Babies have sensitive skin, it's much more sensitive than the skin of adults. This means they are more likely to react to their environment and develop a skin rash. Of course, as a parent or carer, this can be worrying, especially if you aren’t sure whether it is an allergic reaction, a heat rash, a nappy rash or something else. And this certainly isn’t much fun for baby either we would imagine.
Rashes can be caused by several things: irritants to the skin which include things like saliva, baby wipes and soap; allergies which can cause several reactions including eczema and hives; and lastly infections, most commonly those caused by a fungus or a virus.
Babies can also suffer from baby acne, typically in the first few weeks of life. This is thought to be caused by the mother’s hormones passing to the baby in utero. Baby acne will present as a bunch of small red bumps versus a rash which is lacy and red. Baby acne generally occurs on the cheeks, nose, forehead and sometimes the scalp. It lasts around 3 to 4 months, and will generally clear up on its own.
1. Nappy rash
We have spoken about this before, but most babies get nappy rash, around 90 per cent will have it at some point. It is a common side effect of wearing a nappy!
The moist environment inside a diaper makes it almost impossible to avoid nappy rash and the painful inflamed skin that is associated with it. The condition also causes a huge amount of stress for mom, dad and baby. Luckily you can treat most nappy rash at home. Let us look at how we can approach this common problem, how we can avoid it, and how we can treat it when it happens.
What is nappy rash?
Nappy rash means painful inflamed skin that appears on nappy-wearing baby bottoms.
What causes nappy rash?
Unfortunately, there are many causes. They include:
- dirtying of the nappy,
- the type of nappy worn (disposable nappies are more likely to cause nappy rash than cotton nappies),
- a history of cradle cap, and
- the baby’s general state of health.
Upset tummies can also play a role in the onset of nappy rash. The risk of nappy rash also increases when your baby starts to eat cereal as does leaving the nappy unchanged for too long, less frequent bathing and a history of candida infections.
Nappy rash symptoms: How to tell the difference between mild and severe nappy rash
If your baby’s bottom has patches of bright red skin, chances are it's a nappy rash. The signs can range from a mild rash to severely inflamed skin, which is painful and causes your baby to cry when you change the nappy. That is why it is important to watch out for certain nappy rash symptoms and signs.
Symptoms of mild nappy rash
- Your baby’s skin is slightly reddish and dry.
- The red area does not seem painful or is only mildly uncomfortable.
- Your baby may react when urine or stool touches the rash, but otherwise, they are eating, sleeping, and acting normally.
Symptoms of severe nappy rash
- Your baby’s skin is red, raw, broken or bleeding.
- The rash covers a large area. It may have a bright red border or be worse in the creases and folds of the skin.
- The rash is painful and the baby cries when you clean them or change the nappy.
- Your baby is unhappy or unable to sleep.
- Severe infections may even cause fever in your baby.
Nappy rash treatment tips
You can treat most nappy rash at home. If you are treating it consistently, you should see an improvement within hours. We suggest that you learn to add Trifectiv® Plus as a standard step in your routine when you change your baby’s nappy. This not only helps babies already affected with nappy rash but is a great way to prevent it from forming in the first place. It is simple to use and highly effective, so you can pass the method on to other caretakers. If someone is taking care of your baby, be sure to share your nappy rash treatment instructions with them.
Recommended home remedies for nappy rash
- Change your baby’s nappy frequently. How often? Change the nappy every two hours while they are awake, and at least once during the night. This will help keep the skin under and around the nappy clean and dry, which is how nappy rash gets better. This also prevents it from happening again in the future.
- Bare bottom time. Consider letting your baby spend time without a nappy on or put the nappy on loosely. Exposure to air will help the rash heal.
- Avoid using nappy wipes while there is a rash. Instead, use warm water and mild liquid soap, and then pat (do not rub) the area dry after you have rinsed the area well.
- Spray Trifectiv® Plus Wound & Burn Care onto the whole nappy area and allow it to air dry before you apply a barrier cream.
- If there is a rash around the anus, after spraying the area with Trifectiv® Plus, you can apply petroleum jelly or other over-the-counter ointments just on this area to help. We do not recommend using powders because your baby can inhale those.
2. Heat rash
Causes of heat rash in babies
Heat rash happens because the sweat ducts in the skin are blocked and sweat gets trapped, creating fluid-filled bumps on the skin. In most cases, the tiny red bumps show up where there is friction, like where one body part rubs against another, or where clothes rub against the skin. Heat rash can sometimes occur while children are sleeping. If pyjamas are bulky, blankets are too heavy, or the fabric doesn’t breathe, these items could be trapping heat and cause perspiration. The rash is often itchy so your baby may scratch the irritated areas.
Use a lighter blanket and make sure that your baby has breathable sleepwear. Layer blankets over baby so that you can easily remove or add blankets depending on the temperature.
Types of heat rash
Miliaria crystallina is the mildest type of heat rash. It affects the top layer of skin, which is called the epidermis. You might see small, blister-like bumps on the surface of your baby’s skin. The bumps aren’t painful. They don’t usually itch, but the lesions can sometimes break open if they are scratched. Miliaria rubra is a red, bumpy rash that affects the mid-epidermis, a deeper layer of the outer skin. Miliaria rubra is often called prickly heat because the bumps on the skin can be tender. Miliaria rubra is the most common type of heat rash. The rash can cause discomfort and pain. Babies may be irritable while it is healing. Miliaria profunda affects the deepest layer of skin (the dermis). It’s very rare among babies and toddlers. It occurs when sweat leaks out of the glands, forming fluid-filled pockets under the skin. The bumps are skin-coloured, not clear or red. They’re usually much bigger and tougher than the bumps from other types of heat rash. Although it may look milder, the effects can be more serious.
