Newborn (0–2 months) · Infant (2–12 months) · Toddler (1–3 years) · Newborns & feeding, Illness & symptoms
Diaper rash, cradle cap and baby skin: what needs treatment and what does not
Most newborn rashes, from baby acne to cradle cap, clear on their own. Diaper rash responds to air, frequent changes and a thick zinc oxide barrier. A bright red rash with satellite spots is yeast and needs an antifungal cream.
Key takeaways
- Air time and frequent changes prevent most diaper rash; wipe gently, pat dry, apply a thick barrier
- Zinc oxide or petroleum jelly at every change while healing; no need to remove it all each time
- Beefy red with small outlying spots, especially in the folds, is yeast: needs clotrimazole or nystatin
- Cradle cap: soften with a little oil, brush off the scales, wash with baby shampoo
- Baby acne, milia and erythema toxicum are normal newborn skin and need nothing
Normal newborn skin
- Baby acne: small red bumps on the cheeks at 2 to 4 weeks, gone by 3 months; wash with water only
- Milia: tiny white bumps on the nose and chin; they clear on their own
- Erythema toxicum: blotchy red spots with a small pale center in the first week; harmless
- Peeling and dryness: normal in the first two weeks; a fragrance-free moisturizer is fine
- Cradle cap: yellow greasy scales on the scalp and eyebrows; see below
Diaper rash: prevention and home care
- Change wet and dirty diapers promptly; stool is the main irritant
- Clean with water and a soft cloth or fragrance-free wipes; pat, do not rub
- Air time: a few minutes without a diaper several times a day
- Apply a thick layer of zinc oxide paste or petroleum jelly at every change; leave the layer in place and add on top
- Loosen the diaper a size if it is rubbing, and avoid plastic pants
Most irritant rashes improve in 2 to 3 days with this routine.
When it is yeast
A rash that is bright red, slightly raised, worst in the skin folds, with small red “satellite” spots beyond the edge is usually Candida, especially after antibiotics or with thrush in the mouth. It needs an antifungal cream (clotrimazole is over the counter; nystatin by prescription) two to three times a day for a week, under the barrier cream. Call us if it is not better in 3 days.
Cradle cap
Rub a small amount of baby oil or petroleum jelly into the scales, wait 15 minutes, brush gently with a soft brush, then wash with baby shampoo. Repeat every few days. It is not itchy or contagious and clears by 6 to 12 months. If it spreads to the face or body, or is red and weepy, we will look at it.
Eczema in babies
Dry, itchy, red patches on the cheeks, outer arms and legs from 2 to 6 months are often eczema. Daily lukewarm baths, a thick fragrance-free moisturizer within 3 minutes of bathing, and short courses of 1% hydrocortisone for flares (with our guidance on the face) control most cases. Persistent eczema deserves a visit; it can be linked with food allergy and asthma.
When to call us
- A diaper rash not improving after 3 days of home care, or with blisters, pus, open sores or bleeding
- A rash with fever, or a rash that spreads quickly
- Eczema that is weeping, crusted or keeping your baby awake
- Any rash you are worried about; a photo through the portal often settles it
Go to the emergency room or call 911 if…
- Purple or dark red spots that do not fade when pressed with a glass
- A rash with fever in a baby under 3 months, or with difficulty breathing or facial swelling
Questions parents ask
Is cornstarch or talc powder okay?
No. Powders are inhaled and do not treat the rash. Use a barrier paste instead.
Can I use adult hydrocortisone on a diaper rash?
Not without asking us. Steroid creams under a diaper are absorbed strongly and can worsen a yeast rash.
Not sure? Ask us
Call or text the office during hours, or send a portal message. For emergencies call 911.
(770) 615-7000Trusted further reading
- HealthyChildren.org (opens in new tab)American Academy of Pediatrics