Prev Next
Diaper Rash

Diaper Rash From Hell

By Amalah

Amy,

I know I have requested advice with a lot of issues, and I really hope you can help me out with this one. My daughter is two and around the time our third baby was born (five months ago) she started breaking out in this horrible rash. The worst was her diaper area, but it was also all over her body. It would go away a little and flare up again. We took her to the pediatrician a few times and nothing he suggested seemed to work.

I finally took her to a pediatric dermatologist (there was a two month wait). By the time I got in her diaper area was bleeding constantly and the rest of her body was a complete mess. The first person we saw was a PA and she diagnosed her with severe eczema. She told me I needed to keep her skin moist constantly. I was told to mix vaseline with a specific lotion and rub it all over her during every diaper change. She had the worst allergic reaction to that. I spent all weekend taking pictures of her and e-mailing them to the head of the pediatric dermatology practice. I took her back in the following Monday and they put her on a steroid cream (triamcinolone). It cleared it up pretty quickly. I was told to lotion her up a lot (with a different lotion). We found out she is allergic to a component called balsam of peru, which is in a lot of lotions and shampoos. It is also in baby wipes. We avoid a lot of things now.

The problem is her eczema still flares up a lot. The dermatologist told me to just put on the steroid cream when that happens. The thing is I feel like I am putting it on her almost everyday. I don’t know how good it is to put steroid cream on a two year old every day. The dermatologist kind of brushed me off when I asked her about this. We already had to drive an hour and a half to get to her, and there are no other options to see another doctor (yea for living in a small town). So my question is: Is it ok to use steroid cream this often? Is there anything else I can do? I have tried every diaper cream possible and nothing seems to help except for the steroid. Is there another diaper cream that might work on that area? We use disposable diapers and I thought about switching to cloth, the problem with that is she can’t be in cloth diapers in preschool.

Help please!
Ally

Okay, first off: I CANNOT give you medical advice here. Or anything close to it. So the questions about the safety of the steroid cream…whoooooosh, way over my head and out of my realm of expertise.

I’m sorry that your second opinion options are so severely limited, but it sounds like you need to find a way around that somehow, since YEAH. I think your concerns about regular, long-term use of a steroid cream are incredibly valid and you (and your daughter) deserve to get those concerns ANSWERED and not “brushed off.” Gah. From here, I’d say your options are:

1) Talk to the pharmacist who fills the prescription. Ask questions about it, about side effects, about any research or studies on its use on children, etc. Ask for any over-the-counter or home remedies he or she might know about that you haven’t tried yet. Hopefully one of the benefits to your small town is a helpful, involved pharmacist.

2) Find another pediatric dermatologist who is willing to do a phone consultation, maybe look at the photos over email, offer any additional suggestions or confirm that yes, that particular steroid cream is your best option. This may be difficult to impossible, and I have no idea if anyone would agree to do it or how your insurance would view it, but it’s worth a try?

3) Go back to your doctor and ask again. Call the office and ask again. Refuse to let her brush you off. Make sure she knows you’re still using the cream almost daily and that things are still not fully under control. Tell her right to her face if her answer isn’t satisfactory to you. It’s entirely possible that you’ll be dealing with this practice for a long time, if your daughter doesn’t outgrow the problem, so while I’m sure you’re trying to stay on their “good side” and all…well, NO MORE BRUSH-OFFS. NOT ACCEPTABLE. YOU TALK TO ME LIKE A GROWN-UP, DOCTOR.

As for any other treatment options, yeah: There’s a wealth of suggestions all over the Internet (diluted bleach baths, various emollients, etc.) but many of them should not be implemented without the blessing of your doctor in a case of eczema this severe. I’m sorry.

Has your daughter been tested for food allergies in addition to the lotion/shampoo/etc. ingredient allergy? Eczema can be triggered by allergens in a baby’s diet — cow’s milk and eggs being the usual suspects, but wheat, soy, nuts and fish are also common triggers. Not in all cases, but some.  If you don’t have a good allergist nearby or you’re faced with another long wait for an appointment, you can try eliminating these foods COMPLETELY, one at a time. Rule of thumb for elimination diets is that it can take up to two weeks for the food to completely leave a baby’s system, at which point you would either notice an improvement or nothing at all. However, I think a trip to the allergist is still definitely called for here, because if she has multiple food allergies (like milk AND soy or wheat AND eggs), it can get very difficult to figure that out on your own.