Symptoms of heat rash include small bumps that may be clear, red, or skin-coloured, redness, itchiness, or even a stinging feeling. The areas that are often affected are neck folds, elbow and knee creases, armpits, and inner thighs.
Treatment for heat rash in babies
Most of the time, heat rash starts clearing up on its own as soon as you cool off your baby. There are several at-home treatments to start healing the rash.
- Cool the skin. You can cool the skin by removing extra layers of clothing or by moving to a cooled indoor space. If your baby has been outside in heat and humidity, remove damp clothing and turn on a fan to dry their skin.
- Apply water. If the affected area is relatively small — just a patch on the back of the neck or in the creases of the elbows — gently dab a cool, wet cloth on the rash to relieve tenderness and bring down the skin temperature.
- For larger rash areas. You can also give your baby a cool bath for at least 10 minutes, but don’t use soap — it could further irritate the skin. Afterwards, let their skin air dry.
Avoid hydrocortisone ointments, especially if they contain petroleum or mineral oil. They can block pores and keep sweat from naturally evaporating.
Heat rash usually clears up on its own within 1 week. If your baby’s skin hasn’t cleared up by then, or if the rash gets worse or looks infected, it may be time to talk with a paediatrician.
3. Allergies
As you introduce your baby to new foods, or even if you change your brand of laundry soap or baby shampoo, you may find your baby has a reaction. The two most common signs of an allergic reaction are hives or eczema. Hives show up as pink, blotchy welts whereas eczema patches are dry, red and flaky. These are both itchy rashes.
Spraying the area with Trifectiv® Plus Wound & Burn Care can help with any redness or itchiness and will calm the skin down. It might be hard to pinpoint what is causing the reaction so you may need to take your baby for a blood or skin test to figure out the cause, especially if the allergy persists.
If your baby shows any signs of difficulty breathing or has any swelling of the face or lips after you introduce a new food then this is a sign of a severe allergic reaction and you need immediate medical treatment.
4. Eczema
Up to 60 percent of babies suffer from eczema in their first year. These red, dry patches of skin are very itchy, and baby will sometimes scratch these areas until they bleed. Eczema generally runs in families. Our Wound & Burn Care spray can help to manage the symptoms (redness, inflammation and itchiness) of this annoying condition, although it won't cure it. Using a moisturising lotion once the spray has dried on the skin may also help.
5. Baby drool rash
Your baby’s saliva glands turn on around month 3 or 4 and this can cause irritation of the skin around the mouth as they start to drool a lot. Make sure to keep the baby’s face as dry as possible by having a soft bib handy. Our spray can help here as well as it will calm and heal the skin and is completely safe if it gets into your baby's mouth. Re-apply after meals.
6. Fungal rashes
Yeast can cause several infections on the skin - anything from ringworm to cradle cap. Ringworm generally shows up as red, ring-like patches on the body. These will need an antifungal cream to treat them. Cradle cap shows up as flaky skin on the scalp. These patches can also sometimes be oily as well. Regular shampooing and a soft brush should deal well with this. Cradle cap responds well to Trifectiv® Plus spray, apply 4 times a day.
Yeast rashes will often present in the skin folds (under the arms for example) and will have small dots around the edge. Keep baby clean and dry, and spray any patches that may start with Trifectiv® Plus Wound & Burn Care. The trick to preventing a rash is to keep your baby’s skin healthy. Keep baths to under 10 minutes, 2 to 3 times a week, and use lukewarm water to prevent the skin from drying out even further. Choose a gentle, skin-friendly liquid cleanser to protect the microbiome on baby's skin - soap bars, preservatives, essential oils and fragrances can all cause imbalances in the pH of the skin (which is happiest at around 5).
7. Viral rashes
These rashes can be caused by meningitis (both viral and bacterial), chicken pox and even the Streptococcus pyogenes bacteria.
With meningitis, your baby may not actually have a visible rash, but will have a fever, be lethargic and may even start vomiting. Any rash that does occur will be all over the body, showing up as pink or red dots. The rash can even look like tiny bruises or broken capillaries under the skin.
A strep rash will usually show up on baby if someone in the family has had strep throat. It is very contagious, so please keep your baby away from anyone who has strep throat. This rash will show up as wet, oozy patches in the skin folds of the neck or a bright red circle patch on the baby’s anus. Your doctor will need to confirm the diagnosis with a swab test and your baby may need an antibiotic.
Chickenpox is also a virus that causes a rash on the body. This is less common these days as most babies are vaccinated for varicella zoster now. This virus is very contagious and causes a blister-like rash on the skin. This usually starts with one or two lesions on the back, tummy or face that become more numerous and spread all over the body. Your baby will have a fever, and the blisters will be very itchy as well.
Daily baths and keeping your baby’s nails short can help prevent secondary infection with itchy rashes, as they won't break the skin when they scratch themselves. Chickenpox will generally clear up on its own. The first vaccination is recommended at age 12 to 15 months with a second dose around 5 or 6 years.
Most baby rashes are no cause for concern, but you should look out for the following symptoms if your baby has a rash:
- Swelling of the face or wheezing when breathing
- If your baby has a fever (38°C or above)
- If the rash has blisters, bleeds or oozes
- If the rash gets worse and spreads
- If your baby starts coughing or develops cold symptoms
- If the glands in the neck are swollen
- If the rash doesn’t improve or go away after 2 days.
It is always better to be safe than sorry so if you are in any doubt or are concerned about your baby's rash then please visit your family doctor or the hospital as soon as possible.