Persistent fungal nappy rash - advice?

[MamandeRose]

DD is 14 months and has had severe nappy rash for c. 6 weeks. Was diagnosed as fungal and we have so far had Miconazole and Hydrocortisone from GP and now we're 5 days into a 7 day course of Ketaconazole, but it keeps coming back. DD gets v uncomfortable and the other evening couldn't sit down properly and screamed for 30 minutes, before we realised what it was. Anyone had this? Would really appreciate advice/reassurance.

Hi. Sorry to hear this, must be awful. Have the doctors taken a swab yet? Usually you need to use anti fungal creams for 7-10 days after it looks like its cleared up. Keep pressure up with the drs. The swab will show if there is any other infection (bacterial). Good luck and hope they get it sorted ASAP

No they haven't, thank you for that. I feel pathetic going back each time, but I've been told definitely to stop using the cream after 7 days, so that's why it's coming back. Next time I'll ask for a swab. Fingers crossed.

Don't feel bad, it should be clearing up and isn't :-( sometimes you need to be pushy, its horrible for your little one and you. You were probably told to stop after a week because of the steroids, but google 'nappy rash nhs' and see NHS Choices website - says to use the antifungals for longer. You could use that info to ask for a separate steroid and antifungal cream, and a swab. Don't feel bad, it's sometimes necessary to be a bit insistent as its horrible for your child.
I was always going to drs with DS eczema and they thought I was being neurotic , but a swab showed that the wrong antibiotics were being used so it was worth the awkwardness in th end!

Def get a swab, we had ongoing issues for over a year turned out it was Strep A which actually needs antibiotics - it looked thrush/fungal like so the drs kept treating it as such which made no difference

Everytime we use canestan with steroids it improved as soon as we stopped/switched it returned which in hindsight was a huge clue that it wasn't actually fungal at all.

Not sure if this will help, but my daughter had the most horrendous nappy rash for weeks and weeks, with actual cuts appearing and no matter what cream the doctors gave me it didn't seem to make any difference. Then a friend of mine asked if I'd tried a special cream that a pharmacists make in Knutsford, as they said it was miraculous. I went the next day and after weeks of my baby crying with the pain within 2 days it was almost gone, and I now apply it daily, and she has never had a rash since. The cream is called Helgasons nappy rash cream and I don't know where you live, but when I spoke to the pharmacist she said they get people phoning up for them to post it, so I'm sure they would! It's got to be worth a shot! The tel no of the chemists is 01565633078. Good luck! Xx

Do everything everybody else said and then when you're with the doctor, cry and weep that no-one seems to be taking this seriously even though your baby is suffering.

This is what I had to do to get extra strength anti-fungal stuff recommended by the health visitors. The doctors were reluctant to prescribe because 'it's the same strength given to aids patients' but I told them I didn't care, I really needed the pain to stop!
Good luck.

Apart from treating the rash, you also need to protect the skin from further irritation. Our paed recommended using Daktacort (sounds like what you are using, same active ingredient), then letting it dry for 10 minutes, then applying nappy cream - bepanthen in our case. Good luck.

Hi
DD had a persistant rash when she was 14 months. The first dr tried treating it as fungal (e.g. anti-fungal, hydrocortisone) and as eczema (moisturiser). In the end we took her to a different Dr in the same practice and he suggested maybe she was allergic to the nappies.
We stopped using pampers (used cloth nappies for a month till it cleared and just use supermarket own brand now) and have never looked back. Once her CM put her in another child's pampers and it brought the rash straight back up.
Just suggesting it as another avenue for exploration.