Identify and Treat a Yeast Diaper Rash at Home

A yeast diaper rash is a common condition that affects babies and other people who wear diapers. Known medically as candidiasis, it is caused by an overgrowth of yeast (Candida albicans) in the diaper region. Topical antifungal medications like Lotrimin (clotrimazole) are among options used to treat the rash and prevent it from returning.

Diaper rash has a range of potential causes, from skin irritation due to moisture to bacterial infection. Over-the-counter treatments or home remedies like oatmeal baths may soothe skin but not address an underlying cause that needs diagnosis by a healthcare provider.

Symptoms

A yeast diaper rash causes the skin in the diaper area to become bright red. Some defining characteristics of a yeast diaper rash include:

• Smaller patches that blend in with the bigger patches, or the entire diaper area may become red
• Raised borders that may have small bumps and pus-filled pimples
• Usually worse in the skin folds
• Possible scaly and very red scrotum or vulva
• Shiny appearance
• Cracking, oozing of skin, or sores present (severe cases)

While it is not usually painful, a yeast diaper rash can be itchy and irritating.

Candida albicans can also cause a yeast infection in the mouth called thrush. Oral thrush appears in white patches that look like milk curds; when scraped off, it reveals a sore and reddened area.

How to Identify a Diaper Rash by Type

Identifying the cause of a diaper rash is the first step to healing it, as different types of diaper rashes require different treatments.

Yeast

Yeast diaper rashes show up as bright, scaly red patches that cover the entire diaper area but are typically worse in skin folds and creases. Small, inflamed bumps with slightly raised borders and pus-filled pimples may crack, bleed, or ooze pus. There may also be satellite lesions—pustules that appear outside of the main rash.

Irritant

Diaper dermatitis usually looks bright red and shiny with satellite lesions. The rash may feel warm to the touch. Diaper dermatitis is usually centered around skin areas that come in contact with feces, particularly the genitals, buttocks, and inner thighs. The folds of the skin will usually look normal.

Bacteria

Rashes caused by Staphylococcus bacteria (staph) or Streptococcus (strep) are referred to as perianal infections, because the rash usually forms strictly around the baby's anus where stool leaves the body. It may also spread to the genitals. The rash may appear as a bright red circular area that is tender and itchy.

With both types of infection, the baby may experience severe itching and burning after defecation.

Allergy

Diaper rashes caused by allergic reactions are red and shiny and may cover an extensive area of skin, including the buttocks, genitals, legs, abdomen, and in skin folds.

This type of rash happens when your child is allergic to something in their diaper, wipes, or another substance that touches their skin. The rash will appear anywhere that comes in contact with the allergen.

Risk Factors

Candida albicans occurs naturally in the bodies of healthy people. Yeast diaper rashes occur due to an overgrowth of this naturally occurring fungus, typically in warm, moist areas, like in the folds of skin and in the area covered by a diaper.

Yeast diaper rashes are more likely to occur:

• When the diaper area is not kept clean and dry
• If the baby is on antibiotics
• If the nursing parent is on antibiotics
• If the baby has frequent bowel movements

It is possible to have more than one type of diaper rash at a time. If a diaper rash is not getting better with typical treatments, it is likely yeast is present as well.

Treatment

A yeast diaper rash is treated with topical anti-fungal treatments. The baby’s healthcare provider may prescribe a cream or ointment, or they may recommend an over-the-counter medication such as Lotrimin. Other antifungal options include:

• Monistat (miconazole)
• Nizoral (ketoconazole)
• Ertaczo (sertaconazole) 
  

They may also prescribe or recommend an anti-itch medication and other OTC products, including:

• Petroleum jelly, such as Vaseline, to create a barrier against moisture
• Products with zinc oxide, such as Desitin

Additional products for adult use can include:

• Calmoseptine
• Aloe Vesta 
• PeriGuard
• Hydrocortisone (steroid) cream (talk with your healthcare provider if considering use in babies)

