See a pediatrician for persistent or severe rash

Consult your pediatrician if the diaper rash does not improve within 2-3 days of home treatment, or if it worsens, spreads, or shows signs of infection. A doctor can distinguish between simple irritant dermatitis, yeast infection, bacterial infection, and other skin conditions that mimic diaper rash.

When to Seek Medical Care

• Rash has bright red patches with sharp borders and satellite spots (suggests yeast/Candida)
• Blisters, pus-filled bumps, open sores, or bleeding
• The baby has a fever along with the rash
• Rash spreads beyond the diaper area
• The baby seems to be in significant pain during diaper changes
• Rash does not improve after 2-3 days of consistent home care

What the Pediatrician May Prescribe

• Antifungal cream (nystatin or clotrimazole) for yeast-related rash, which is the most common secondary infection
• Low-potency topical steroid (hydrocortisone 1%) for a short course to reduce severe inflammation
• Topical antibiotic for bacterial infection (impetigo-like lesions)
• In rare cases, a combination prescription cream

Tips

• Do not apply over-the-counter hydrocortisone to the diaper area without your pediatrician's guidance -- prolonged use can thin the skin
• Take a photo of the rash before the appointment in case it changes by the time you are seen
• Most yeast-related diaper rashes clear within 3-7 days with proper antifungal treatment
• A rash that keeps recurring may warrant discussion about dietary factors, especially when introducing new foods