To take my 18month old DS to the local PANDA unit tomorrow

[Elsabean]

He has had really severe nappy rash for over 4 weeks. By severe I mean multiple ulcerated patches that bleed when he is wiped. I have taken him to the GP 3 times and he has had 3 different creams and 2 oral antibiotics. I have also tried all the usual barrier creams. Initially I tried to give him more nappy-free time but now he scratches himself and the area just bleeds. Your opinions and suggestions much appreciated as I feel as if we are getting nowhere and it must be so painful for him. Thanks in advance

Sadly, I have extensive experience with this, as my daughter is disabled and still in nappies (she will be 9 this month).

Definitely take the poor pup to be seen, I am sure he is miserable. Not only should you tho la bout what is on his bottom, but also what is in his diet. If his stool is particularly acidic, he might be dealing with acid burns. If you can get it, plain Mylana applied instead of (or as well as) a barrier cream will help to neutralise the acid in his stool before it can burn him.

I do hope you can get it sorted, we ended up with a combination of ingredients mixed into a balm for DD's bottom, but she went through misery in the meantime.

Ease keep us posted.

tho la bout = think about

Idiot autocorrect

so sorry to hear your dc is in so much pain. i would definitely take them to a&e tomorrow, i think dc1 had canesten hc which cleared his very sore nappy rash up. we use bepanthen every nappy change and use water and cotton wool rather than wipes if sore. if no infection then we use simple baby wipes.
i know some people swear by metanium but it doesn't seem to help dc1 or 2, so think a bit of trial and error is required once infection cleared up to find a good every day barrier cream.

If you're taking him to A&E, or OOH centre, just bear in mind that they probably won't be able to access your dc's GP records: taking the time before you go to make a list of exactly which creams/treatments have been tried so far could really improve the odds of them being able to figure out what to try now.

I would definitely go to Panda in your situation.

We didn't need to fortunately. The doc gave us Fucidin/Fuciderm steroid cream. Apply a thin layer for 5 mins nappy off time twice a day. Then metanium on thin layer rubbed in well, then more slathered on top.

Yes yes to no more wipes. The screaming died down instantly during nappy changes.

Try putting stickers loosely on his hands/fingers whilst you nappy change and have a bit of nappy off time. Keep his distracted. Or a bit of Teletubbies - it is truly hypnotic.

Have a think about diet. My DS gets horrendous nappy rash when he eats a lot of watermelon. Try making sure he only has small amounts of everything, especially fruit, see if that helps.

The best cream I ever used was called Timodene - it worked better than Canestan, Metanium etc, when DS's nappy area skin broke down.

Apparently Metanium should not be used on broken skin. And tepid water with cotton wool definitely helps.

OP, you shouldn't be using a cream with hydrocortisone in it on broken or infected skin.

can you wash off in a bath rather than wipe and blow dry on cool setting (keep your hand under the dryer so you know the temperature is ok) then metanium and into a nappy?

ps if metanium is not for broken skin then whichever cream is

When dd has horrific issues sprilon spray which is usually for bed sores was amazing. Just cleaned in cotton wool and water let air dry and the thinnest of coats of this stuff.

The cause for my other dds horrific bleeding nappy rash was actually strep A - so yes yes yes to getting swabs done.

Both of mine were allergic to most nappies - I ended up using eco-friendly nappies like www.google.co.uk/search?sourceid=chrome-psyapi2&ion=1&espv=2&ie=UTF-8&q=nature%20nappies. My favourites were Naturecare from Boots - a bit more pricey than Pampers and Huggies, but worth it, as it meant they were comfortable and rash free from then on.
HTH

That said, the current rash is going to need treating at the same time, but many posters have given suggestions for you there. But if the problem is caused by an allergic reaction, long term the only thing that will help is to change brands.

I took my 4 week old to paediatric A&E with hideous nappy rash which looked like chemical burns - bleeding open sores. We were sent there by the GP who had already tried everything. We were given a cream called orabase which cleared it up completely within a week.

My DD had horrendous nappy rash.
I discovered that she had a reaction to zinc oxide which is in a lot of the barrier creams.
We got Timodene and I started using bepanthen.
As long as I avoided creams with zinc oxide in she/was fine.
Timodene was marvellous but also a pita as it had to be kept in the fridge....
The number of times I HD to talk Ds, who was three at the time, through finding the tube..........

Cloth nappies, cloth wipes (home made) with a home made solution containing tea tree and lavender use a spray bottle to apply generously! Ds is rash free. May be worth a try. If docs give you cream to heal it maybe try a home made wipe solution going forward.

I hope you got sorted, ds1 had this and it turned out to be aqueous based creams.

Wiping with cooled camomile tea really helps sometimes. Waitrose bottom butter is great stuff too.

Just wanted to give everyone an update. We went this morning and they have taken a swab, changed his antibiotics to cephalexin and given us more canestan cream. They think it may be impetigo. They also suggested using a barrier cream and mentioned metanium which confuses me if the skin is broken. Thank you again for all the suggestions, I will continue trying to make him more comfortable.

Glad of the update and I'm so glad they are investigating it properly.

Bepanthen is very very good cream if you're wary or Metanium. It allows the sliwn to breath as well as protecting against urine etc.

• the skin

Thanks for update. Hope it clears up soon.