5 year old with a sore bottom - not in nappies and dry at night

[pickleparent147]

Just looking for advice and to see if I ought to be doing more about it/if there’s anything I can do to prevent it.
My 5 year old DD is out of nappies and dry at night. But she keeps getting really sore, like nappy rash, quite angry and red and it hurts her. Cream seems to help, and then it’s ok for a little while, but it keeps coming back and I just wanted to gather some opinions about whether I should change something I’m doing.
She has a bath a few times a week, not every day, and we wash her bottom with a flannel and soap morning and night, just on the outside. She sleeps in pj bottoms with no pants. She seems quite meticulous about wiping after a number one, a bit less so after a number two. Any thoughts?

What do you wash her clothes in? Some detergents can cause this reaction.

If she's not wiping properly after a poo, that will be the issue. It's basically nappy rash.

Could it be thrush? Have you tried canesten on it?

Could be:

worms
thrush
infection in urinary tract
eczema

I would recommend a trip the the doctor. My daughter had this and initially they said it was fungal and gave us a cream which didn’t help. It then turned in to a bright red ring around her anus and she was screaming in agony and itching. I think it was strep A (I would say google it but the images are not pleasant!) I took her back to the drs, they took a swab and gave antibiotics and it cleared up within a day. I only knew about the step A thing cos a friend had had similar with her daughter and it lasted weeks before she managed to get it sorted.

My son had this and it was strep a. If it is that, please make sure they give you a long enough antibiotic course to clear it. My son kept being given 5 day course and it kept returning.

Persil non bio and comfort fabric conditioner. I had t thought of that, thank you! Do you know what ingredients are typically the problem?

Persil non bio works for us. I do however do a second rinse and spin to try to take as much out of the fabric as possible. Everyone’s skin is different though so what impacts one might not hit another. Do you need Comfort?
Also we are very careful with shower gel and bath bombs etc, plain water is best.

DD1 has similar issue. Like yours she has a bum wash every morning and night. Most number 2 are done at home so it’s easier for me to clean her after, but if she does one at school, will often come home sore. We use wype gel at home which helps get you clean, they do travel size but she’s probably a bit too young to remember to take it and use it at school. I use metanium nappy cream, very sparingly as it is now discontinued 😩 if she is sore

I'd try canesten cream initially, as chances are that it's fungal. If this doesn't improve it within a couple of days, seek further advice. If it does improve, still continue with the canesten for a week or so.

Is the rash sort of shiny looking? That'll be thrush if so.

Worms tends to mainly hurt at night when the worms come out to lay their eggs.

My DD used to be very sensitive to fragrances so for a while I had to go completely fragrance free detergent (smol or ecover zero usually) and no fabric conditioner at all. Fragrance free natural bar soap for washing and just something gentle like aveeno baby shampoo

I know this sounds crazy, but I as an adult get thrush or similar from using cheap toilet paper. Could the swap from wipes to toilet paper be an issue?

similarly my baby girl reacts to certain types of wipes whereas my boy never did.

My DD had this too also diagnosed as strep A. GP told me it’s common at that age.

I don't think you should be washing the genital areas with soap - water is sufficient. My DD often has this, and I have also had issues related to washing powders, shampoos and even some types of toilet roll. We use epaderm ointment which helps create a barrier to protect from irritants (it's kind of thick and greasy). Other things suggested by our doctor were a shallow bath with lots of bicarbonate of soda in, and avoiding shampoos etc when in the bath, only washing hair in the shower. As others have said though, there are other possibilities to consider.

Give her wet wipes for no 2

Try canestan, but book a GP appointment or call tomorrow

the people who suggested strep A - was the rash continuous? In this case it will clear up and maybe be bad again a week later - was it the same for you? And also were there any other symptoms? Thank you for the info 🙂

Possibly, and it might be the paper they have at school I suppose.
might have to try a process of elimination!

Yes shiny I suppose, rather than bumpy, thank you, I’ll look into thrush. She isn’t complaining particularly at night so I don’t think worms is the culprit.

not yet - do you know if you would see any other symptoms in a child, like discharge etc?

Yes the rash was continuous with strep a, would clear up sometimes with a cream then be back. There was also a discharge. I would go to doctors and ask them to do a swab to test. They usually do a swab and send it off but you can also buy rapid strep a swabs from Tesco.

See if a daily shower with a very mild soap would work better, and see if a onesie pajama style would help too. Sometimes kids of 4-6 don't wipe thoroughly enough after either peeing or pooping, especially in school, and sometimes they scratch themselves too. Make sure the pajamas are clean every night.

Does she wear tights in school? Trousers? Are they cotton or synthetic? Does the school insist on bike shorts under skirts or dresses for girls?

It’s likely she isn’t wiping properly after a poo