Diaper rash, diaper rash and sore bottom

Diaper rash, diaper rash and sore bottom

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Diaper rash: A wonderful bottom for infants and young children

Babies and small children often develop inflammatory skin diseases in the diaper area, which are known as diaper rash or diaper rash. The build-up of heat and moisture caused by wearing diapers and permanent skin contact with urine and stool can lead to different forms of a sore, painful buttocks. Targeted changes in the care measures and the diet, as well as gentle applications from naturopathy, can provide a simple and quick remedy.

In brief: miracle buttocks in babies - what helps?

  • Frequent and appropriate diaper changes, loose diapers and times without a diaper help to keep the irritation to the baby skin as low as possible and allow adequate ventilation of the skin.
  • Thorough but gentle cleaning and care helps to relieve symptoms and the healing process. Only clear water and possibly certain oils should be used. The skin should be dried thoroughly after cleaning.
  • The use of cloth diapers or a change in the brand of disposable diapers used can ease the symptoms of diaper rash.
  • With stronger forms, anti-inflammatory and moisture-absorbing ointments and pastes can alleviate the symptoms. Ointments with the addition of dexpanthenol, zinc or cod liver oil are often prescribed.
  • If the symptoms do not go away within a few days or if it is severe dermatitis, which may be due to an infection, a visit to the doctor is advised. An exact diagnosis helps to determine the further therapy. Antifungal or antibacterial agents may be necessary.
  • Experienced alternative practitioners or other experts should be consulted on the use of special home remedies and naturopathic procedures.


In principle, dermatitis is an inflammatory reaction of the skin. The terms diaper rash and diaper rash are derived from the diseased region of the body. This childhood disease leads to different skin irritations and inflammations in the diaper region. One often speaks of a sore or a sore bottom. Infants and babies in the first year of life are particularly affected.

Diaper rash is one of the most common diseases in infancy and toddlerhood. Up to a third of all children who change diapers experience an itchy rash in the diaper region once or even several times. Babies between the ninth and twelfth month are particularly affected. About six percent of children develop severe dermatitis that can be associated with secondary infections from yeast or bacteria. But adults can also be affected. Protective pads and sealing pants that must be used in the presence of incontinence can have the same effect as wearing a diaper.

In diaper rash, a distinction is made between different forms. The spectrum ranges from rather mild skin irritation to severe rashes to complicated cases with secondary infections caused by fungi (diaper thrush) or bacteria and ulcers that occur.


The signs of diaper rash appear in the diaper area (genital area, anal area). The skin areas of the buttocks, genitals, groin and thighs that are in direct contact with a diaper are affected. The skin folds in this area typically remain symptom-free. The rash can also spread to adjacent skin areas.

The first sign is a blurred redness in the diaper area, the so-called "sore bottom". In addition, mainly in the marginal area of ​​the reddened, irritated and inflamed skin areas, blisters, nodules or pustules can form.

The complaints are often accompanied by itching, burning and pain. Babies and small children then often feel uncomfortable and appear restless, sensitive and tearful. Burning stools and urine in particular cause burning pain. However, touching or moving, and the resulting friction between the skin and the diaper, can be perceived as very uncomfortable and cause additional skin irritation. Some children sleep and eat poorly as a result of feeling unwell.

In more severe cases, and mostly due to subordinate infections by fungi or bacteria, the symptoms intensify. The redness can then appear sharply limited and swelling may be visible. If existing bubbles burst and the affected areas of skin are wet, this can also result in loss of skin and tissue (erosions and scaling). It is not uncommon for open, bleeding wounds to form and scabbing. Skin folds can now also be affected and there is a possibility that ulcers will develop, especially in the marginal area. Fever or complaints in more distant parts of the body or infestation of the entire body rarely occur.


The main causes for the development of a diaper rash are the build-up of heat and moisture under a diaper, as well as the prolonged and repeated contact of urine and stool with the sensitive baby skin. Diarrhea, in particular, has a damaging effect on the skin due to the activation of certain enzymes.

Moisture and heat quickly form under the air- and waterproof condition of a diaper. As a result, the top layer of skin softens and the natural protective function is impaired. Skin irritation is mainly caused by ammonia. This occurs when bacteria (from the stool) split off ammonia from the urea in the urine. The result is an increase in the pH value, which leads to the leaching of the skin, similar to the case when washing too often with soap. This, and the warm, humid environment, favor the colonization and multiplication of pathogens on the skin. The fungal infections are mostly infested with yeasts (Candida albicans) and one speaks of a so-called diaper thrush. If, on the other hand, it is bacteria (less common), staphylococci or streptococci are the most suitable. In general, germ colonization can be both the result and the cause, with previous damage to the skin making it easier for microorganisms and harmful substances to penetrate. Poor general health and a reduced immune system can also promote infections.

