. However, these are very thick and are not typically the best everyday option. Examples include:

  • Boudreaux's Butt Paste
  • Desitin Maximum Strength
  • Aquaphor Baby Diaper Rash Paste
  • Bentonite Clay Cream (a powder you mix with other ingredients to make a paste or cream)

Hydrocortisone Cream

Hydrocortisone (steroid) cream can be helpful for adults when irritants or allergens cause persistent redness, inflammation, or itching.

You can apply a mild (0.5% to 1%) over-the-counter (OTC) hydrocortisone cream twice a day for three to five days, up to a maximum of two weeks.

Consult a healthcare provider before using hydrocortisone on babies.

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Anti-Yeast Creams

While babies frequently get rashes from irritants, yeast accounts for 63% of diaper rashes in adults (average age 85). Yeast-related rash risk increases after taking antibiotics.

Characteristics of a yeast rash include:

  • Reddish-purple spots with sharp borders and bumps around the edge
  • Rash in the skinfolds
  • Patches in different, small areas
  • A rash that lasts longer than three days, despite treatment

In this case, you can try an over-the-counter (OTC) anti-fungal cream such as:

  • Lotrimin (clotrimazole)
  • Monistat (miconazole)
  • Nizoral (ketoconazole)
  • Ertaczo (sertaconazole) (may be helpful for atypical yeast types)

When you apply these medications to a yeast rash at least twice daily for seven to 10 days, the cure rate is 50% to 68%.

Antibiotic Creams

Many people add OTC antibiotic creams or ointments to diaper rash cream. While this could help with some rashes, consult a healthcare professional before trying an antibiotic cream.

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Diaper Rash Treatment Alternatives

You can try natural or alternative options to prevent and treat mild diaper rashes.

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Warm Water Soak or Bath

Soak the affected area in warm water for 10–15 minutes several times daily.Add colloidal oatmeal or a couple of tablespoons of baking soda to the bathwater for added relief. Some people also use colloidal oatmeal in balms or creams.

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Natural Creams or Balms

Many people make their own diaper rash creams or balms with natural ingredients. If you are looking for a recipe, consider including the following topical ingredients:

  • Calendula
  • Aloe Vera
  • Lanolin
  • Zinc oxide
  • Coconut or sunflower oil (better barrier function than other oils)
  • Shea butter
  • Colloidal oatmeal
  • Witch hazel
  • Bentonite clay
  • Yogurt (plain) and honey

There are also commercially available brands that make natural products, including:

  • Baby Bum
  • Babyganics
  • Babo Botanicals
  • Burt’s Bees
  • Earth Mama
  • Maty's All Natural
  • Motherlove
  • Relizema
  • Zarbee’s

Witch Hazel

Witch hazel (winter bloom) is a flowering plant. You can get distilled liquid (from the leaves, twigs, and bark of witch hazel) at almost any retail store. Research shows this is an effective treatment for diaper rash and skin inflammation.

Bentonite Clay

Bentonite clay (sodium bentonite) is a gray clay with a fine texture. It’s readily available at health food stores.Mix it with distilled water for skin application alone or in a balm, soap, or shampoo. One study shows that 88% of rashes started clearing after six hours of applying a bentonite cream.

Calendula

Calendula is an extract of marigold that has skin-healing properties. Research shows that 54% of rashes started clearing after six hours of applying a calendula cream.

Breast Milk

For centuries, people have used breast milk to treat, soothe, and soften skin. It contains multiple vitamins, protein, calcium, lactic acid, and antibodies (to help fight infection).You can apply breast milk directly to the rash or use it to make a cream or balm.

Yogurt and Honey

One study shows that applying a mixture of plain yogurt and honey for seven to ten days may be helpful for some yeast rashes. However, they note that Lotrimin (clotrimazole) was more effective in comparison.

Sanitary Care in Addition to Diaper Rash Treatment

The most essential step in treating diaper rash is to keep the area clean and dry. Change the diaper frequently, at least every two to three hours.

The reasons diapers that are left too long can lead to diaper rashes include:

  • Trapped moisture can irritate or worsen the rash.
  • Urine or stool left on the skin can cause excess moisture, skin breakdown, and infection.
  • Lack of air circulation creates a warm, moist environment, making it easier for bacteria and yeast to grow.
  • The diaper itself can irritate when left on too long.

You can clean the area using a gentle wipe or soft cloth for diaper rash prevention or mild diaper rashes. Be sure to pat the skin dry rather than rubbing it.

For moderate to severe rashes, cleaning the area through bathing, splashing water, or using a squirt bottle with warm water is best. These methods are gentler than a cloth or wipe.

It’s also important to wash your hands before and after diaper changes to prevent the spread of germs. If you use cloth diapers, wash them in hot water to prevent the growth of bacteria or fungi.

ABCD Approach to Diaper Rash Treatment


You can refer to the letters "ABCD" to recall these diaper rash prevention and treatment measures:

  • "A" is for "air it out": Go diaperless as much as possible.
  • "B" is for "barrier": Use a diaper ointment, cream, or paste.
  • "C" is for "clean": Change the diaper frequently, and wash the area.
  • "D" is for "Disposable diapers": Consider breathable disposable rather than cloth diapers during a diaper rash episode.

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How Long Does Diaper Rash Treatment Take to Work?

When irritation or moisture cause a mild diaper rash, it can heal quickly (within 12 hours to a day) using the steps above.

Moderate rashes may take two to three days. If a rash lasts over three days despite treatment, consult with a healthcare provider.

Severe rashes can take a couple of weeks or longer to heal. Timing depends on the underlying cause and the type of medical intervention.

Diaper Rash Not Healing From Home Treatment

If the rash does not clear within three days of using the tips above or if it worsens, contact a healthcare provider.

Depending on the underlying cause, the healthcare provider may suggest diagnostic tests and a prescription-strength antibiotic, antifungal, or steroid cream.

When to See a Healthcare Provider

Signs that you should call a healthcare provider include:

  • A rash that remains (or worsens) after three days
  • Peeling skin
  • Blisters or open sores
  • Pus or oozing fluid
  • Recent oral antibiotics use
  • An extremely painful rash
  • A raw rash that bleeds
  • Fever
  • Pain (babies may be hard to console)

Speak with a healthcare professional before trying a new product on a baby.

Summary

Mild to moderate diaper rashes typically clear within three days of preventive methods and treatment.Prevention and treatment include keeping the area clean and dry, using breathable diapers, and avoiding irritants. There are various OTC diaper rash treatments for babies and adults. Some are better for prevention, while others treat mild to moderate diaper rashes.

Fragrance-free products with zinc oxide or petroleum jelly are good choices. You can also use natural products and control ingredients by making a balm (or using breast milk) to treat the rash. Notify a healthcare provider if the rash persists or worsens after three days.

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Diaper Rash Treatment: Creams, Alternatives, Antibiotics (2024)

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