Diaper rash: causes, myths, and what really helps

In nearly thirty years of working with newborn babies and their parents, I have seen many red bottoms. And almost always the same conversation: "Am I doing something wrong?", "Is it because of my diet?" or "Is it really because of the teeth?"

Diaper rash is one of the most common concerns of young parents. It happens to almost every baby at some point, yet many parents feel guilty about it. There is no need for that.

In this blog, I explain exactly what happens with diaper rash, why some 'proven tips' from the internet do more harm than good for your baby, and what really helps. Based on science and what I see working in practice.

What is diaper rash and why does it occur?

Diaper rash, medically called diaper dermatitis, is an inflammation of the skin in the diaper area. The skin looks red and irritated, sometimes scaly, and in more severe cases, blisters or open sores can develop. It is the most common skin condition in babies.

The cause is almost always a combination of factors, not one specific one. Moisture plays the biggest role.

What does a diaper do to your baby's skin?

A diaper creates a warm, moist environment that continuously exposes the skin to urine and stool. When these two substances mix, ammonia is produced, which raises the skin's acidity. A higher pH activates enzymes in the stool that break down your baby's already vulnerable skin barrier. Add the friction from the diaper, and the skin has little chance to recover.

A newborn baby's skin is thinner and more sensitive than an adult's. It needs more time to adjust to the outside world. This makes diaper rash in young babies quicker and more severe than you might expect.

Diaper rash myths you can let go of

The internet is full of well-meaning advice about diaper rash. Unfortunately, some of it is outdated or even harmful. Below are the most persistent myths.

What really helps with diaper rash?

Air, rest, and thorough drying

Fresh air is the simplest and most effective remedy. After changing or bathing, let your baby lie for a while with bare bottom on a large soft towel. Ten to fifteen minutes is enough. Oxygen helps the skin dry and heal.

Then gently pat the skin dry. Do not rub, not even with a warm hairdryer — that actually dries the skin further and causes more irritation.

Which wipes are best to use?

For diaper rash, it’s best to avoid scented baby wipes. Prefer lukewarm water with a soft washcloth or cotton pads. Always pat dry, never rub.

If you do use baby wipes, choose wipes without alcohol, perfume, or preservatives. The fewer ingredients, the better for sensitive baby skin.

A good barrier ointment: zinc oxide and calendula

Applying a thick layer of protective ointment at every diaper change is the difference between healing and further irritation. Zinc oxide forms a protective layer on the skin, so new urine and stool do not directly affect the already irritated skin.

An ingredient I have personally valued for years is calendula — also known as marigold. Not only in baby care at home but also in the hospital.

Modern science confirms what we have long seen in practice. Calendula contains flavonoids and triterpenes with proven anti-inflammatory effects. They reduce redness and swelling and stimulate the production of new skin tissue. Clinical research shows that ointments with calendula are effective for diaper rash, sometimes more effective than aloe vera or standard base ointments.

A practical tip: you don’t need to completely rub off the old layer of ointment at every change if the diaper was clean. That rubbing irritates more than it helps. Just apply a new layer on top of the existing one.

When should you see a doctor?

In most cases, diaper rash clears up on its own after a few days with good care. But there are signs when it is wise to contact the doctor or the consultation clinic.

A fungal infection requires a different treatment than regular diaper rash, namely an antifungal cream prescribed by a doctor. Do not treat it yourself with random creams, but have it assessed by a doctor.

If you have medical concerns about your baby's skin, always contact your doctor, midwife, or consultation clinic. This blog is intended for informational purposes and does not replace medical advice.