Diaper Rash vs Yeast Infection: How to Tell the Difference - Verywell Health
Diaper rash can easily be mistaken for a yeast infection in babies and toddlers, and vice versa. Although they look similar, diaper rash occurs when prolonged exposure to urine (pee) or feces (poop) irritates the skin. Yeast infection is caused when urine changes the acidity of the skin, allowing fungus on the skin to overgrow.
Both can be caused by wet or infrequently changed diapers.
Yeast infections can also occur in children with weakened immune systems or be caused by antibiotics that throw off the natural balance of fungus and bacteria on the skin. However, these are not factors associated with diaper rash.
This article explains the similarities and differences between a yeast infection and diaper rash. It also explains how each condition is diagnosed so that the correct treatment is used.
Verywell / Jessica Olah
What Is a Yeast Rash?
"Candidiasis" is the term that describes a yeast infection. It happens when a common skin fungus, typically Candida albicans, starts to overgrow. The overgrowth occurs when the composition of bacteria and fungus on the genitals or anus is suddenly thrown off balance.
In babies and toddlers, the imbalance can be caused by different things:
- Wet diapers; Urine is highly acidic and can create an inhospitable environment for naturally occurring skin bacteria. By stripping away "good" bacteria, yeasts like C. albicans can fill the void and overgrow, causing infection and inflammation.
- Weakened immune systems: A normally functioning immune system can keep the natural flora of the genitals and anus intact. Infections and illnesses can weaken the immune response and allow robust microorganisms like yeasts to overgrow.
- Antibiotics: Antibiotics are used to treat bacterial infections. Broad-spectrum antibiotics can kill a wide range of bacteria, including "good" bacteria on the skin, providing C. albicans the opportunity to overgrow.
What Is Diaper Rash?
Diaper rash is also known as irritant diaper dermatitis. As with any form of dermatitis, diaper rash causes skin irritation that leads to areas of reddened skin (erythema) accompanied by itching, scaling, and tiny bumps.
Irritant diaper dermatitis is caused by overhydration of the skin and the trapping of moisture inside diapers. Prolonged exposure to feces is the main cause of diaper rash, but it can also occur with prolonged exposure to urine.
Certain laundry detergents can also cause diaper rash. In addition, friction caused by ill-fitting diapers or rough fabrics can cause chafing that aggravates diaper rash.
If left untreated, diaper rash can cause tiny breaks in the skin that allow bacteria or fungus to enter underlying tissue and establish a secondary infection.
How to Tell a Yeast Rash From a Diaper Rash
A diaper yeast infection can look very similar to irritant diaper dermatitis, but there are key differences.
Inflamed skin is shiny, cracked, or oozing
Appears mainly in skin folds such as the groin or between the buttocks
Rashes appear in well-defined patches, often with small pimple-like bumps
Treatment with antifungals can sometimes take weeks
Inflamed skin is dry, scaly, or smooth
Appears mainly on the buttocks where urine or feces have pooled in a diaper
Rash often runs along the perimeter of pooling
Treatment with a mild steroid cream usually works in days
Diagnosis
Diaper rash and a diaper yeast infection can usually be diagnosed with a physical exam and a review of your child's medical history. Lab tests can be performed to confirm the suspicions, but they are usually not needed.
If there is a high level of doubt (or the rash is especially severe), a skin swab can be performed to obtain cells and fluids to culture (grow) in the lab. This can differentiate between a fungal or bacterial infection and determine which antifungal or antibiotic medication is most appropriate.
Diaper Rash Treatment
Diaper rash is treated, first and foremost, by keeping the skin dry and changing diapers immediately when wet or soiled.
To treat the rash, your healthcare provider may recommend:
- Cleaning the skin with a soft washcloth or baby wipe after removing the diaper and using a squirt bottle to gently rinse especially sensitive areas
- Allowing the diaper area to dry for five to 10 minutes before putting on a new diaper
- Applying an over-the-counter (OTC) zinc oxide cream like Desitin
- Avoiding plastic pants until the rash is fully resolved
- Using mild detergents to wash diapers and avoiding bleach
Yeast Rash Treatment
As with a diaper rash, it is important to change diapers as soon as they are wet or soiled. To treat the rash itself, your pediatrician may recommend:
- Washing the skin gently with mild soap (but avoid baby wipes containing alcohol or propylene glycol as they can cause stinging)
- Air-drying the diaper area for five to 10 minutes before putting on a new diaper
- Applying an OTC topical antifungal like Mycostatin (nystatin), Lotrimin (miconazole), or Monistat (tioconazole) with every diaper change
Yeast infections usually improve within two weeks with consistent treatment. You may help speed your child's recovery by reducing their sugar intake, as yeast feeds on sugar.
Should I Use Baby Powder?
Do not use baby powder while your baby has a diaper rash. The powder can build up in the skin folds and hold moisture, making things worse.
Summary
A diaper rash is caused by prolonged exposure to feces or urine, which irritates the skin and causes a rash, mostly around the buttocks.
A diaper yeast infection can be caused when urine changes the skin acidity and allows fungus on the skin to overgrow, causing a rash primarily in skin folds.
The treatment for a diaper rash includes an OTC zinc oxide cream, while diaper yeast infection is treated with topical antifungals. Both can be prevented by changing diapers as soon as they are wet or soiled.
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