Home Remedies

You may be able to treat a diaper rash caused by yeast infection with the following home remedies:

• Apple cider vinegar: This offers antimicrobial properties which may treat yeast infection. Mix 1 teaspoon of apple cider vinegar with 1/2 cup of water and apply it to a washcloth, then gently pat the washcloth against your baby's skin. Let the area air-dry then diaper as usual.
• Chamomile: Chamomile has long been used in traditional medicine to treat diaper rash due to its anti-inflammatory, pain-relieving (analgesic), and soothing effects. The anti-fungal properties in chamomile extracts have been shown to combat yeast, although its effectiveness against candida may depend on the species of chamomile, the type of extract used, and how it's applied.
• Oatmeal bath: Colloidal oatmeal can help to relieve skin irritation caused by diaper rash.
• Calendula: Calendula (marigold) has been shown to have strong antifungal properties against candida. Antiseptic and anti-inflammatory properties can help soothe inflamed skin and prevent infection. Calendula ointment and calendula oil can both be used on your baby's skin.
• Bentonite clay: This mineral clay has been shown to have healing effects against chronic dermatitis. Bentonite clay can be purchased online and in stores.
• Coconut oil: Oils including coconut and sunflower may offer benefits, but olive oil and mustard oil appear less effective.
• Witch hazel: Small amounts of witch hazel applied to the skin can help soothe diaper rash.

When to See a Healthcare Provider

If a diaper rash has lasted more than three days with at-home remedies, it is likely a yeast diaper rash and may require antifungal treatments. A healthcare provider can confirm diagnosis and recommend treatment.

Contact a healthcare provider if:

• The rash isn’t getting a lot better after three days of using antifungal medication.
• The rash is getting worse.
• The rash shows signs of infection (sores, scabs, increased pain, swelling, warmth, redness, red streaks leading from the rash, pus drainage).
• A fever develops.
• There is unusual or foul-smelling drainage in the affected skin areas.
• The baby is fussier than usual or is crying a lot and is difficult to soothe.
• New symptoms develop, such as blisters, open sores, raw skin, or bleeding.
• The rash spreads outside of the diaper area, such as the abdomen, back, arms, or face.
• The baby is less than 6 weeks old and has a rash.
• The baby is having recurrent yeast diaper rashes.
• You think your baby needs to be seen by a healthcare professional.

Prevention

You can prevent diaper rash by following a routine approach with these steps:

• Air: Allow your baby to have diaper-free time. This will decrease diaper-to-skin friction along with the amount of time the skin is in contact with urine, feces, and other irritants.
• Barrier: Apply a barrier cream, such as petroleum jelly or zinc oxide to the diaper area a few times per day or whenever you change the diaper.
• Cleansing: Clean and change diapers often, using warm water and a soft cloth or diaper wipe. Avoid baby wipes that contain alcohol, perfume, or propylene glycol. Take care to pat skin dry and wipe gently. Make sure there are no feces in hidden places such as the skin folds or scrotum.
• Diaper: Avoid cloth diapers and opt for super-absorbent diapers instead. These diapers help prevent urine and feces from sitting on your baby's skin. Change the diaper as soon as it is soiled—at least every one to three hours and once during the night. Don’t put the diaper on tightly.

Learning proper diaper hygiene and infant skincare practices is essential to preventing diaper rash. For parents, this includes washing your hands before and after every diaper change to prevent the spread of germs that could make your baby's diaper rash worse. Wipe the genital area from front to back, and pat your baby's skin dry or allow it to air dry.

Summary

Yeast diaper rashes occur when the warm and moist conditions of the diaper cause an overgrowth of the candida fungus. Yeast diaper rashes are bright red and can appear shiny. They typically cover the entire diaper area and are worse in skin folds. In severe cases, there may be pus-filled bumps that can crack, bleed, or ooze pus.

Yeast diaper rashes can be treated with over-the-counter anti-fungal ointments. Some home remedies like chamomile and bentonite clay along with plenty of diaper-free time can help a yeast diaper rash heal.