Your guide to prescription diaper rash creams

Diaper rash is a skin irritation condition most common among babies and young children who wear diapers. It can happen after sitting for too long in a soiled diaper, if the diaper is too tight and causes chafing, or if chemicals in certain products irritate the skin.

Diaper rash causes inflamed skin around the bottom. The skin might also be warm to the touch. It usually clears up on its own within a couple of days, but if it doesn’t, prescription treatments may be necessary. These are often in topical creams that you apply to the skin.

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When are prescription medications necessary?

Diaper rash cases are usually mild and can go away on their own with the proper care at home. However, there are two key indicators where you may need to seek medical treatment:

• Length of infection: If the rash doesn’t go away within 2 to 3 days of using home remedies, doctors may consider prescribing medications, as it may be due to an underlying infection.
• Signs of infection: If there are any signs of an underlying infection, seek medical attention right away. These signs include fever, blisters, or pus around the rash. If your baby seems to be in pain or difficult to console, this could be another sign.

Types of prescription diaper rash creams

Doctors might use several different types of prescription creams to manage diaper rash.

Steroid creams

If you’ve tried home remedies and the rash isn’t going away, but there’s no sign of an underlying bacterial or fungal infection, doctors might prescribe a short course of topical corticosteroids. These creams have anti-inflammatory effects and can help stop the immune response that causes the rash.

Topical corticosteroids come in different strengths and forms, including creams, gels, or ointments — all of which you apply directly to the affected area. A 2018 research review suggests that ointments may have better effects than other forms because of how well they can coat and moisturize the area.

For diaper rash, doctors will generally prescribe a very short course of low strength steroid cream to avoid any adverse effects of the medications. The course will usually be limited to 1 week. Steroids that doctors might prescribe include:

• hydrocortisone 0.5%
• desonide 0.05%
• triamcinolone 0.1%

Antifungal medications

Sometimes, diaper rash is due to an overgrowth of yeast, a type of fungus. A fungal diaper rash will look different than a nonfungal one.

For example, a yeast infection will appear with red or discolored spots or pimples and may affect the folds of the legs, buttocks, or stomach. A regular diaper rash is more of a smooth or chapped rash that affects smoother areas of the skin instead of the folds.

The first cream doctors usually recommend is nystatin (Nystop), which you apply with every diaper change. If this doesn’t work within around 3 days, you may switch to other topical antifungals, known as azoles. These include:

• clotrimazole (Lotrimin)
• ketoconazole (Extina)
• miconazole (Monistat)

These creams are often available over the counter (OTC), but it may be best to speak with a doctor before using them to get an accurate diagnosis, especially if you’re treating a baby.

Topical antibiotics

If there are signs of a bacterial infection, doctors will prescribe topical antibiotics to treat the infection. Bacterial infections will likely cause blisters or pus around the rash, and the baby may also have a fever and appear to be in pain.

For milder infections, doctors will likely prescribe mupirocin cream (Centany) to apply twice daily for 5 to 7 days. Another option is bacitracin (Baci-Rx).

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Possible side effects

Like any medication, diaper rash treatments can come with side effects. Babies also have very sensitive skin, so if you notice any adverse effects, you may want to speak with a doctor as soon as possible.

Topical corticosteroids may cause burning or stinging when you apply it. You might notice some further irritation or dryness. A more serious possible side effect of topical steroids is thinning of the skin. This is why doctors will only prescribe low strength creams for a short time to treat diaper rash.

Topical antifungals may also cause itching, burning, or dryness. Speak with a doctor if you notice serious side effects, such as blistering or open sores.

Topical antibiotics can cause similar effects to the other creams, including skin irritation. You should also monitor for unusual skin changes or a further rash in the area.

Alternative treatments for diaper rash

While medications are sometimes necessary, the first-line treatment for diaper rash is at-home strategies to manage the rash. These include:

• Maintaining good hygiene: This includes frequent diaper changes to reduce exposure to urine and poop. Keeping the area as clean as possible is also helpful.
• Using gentle cleansers: Using only gentle soap and water on the rash can prevent further irritation.
• Using topical emollients: Emollients are moisturizing treatments that form a barrier on the skin. They can reduce irritation and help prevent further issues. These are available OTC and usually don’t contain medications. Examples include zinc oxide creams and lanolin.

Summary

If you or your baby has a diaper rash, the first recommendation is usually to manage it at home by maintaining good hygiene, making sure to change the diaper regularly, and using OTC products like emollients. However, in some cases, doctors might prescribe medications.

In severe cases that don’t get better on their own, doctors might prescribe topical corticosteroids. These will usually be very low in strength and only suitable to use for a short time.

Some diaper rashes might be caused or worsened by an infection with bacteria or an overgrowth of yeast. If this is the case, a doctor will usually prescribe topical antibiotics or antifungals, respectively.

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