When to see your doctor
• if the rash has not improved after 3-4 days, despite all the above measures;
• if blisters, crusts, or pimples appear;
• if your child is very distressed and not sleeping;
• if your child has an unexplained fever;
• if the rash is spreading;
• if the end of your child’s penis is red and swollen, or has a scab on it.
Complications
Secondary infection can sometimes occur, especially a fungus or yeast called thrush (Candida albicans). These bugs are normally present on the skin, but are real opportunists and multiply when the chemical balance has been disrupted in their favour. Thrush appears as bright red and shiny areas in the napkin area; they have clearly defined borders and also affect the skin folds. Numerous red dots (satellite lesions) may be studded beyond the outer edge of the rash.
Treatment is with an antifungal cream which will be prescribed by your doctor. As opposed to a simple nappy rash, which clears up quickly, thrush can take longer to clear, and has a tendency to recur. Treatment can be prolonged, and sometimes very frustrating.
Prevention
If used consistently, the simple measures outlined above should help prevent nappy rash. Keep the nappy areas clean and dry, and use protective creams (often containing a zinc oxide base).
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