Nappy rash in toddler

[AngelsfromtherealmsofgloryDog]

23 m.o. DS has a bad patch of nappy rash which has been hanging around for about 2 months now.

I took him to the GP who was unhelpful - said it didn't look infected and the skin was in good condition. (That's because I put emollient on it about 10 times a day. ) Unfortunately that day was the best it'd been for weeks, and it's got worse again since.

Leaving a cloth nappy (with fleece liner) on once he's done even one wee seems to make it flare up badly. We've been mostly using disposables although that hasn't cleared it up.

He has quite smelly urine at the moment, although I don't know why. When we're at home he's nappy free most of the time and just wears a pair of loose trousers (he uses the potty when he's in the mood for it). That doesn't seem to help as much as I'd expect.

He has eczema although not usually in his nappy area. A while ago he had a bad spotty napy rash for which the dermatologist gave him Daktacort, which cleared it up. We're not due to see her again for ages though so I can't ask her advice. The pharmacist was no help and said to go to the GP.

I wash with cloth wipes and water, and put Dermol cream on, which has an anti-microbial in, or a general emollient. I did have a phase of just using cotton wool & Dermol to clean it with, although that didn't clear it up.

Any suggestions as what I can use on it? Might it be fungal?

Hi angel sounds like you are doing a good job keeping it at bay which is prolly why the GP thought it was ok . Can you see them or a different GP now it's worse again?

Is it a patch that stays in the same place more or less? It could be more eczema. Skin rashes always look a bit different in your genitals cos its so moist and there's wee and stuff iyswim. Might be worth trying the Dacktocort again for a week or so to see if it helps - the steroid bit of it will sort out the eczema and if there is fungal infection it will get rid of that too.

Do you use the antibacterial cream for the rest of his skin cos of the eczema (don't know much about children and eczema, sorry)? Could it be irritating it a little bit? (Only know that from personal experience!) Could try Aqueous cream only to wash it instead as its the least irritating thing and a little bit moisturising too, and no exposure to anything else other than water)?

Also it's a long shot but could try Eco type nappies - I found some disposables had loads of stuff in them that was quite irritating and made nappy rashes much worse but the Eco ones with less chlorine etc. really did help.

Not sure about smelly wee. If you're convinced he drinks loads or it's the same after you've upped his fluids its worth going to see the HV or GP again. good luck!

Thanks very much for your reply.

Yes, I think seeing a different GP would probably be a good idea - it was worse again today than yesterday. Even one wee in the cloth nappy seems to set it off at the moment.

The main part of the problem does stay pretty much in the same place, so it could be eczema-related. Unfortunately we finished the tube of Daktocort and the pharmacist wouldn't give it to me unless on prescription.

I do have plain hydrocortisone though, so perhaps I'll put a bit on and see if that helps at all.

We use the antibacterial cream for washing him with, and I've used it on his face when it's been infected. I'll perhaps try using something else gently moisturising.

I'll have a look out for the eco nappies - thanks.

I'll have to have another sniff of his urine tomorrow. His night time nappy always stinks, but it's on for 10 hours and he bfs to sleep as well as several times a night, so he wees a lot. I didn't notice it ponging today, so maybe it was a one-off. He does drink a lot of water and bfs pretty frequently too.

Could it be allergy or just skin sensitivity to something? Laundry detergent not risng out of cloth nappies/pants properly for example? Could it be fungal - a ringworm or sweat rash type skin problem? If so the only thing that will get rid of that is an anti-fungal cream. Go through the list of possibles and eliminate things first but if you've already done all that and it's still not clearing up you need to go back to the GP!

Is he getting his molars (teething)? Our LO's bum is red when she is teething, something to do with excess stomach acid being produced at the same time we think. Only other thing I can think of is that it's something he eats, something acidic perhaps - citrus fruit is particuarly bad for creating sore bums, also pineapple and kiwi fruit. Tomatoes and capsicums (peppers and chillies) also contain chemicals that could cause sore skin if he eats them. Our LO's face always looks red and sore when she eats tomatoes, even though she isn't allergic to them in any other way and she really enjoys eating them, but we wonder if they make her bum sore as well. Any soreness is a minor thing for her and hasn't been as bad as you describe, but if you son's skin is very sensitive to something in a particular fruit I guess it could make his skin very sore.

Ps if you can't get a Dr appt for a while, I'm certain you can get Dactocort over the counter for athletes foot. Its also used for adult genital thrush treatment though I don't know if it will say that on the package! You know he's not likely to have any probs with it if you've already used it in the past. Just don't tell the pharmacist! X

Have you tried Calendula cream? It helped my DS' nappy rash. Think it's made by Weleda, Waitrose and Boots sell it.

Ah, we used to use Calendula cream but I chucked it away because I never used it.

All his molars are through, although he continues to be dribbly and chewing on things, so I think they're still bothering him.

Something he's eating is entirely possible. He has a nut allergy, and the eczema on his face gets really aggravated by tomatoes, citrus etc.

I found some anti-fungal cream he was prescribed before, and it says it can be used to treat thrush infected nappy rash, so I'm giving that a go. GP appointment is booked for the new year (unfortunately it always takes ages to see anyone at our surgery).

Thanks everyone.

I foumd conotrane cream very effective on my dd who has always suffered from excema. It's a kind of barrier cream you need to ask for it at the chemist because it's not usually on display.

I've only skimmed through this (because it's time for bed) but I'm sure you've tried leaving his nappy off as much as possible and all that sort of thing?

Definitely take him back to the gp though.

Yes, he hardly wears a nappy in the house at all. Thanks for the suggestion, I'll add it to the list of things to try.