Yeast diaper rash

Chafing, sensitivity, and wetness are common causes of a typical diaper rash, but if usual treatment efforts (like keeping your child's bottom dry and using a diaper rash cream or ointment) don't seem to be working, your baby may have a yeast diaper rash.

Yeast diaper rash causes

A type of yeast called candida most commonly causes a yeast diaper rash. Everyone has harmless amounts of candida in and on their body. This fungus thrives in warm, moist areas, like the mouth, bowels, skin, vagina, and groin area. The moist environment of a dirty diaper can easily cause a yeast infection – especially if there's already an untreated diaper rash.

Babies taking antibiotics and breastfed babies whose mothers are on antibiotics are also more susceptible to yeast infections. That's because antibiotics kill the good bacteria in the body that keep yeast in check. Without these bacteria around, yeast can grow more abundantly.

If your child recently had thrush (a yeast infection of the mouth), they may end up with a yeast infection in their diaper area, too. Yeast passes through your child's digestive system when they eat and ends up in their poop, which eventually lands in their diaper right next to their warm, damp skin.

Yeast diaper rash symptoms

You may not be able to detect yeast in a mild diaper rash, but you can usually identify a full-blown yeast infection if the rash:

• Lasts longer than two days and doesn't respond to typical treatments for diaper rash
• Is well defined and reddish or bright red
• Has slightly raised borders
• Shows up in the folds of skin in the groin area
• Has "satellite" lesions or additional irritation near the main skin rash
• Is scaly

© Dr. P. Marazzi / Science Source

Yeast diaper rash treatment

Regular diaper barrier creams or ointments won't help, so your baby's doctor may recommend using a topical antifungal cream (such as nystatin, clotrimazole, or miconazole), possibly with a mild corticosteroid cream as well.

Some of these medications are available over the counter, but a yeast diaper rash often requires nystatin, a prescription ointment. You may need to have your baby examined by their doctor before starting treatment. 

Applying the cream two to three times a day is usually enough, but when you're using an antifungal cream, it's important to rub it into the skin, not just apply it on top (the way you would with a regular barrier cream for diaper rash). The rash should clear up after a few days.

Sometimes doctors also recommend applying a barrier cream or ointment over the medication to keep the rash from getting worse.

Don't use powders like talcum or cornstarch, which can get into a baby's lungs if inhaled. (Also, some experts believe that using cornstarch might make diaper rash worse by spreading yeast and bacteria.)

Let your baby's doctor know if the rash doesn't improve within three days of starting treatment. Also, make an appointment to see the doctor if your child develops a fever, or if the rash develops open sores or oozing yellowish patches. These could mean your child has a bacterial infection and needs an antibiotic.

What's the best way to keep my baby's bottom clean so it heals?

• Change your baby's diaper frequently.
• Give your child some bare-butt time. Let them play diaperless (perhaps on a waterproof cloth with a towel on top of it) to let their bottom get some air.
• Gently clean the affected area with a soft washcloth or a cotton ball and water. Don't use wipes, and be careful not to rub too hard.
• Use a squirt bottle filled with water to clean the area if it looks very irritated or sensitive.
• Choose a mild, fragrance-free soap.
• Pat the area dry or let it air-dry, then apply the ointment or cream.

Can a yeast diaper rash be prevented?

That depends. If your child is taking an antibiotic (or if you're breastfeeding and taking antibiotics), or if your child has recently recovered from a bout of thrush, you may not be able to prevent a yeast infection.

But you can take steps to prevent the kind of environment where yeast thrives – a dark, moist place.

Try these diapering tips, which also can help prevent regular diaper rash:

• Check your baby's diaper often, and change wet and soiled diapers right away.
• Clean your child's bottom thoroughly after they have a bowel movement, and give the area a chance to dry completely before putting on another diaper.
• Don't put diapers on so tightly that air can't circulate around your child's skin.
• If your child is prone to diaper rashes, give them extra bare-butt time whenever it's convenient, such as during weekend diaper changes at home.

Do cloth diapers help prevent a yeast diaper rash?

There's no evidence that one type of diaper is better at preventing diaper rash than another. Whether you use cloth or disposable, what's most important is changing dirty diapers as soon as possible. It's also a good idea to avoid using tight-fitting disposable diapers or non-breathable covers over cloth diapers because these prevent air from passing through.

If you use cloth diapers:

• Wash them with a mild detergent and bleach.
• Rinse them thoroughly.
• Don't use fabric softeners or dryer sheets. (These might irritate the rash and make it worse.)

If your baby already has a yeast diaper rash, consider using disposable diapers temporarily until the rash goes away because they're highly absorbent and designed to keep moisture away from the skin.

Learn more: 

Visual guide to children's rashes and skin conditions

Best diapers for sensitive skin