In addition, a lack of or improper hygiene and care increases the risk considerably. Not infrequently, this is the actual trigger for diaper rash. However, it can also happen that dermatitis develops due to intolerance to certain components of diapers (disposable diapers) or any ingredients in detergents (cloth diapers) and care products. Even diapers that are too tight can cause chafing on the skin and ultimately a rash.

Diet is known as another risk factor. Especially acidic and spicy food that is fed to babies can cause soreness as a reaction. This can even be triggered by the feeding of nursing mothers. In this context, attention is also drawn to a low-sugar diet.


Rashes, even in the diaper area, are a common reason to go to a pediatric practice. A detailed, external examination of the affected skin areas is usually sufficient to make the appropriate diagnosis. However, since, for example, allergic reactions, neurodermatitis or other infections can cause similar skin eczema and symptoms, other diseases must also be excluded during the examination.

If it is suspected that it is a diaper rash with secondary infection by fungi or bacteria, the pathogens can be determined by a smear and its examination in the laboratory. This can be a decisive diagnostic criterion for the following form of treatment. In the case of diaper thrush, it is also important to also examine the intestine by analyzing the stool, since there may also be a fungal colonization that requires treatment.


Frequently, and especially with the lighter forms, relatively simple hygiene and care measures are sufficient to treat diaper rash. The following measures show both preventive and curative effectiveness:

  • Change diapers as needed, a three to four hour interval is advisable or immediately after the bowel or bladder has been emptied,
  • Put on diapers as loosely as possible,
  • allow longer times without wearing diapers,
  • wash the skin in the diaper area as little as possible and do without care products (e.g. wet wipes or creams),
  • Use warm water and clean cloths for cleaning, if necessary also gentle oils (almond, olive),
  • after cleaning, dry the skin well,
  • avoid spicy, acidic and sugar-rich food (children and nursing mothers).

Switching to cloth diapers or changing the diaper brand can also help if an allergic reaction is suspected. With stronger forms, anti-inflammatory ointments or moisture-absorbing pastes can often cause a quick healing. Ointments with the additives dexpanthenol, zinc or cod liver oil have proven effective.

If the buttocks are sore due to an infection, therapy should be tailored to the pathogen. Antifungal agents are then used against fungi and antibiotics against bacteria. However, this always requires a medical examination and prescription. In rare cases, treatment with cortisone can be considered. Particular caution is required here and the medical instructions should be strictly followed.

In most cases, diaper dermatitis heals completely within a few days using the measures described. If the illness lasts longer and occurs repeatedly, the intensive hygiene and care measures must be continued and a (renewed) visit to the doctor is advised.

Naturopathic treatment

Many of the preventive and soothing measures described come from the field of naturopathy and are so-called home remedies. Naturopaths postulate the use of cloth diapers as a very useful method against the rashes in the diaper area. Essential oil can be used as an additive for disinfection when washing.

Conventional cleaning lotions, washing gels and creams should therefore not be used according to the naturopathic concept. Instead, hygiene measures using clear water and, if necessary, cold-pressed oils are recommended. Washing, bathing or ointments with chamomile or pansy herb can also have a calming effect on inflamed skin. In acute condition, external Bach flower therapy with "rescue drops" can also be used to relieve the symptoms. A Bach flower mixture for internal use should only be done with expert advice.

Furthermore, certain homeopathic remedies (globules) can be used to support the therapy. This should be done in a doctor's consultation. (Jvs, cs)

Read how naturopathy can help:
Miracle buttocks in babies: Naturopathy can help

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. rer. nat. Corinna Schultheis


  • Professional Association of Pediatricians e. V .: Windeldermatitis / Windelsoor (access: 09.07.2019), kinderaerzte-im-netz.de
  • Steele, Russell W .: Diaper Dermatitis: Facts and Misinformation, Clinical Pediatrics Vol. 56, 2017, journals.sagepub.com
  • Abeck, Dietrich / Cremer, Hansjörg: Common skin diseases in childhood, Springer, 4th edition, 2015
  • Amboss GmbH: Diaper rash (diaper rash) (accessed: July 9, 2019), amboss.com
  • Stanford Children's Health: Diaper Dermatitis (accessed: July 9, 2019), stanfordchildrens.org
  • Mayo Clinic: Diaper rash (accessed: 09.07.2019), mayoclinic.org
  • UpToDate, Inc .: Diaper dermatitis (accessed: July 9, 2019), uptodate.com
  • Johns Hopkins Medicine: Diaper Dermatitis (accessed: July 9, 2019), hopkinsmedicine.org

ICD codes for this disease: B37, L22ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.

Video: Treating diaper yeast at home! (January 2023).