Atherton DJ. Understanding irritant napkin dermatitis. International Journal of Dermatology. 2016; 55:(1)7-9

Baer EL, Davies MW, Easterbrook KJ. Disposable nappies for preventing napkin dermatitis in infants. Cochrane Database Systematic Review. 2006; (3)

Burdall O, Willgress L, Goad N. Neonatal skin care: developments in care to maintain neonatal barrier function and prevention of diaper dermatitis. Pediatric Dermatology. 2019; 36:(1)31-35

Cohen B. Differential diagnosis of diaper dermatitis. Clinical Pediatrics. 2017; 56:(5S)16-22

DermNetNZ. Napkin dermatitis. 2017. (accessed 4 December 2019)

Lavender T, Furber C, Campbell M, Victor S, Roberts I, Bedwell C, Cork M. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial. BMC Paediatrics. 2012; 12:(59)12-59

Lawton S. Nappy rash: diagnosis and treatment. Journal of Family Health Care. 2014; 24:(5)36-40

Merrill L. Prevention, treatment and parent education for diaper dermatitis. Nursing for Women's Health. 2015; 19:(4)324-336

Ness MJ, Davis DMR, Carey WA. Neonatal skin care: a concise review. International Journal of Dermatology. 2013; 52:(1)14-22

National Institute for Health and Care Excellence CKS. Nappy rash. 2018. (accessed 22 August 2019)

Odio MR, O'Connor RJ, Sarbaugh F, Baldwin S. Continuous topical administration of a petrolatum formulation by a novel disposable diaper. Dermatology. 2000; 200:(3)238-243

Ravanfar P, Wallace JS, Pace NC. Diaper dermatitis: a review and update. Current Opinion in Pediatrics. 2012; 24:(4)472-479

Rowe J, McCall E, Kent B. Clinical effectiveness of barrier preparations in the prevention and treatment of nappy dermatitis in infants and preschool children of nappy age. International Journal Evidence Based Healthcare. 2008; 6:(1)3-23

What parents and professionals need to know about newborn skincare. 2018. (accessed 9 February 2020)

Visscher MO. Recent advances in diaper dermatitis: etiology and treatment. Pediatric Health. 2009; 3:(1)81-98

Nappy rash: current evidence for the prevention and management

02 May 2020
Volume 28 · Issue 5
 Midwives need to be aware of the causes of nappy rash in order to better advise on treatment methods
Midwives need to be aware of the causes of nappy rash in order to better advise on treatment methods


Nappy rash affects up to 25% of nappy wearing infants and can be distressing for the infant, their family and carers. This paper focuses on the cause, prevention, diagnosis and management of nappy rash based on current evidence and guidance to provide optimum care and advice antenatally and postnatally. The aim is to shed light on assessment, diagnosis, self-management and therapeutic options to prevent, manage and treat nappy rash. Although common, nappy rash can provide diagnostic challenges. Thus, the paper will highlight further potential causes of nappy rash and when to seek further advice and guidance.

Nappy rash, also known as diaper rash, nappy dermatitis, diaper dermatitis or irritant diaper dermatitis, is one of the most common skin conditions found in infants and is an acute inflammatory reaction of the skin in the nappy area most commonly caused by an irritant contact dermatitis. There are no differences between boys, girls or ethnic groups (Merrill, 2015) and prevalence varies geographically, depending on cultural differences in the use of nappies, toilet training and skincare practices (National Institute for Health and Care Excellence [NICE] CKS, 2018). It affects up to 25% of nappy wearing infants within the first four weeks of life to as much as 100% at some point in infancy (Ravanfar et al 2012, Burdall et al 2019) with the highest prevalence between 9–12 months of age (Cohen, 2017).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month