As for cloth diapers, some daycares and preschools will make exceptions for medical reasons like allergies. However, they might require something disposable-like, such as an all-in-one or a pocket style with a waterproof cover, and just like I mentioned in the diapering in a humid climate column, those aren’t breathable fabrics. At home, though, I would SO vote for keeping her in breathable, natural fibers all the way down to her diaper.  A cotton, bamboo or hemp fitted would work great, and you can let her go without a cover for as much time as possible around the house. (If you need a cover, I’d vote for fleece, since wool is specifically mentioned as a NO in several of the online articles I read about eczema. Wool diaper covers are felted to be soft, but it might still be too scratchy for skin that sensitive.) Even if she wears a disposable for a few hours at preschool, she’d still be in cloth the majority of the time to make the switch worth it for her poor little rashy bottom.

Again, I’m sorry I can’t really address the majority of your concerns or offer specific alternatives. I hope you get to the bottom of everything that’s potentially causing your daughter’s reaction, if there are other allergies, food or chemical or otherwise. Or that she outgrows it, or that you get a good answer from SOMEBODY about her current course of treatment.

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

icon icon
chat bubble icon

Comments

newest oldest most voted
Notify of
Dawn K.
Guest
Dawn K.

Firstly, just like Amy, I’m not a doctor and please consult them. HOWEVER, we’re eczema experts in our house (9 yr. old stepdaughter with moderate to severe outbreaks and 16 mo. old with problems on her feet), so here are some general eczema suggestions (not sure how safe they are to carry over to genital areas) to run by the doctor. Baby Oil-We bathe with doors shut, and then towel dry to the point of leaving some moisture on the skin. Apply baby oil all over, then pajamas. This seals in the moisture. You have greasy kids, but we saw… Read more »

Hillary
Guest
Hillary

Ugh, I’m so sorry for you and your daughter. Eczema is a really miserable thing to deal with. I just finally got my daughter into see a dermatologist and she was extremely curt and insisted that the steroid cream was the best strategy. I’d been avoiding it, but she told me the dose was low and the important thing was to clear it up – you have to apply it as directed until the outbreak clears up, which can be a few days. We kept using a little, getting nervous, going a few days and watching her worsen, and then… Read more »

tdot
Guest
tdot

Similar to Dawn I am a bit of an eczema expert myself – I have had it my whole life and had it similar to your daughter when I was her age. I have been using heavy steroid creams my whole life to combat it, and I have no known health issues that I can tell you about (or had any) that weren’t something completely unrelated (I tore an ACL skiing, got sick with colds/flu like other kids, was a brat when I was a teen, etc :-)). At 29 I have learned to master what brings about my eczema… Read more »

Stephanie
Guest
Stephanie

My first thought was food allergies. Yes, she’s too young for a skin test, but they can do a blood test to get some indicators.
My daughter had mild eczema while we were figuring out what she was allergic to; once we did, the eczema cleared up and we haven’t had it since.

Angela
Guest
Angela

My first thought was a food allergy as well.  My youngest is allergic to dairy and her diaper area is the first to show if she’s been eating too much (she likes to sneak her sister cheese/yogurt/etc.)  Even though she it potty trained the first place the rash appears is her bum, eventually it will spread to her legs and we see it on her face in the winter.  It will blister and peel and bleed.  I use a combo of steroid/bendaryl cream/cornstarch to make a thick paste at night if I see it flaring up…but I would see about… Read more »

Julie W
Guest
Julie W

We installed a home humidifier a few years ago…and my husband’s severe eczema disappeared. It is not cheap and does add to the heating expenses, but he’s not had an outbreak since. If you can’t swing a home humidifier attached to your furnace, they do sell mult-room cold-water units …you just have to work at keeping them clean.

Susan
Guest
Susan

Hi Ally, My son has mild eczema that we control with a basic OTC lotion. He doesn’t have the allergy to balsam of peru that you mentioned, however. But, I love the diaper cream I use on my son, so I thought I’d check to see if that’s an ingredient in it. Based on my online searching, I don’t think it is. The cream is called Resinol, and it’s basically been around forever. My mother in law used to use it on my husband! I buy it on Amazon, and have only rarely found it in a store (behind the… Read more »

Bethany
Guest
Bethany

My son also has food allergies that also show up as eczema and terrible diaper rash. He had the blood test done when he was 5 months old. We eliminated eggs and the eczema disappeared. The diaper rash continued as we continued to find more things that he can’t have: carrots, any kind of berry, and oranges. He’s also lactose intolerant. I highly recommend a trip to an allergist, although your pediatrician can run the blood test. That would at least get you some short term answers if you have to wait to get in. Also, some allergists require a… Read more »

Carie
Guest
Carie

I also recommend seeing a dermatologist. My son had the worst eczema until we found out he is allergic to nuts. He still has it mildly and we were also prescribed a steroid cream. Our dr. said to apply it when he has a flare-up and then stop using it once it’s gone. We noticed a major difference in his skin overall once we started putting Jergens Overnight Repair lotion on him every night before bedtime. I checked the ingredients and it seems to be free of the balsam of Peru. His skin is much softer overall and his problem… Read more »

Jeannie
Guest
Jeannie

For what it’s worth — and I’m NOT a medical professional — I don’t think that steroid CREAM has the same effects on the body as steroids INGESTED.

