At my wits end about dd's nappy rash - in so much pain

[LadyMetroland]

My dd is 2 and since May has developed appalling nappy rash. She gets it in bouts that last about a week, then we have maybe a week or two clear, but then it's back again. During a bout, she is in absolute agony; can barely sit down, walks like a cowboy and is in tears nearly the whole day. Been to doctors four times and am using Canesten with steroid, but to no effect, because of the following:

The major problem is that she lets out little bits of poo throughout the day, rather than one big poo, and so I have to change her nappy very frequently - maybe 8-9 times in a day. She's doing this because it hurts her so much to do a poo that she clenches up as soon as a little bit comes out.

I am using Water Wipes (99.9% water) and am very gentle but it is obviously making it worse to be changing her so often. It also means the steroid cream I put on in the morning has no time to work. There is no time for the skin to heal. I can't let her go round without a nappy for very long because a) she screams that she wants a clean one put on as she knows she's going to let out more poo, and b) she is letting out little dribbles of loose poo all the time so I would just have poo everywhere. Washing her down in the bath or shower is also not on the cards because the poo gets stuck into her skin and needs some kind of gentle wipe, but also because she literally screams blue murder, as if she is really being hurt, if I take her near the bath or shower (I do give a bath before bed, with salt in it, but I have to force her into it and hold her down which is just awful)

Bepanthen etc has no effect because it just slides off the affected area - the area is so red and weepy that cream just won't absorb because it's just raw.

Tonight she has screamed in agony every time I've changed her nappy. She is in constant tears and it is absolute agony to watch. I even considered taking her to A&E to try and get some kind of local anasthaetic or major league painkiller for her (obviously didn't do this but I am desperate)

Does anyone have any advice or experience? I'm off to the docs again tomorrow morning.

Second the clean dry skin wobbly but am finding it impossible to leave nappy off as she rakes frantically with what's left of her nails (I have cut them as far down as I dare) and literally tears the skin to shreds. Totally counterproductive.
Same when I bathe her, I have to pin her arms away and she screams blur murder.
I've also now read the small print on timodene cream package and it says do not use on broken or blistered skin, which is of course all over dds bottom due to scratched skin and chicken pox. Feel a bit torn now as to whether to keep using it even though the nurse who saw her yesterday said to. It's a mild steroid cream with anti fungal and antiseptic in it and it also says using it under a dressing or nappy can cause more absorption and not a good idea.
metro are you still around? Are you any further to getting your DC's sorted?

Knotted have you tried germolene? I am sure it isn't normally prescribed for nappy rash but when ds used to get in a similar state when he was very small (and impossible to rationalise with) the local anaesthetic in it seemed to stop it hurting.

It stings like hell when you first put it on, but if you can get through five mins it really helped. I used to give him chocolate to suck, like buttons, while the cream worked.

I also used to put him commando in really loose pyjama type shorts to let air reach the rash.

Poor little girl. Let us know how you get on OP.

Knotted, speak to the pharmacist if you're unsure about the cream. They will have the best information on its use.

Sounds like she is having a rough time poor thing.

Just coming back to see if ladymetro has reported but no. so as I seem to have made this thread all about me I'd like to report that dds behind has improved no end! Timodene yay!

That's great knotted, what a relief - it was trimovate dd was prescribed which is probably similar, possibly different brand name. It worked wonders for us too

Trimovate is what dd has to use on her really bad psorasis, it works brilliantly but consultant said to use 3 days at a time max only because of the steroid in it.