By Alexis Lieberman
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May 28, 2026
Many years ago, I had a patient with a terrible diaper rash — open, raw skin that looked painful enough to make everyone cringe at diaper changes. The family had used every cream known to man. Fancy creams, prescription creams, zinc creams, all the creams. Nothing was working. Finally, desperate, I sent the baby to dermatology. The dermatologist took one look and said: “Stop everything. Just use Vaseline.” Ever since then, Vaseline has been my go-to treatment for most diaper rashes. The other big lesson I learned is this: when the skin is really irritated, stop wiping. Even “gentle” sensitive wipes will wipe away the new skin cells trying to grow and heal the rash. Instead, use water. You can use a spray bottle, hold the baby under a faucet, or use a handheld showerhead. (Just be careful with flailing little arms and legs — nobody wants an accidental hot-water burn while cleaning baby!) For many babies, severe diaper rash improves with three simple things: * Gentle cleaning with water only * Thick barrier protection * Avoiding friction from wipes The one diaper rash that usually will not improve with just Vaseline is a yeast diaper rash. What Causes Diaper Rash? Diaper rash happens when the skin becomes irritated from moisture, urine, stool, friction, yeast, or bacteria. Some diaper rashes are mild and red, while others become raw, painful, or peely. Different diaper rashes need different treatments. Types of Diaper Rash 1. Smooth Red Diaper Rash (Irritant Diaper Rash) - This is the most common diaper rash. It happens because urine and stool irritate and essentially “burn” the skin. Symptoms include: * Smooth red skin * Tenderness * Irritation in areas touching the diaper Best Treatment for Irritant Diaper Rash Treatment options include: * Vaseline * Desitin * Butt Paste * Zinc oxide diaper creams * Over-the-counter hydrocortisone cream * Prescription hydrocortisone if needed If using hydrocortisone: * Use twice daily for 5 days * Then once daily for another week if needed For many babies, a VERY thick layer of Vaseline works surprisingly well and is all that is needed. 2. Yeast Diaper Rash A yeast diaper rash looks different from a standard diaper rash. It is often: * Dotty * Peely * Bright red * Surrounded by small “satellite” spots Yeast thrives in warm, wet environments, and a diaper is essentially a warm, damp plastic bag — the perfect setup for fungus to grow. Best Treatment for Yeast Diaper Rash Yeast diaper rashes need antifungal treatment, such as: * Lotrimin * Lamisil * Prescription Nystatin These should be applied 3–4 times daily and continued for one full week after the rash appears gone. Many pediatricians feel that if a diaper rash has lasted longer than 3 days, yeast may be contributing and an antifungal cream should be added. 3. Severe Raw Diaper Rash (Erosive Diaper Dermatitis) This is the diaper rash parents dread. The skin becomes: * Raw * Open * Eroded This happens when urine, stool, moisture, and digestive enzymes break down the skin barrier over time. These severe diaper rashes can take several weeks to fully heal. They look terribly painful, but most young babies act normal while they have the rash. Best Treatment for Severe Raw Diaper Rash The goal is to create a barrier so urine and stool cannot touch the damaged skin. This is where Vaseline often works best. And the key is using a VERY thick layer. Other barrier treatments include: * Corona ointment * Xeroform * Phytoplex Z-Guard paste * Cavilon spray * Coloplast barrier cream * Ilex barrier cream * Stomahesive powder mixed with diaper rash ointment Home Remedies for Diaper Rash Some families also find these soothing treatments helpful: * Baking soda baths * Domeboro soaks * Freshly pumped breast milk applied to the skin * Liquid Maalox dabbed on the rash and allowed to dry * Gentian Violet for raw, weepy rashes Gentian Violet can help dry the skin and may help with both yeast and mild bacterial infection. Fair warning: it stains everything purple. Stop Using Baby Wipes on Raw Skin One of the most important diaper rash tips is this: When the skin is raw, stop rubbing it. Even sensitive baby wipes can worsen severe diaper rash. Instead: * Use plain water * Use a spray bottle or rinse the baby under running water * Dab gently instead of wiping * Allow diaper-free time whenever possible Reducing friction is often one of the fastest ways to help the skin heal. When to See a Doctor for Diaper Rash Parents should contact their pediatrician if: * The diaper rash is worsening * The rash is not improving within a few days * The child develops a fever * The rash becomes blistered, crusted, or rapidly spreading A diaper rash with fever may indicate a bacterial infection and should be evaluated promptly. Final Thoughts on Treating Diaper Rash Parents are often surprised that the best diaper rash treatment is sometimes the simplest one. For many babies, the combination of: * Water instead of wipes * Thick Vaseline * Time out of diapers works better than a cabinet full of medicated creams. And if the rash looks dotty and peely instead of smooth and red, think yeast.