But I second every one else with — get a second opinion, and keep asking until you get answers. Doctors shouldn’t brush you off!

But I hope that gives you a little peace of mind until you can get some firm answers.

Amber
Guest

I am so sorry to hear about your daughter. I too have SEVERE eczema, and have spent my entire life being lubed up in steroid creams, lotions, taking steroids, and I can say that I personally have never had any problems health wise. I still continue to use my steroid creams to this day as a 24 year old adult, and have never had any problems. I know they seem scary, but they do work! My ear lobes used to actually split off of my head when I was baby, and I would be covered in blood every morning from… Read more »

Debra
Guest
Debra

My daughter has mild eczema and the diaper cream that always worked best on her was Weleda Baby Calendula Diaper Care.  I took a quick look at it and it doesn’t appear to contain balsam of peru. 
Now that she’s older, we slather her up with unscented shea butter from The Body Shop after each bath, limit the baths, and use steroid cream for outbreaks.
Good luck!

lesliele
Guest
lesliele

My son has had issues with eczema and the very thick cetaphil lotion in the tub has done wonders. He’s not quite 2, so he only gets a bath about once a week… that also helps.

I’m sorry if you’ve already tried that lotion and my comment doesn’t help, but I thought I’d put it out there, just in case. 🙂 Eczema is so hard to deal with, and I know it makes you feel just terrible because you can’t “fix” it for them. (hugs)

Heather
Guest
Heather

My daughter gets really bad eczema and the doctor told me to use the steroid 2 weeks on and 2 weeks off. We let her run around naked after diaper changes for a while and let her have some breathing time and that seems to help. It seemed to get better at different times of the year as well. We use aquaphor ointment instead of any scented lotion and that helps as well. Good luck.

Myriam
Guest
Myriam

is she really too young for an allergy skin test?  my daughter is 9 months old and we just had her tested for a milk allergy (confirmed), which also showed a soy and other dairy allergies!  We are in Quebec, Canada, so protocols might be different, but maybe try to get a referral to children’s allergy specialist, it is worth the wait to know, rather than play the trial-and-error game with a child… 

Myriam
Guest
Myriam

is she really too young for an allergy skin test?  my daughter is 9 months old and we just had her tested for a milk allergy (confirmed), which also showed a soy and other dairy allergies!  We are in Quebec, Canada, so protocols might be different, but maybe try to get a referral to children’s allergy specialist, it is worth the wait to know, rather than play the trial-and-error game with a child… 

Sara
Guest
Sara

I have had some bad outbreaks of eczema, and the only thing that really cleared it up was the steroid cream. BUT I have also had success with coconut oil. The only things that prevent my eczema is lots of moisture like others have suggested. I find that pertroleum based moisturizers sometimes make it more irritated as I have very sensitive skin. I often use food grade organic virgin coconut oil as a moistuizer, and it works very well for me. Also, since it is just pure coconut oil you wouldn’t have to worry about balsam of peru. I know… Read more »

Rachael
Guest
Rachael

We used A & D diaper ointment on the skin “outbreaks” that were not actually broken skin (as in, we rubbed it on him like lotion).  We used the steroid cream on more severe outbreaks–baths were filled with Aveeno baby wash for sensitive  skin.  What actually worked the best was moving back out to AZ from PA–no heating = less dry kids!

Emma B
Guest
Emma B

Are you SURE this is eczema, and not thrush/yeast-based diaper rash? Have you tried a diaper cream which contains an antifungal cream?

The fact that it started suddenly at the time when a newborn appeared on the scene, and that it’s mostly happening in her diaper area, sounds really suspicious to me.

My son has eczema, which I treat with Curel Advanced and triamcinolone in the winter, but that mainly affects his arms and legs. He is also prone to yeast-based diaper rash, but that clears up with a compounded diaper cream that contains an antibiotic, an antifungal, and hydrocortisone. 

Ally
Guest
Ally

Thanks everyone! We did have her tested for allergies (everything we could think of) and she came back negative every time. Emma, we thought at first it was yeast. We had her one three different anti-fungals and it clearly wasn’t that. She gets it the worst on her diaper area, but it really is all over her. I’m going to try to find a new doctor to consult soon. I really appreciate all the suggestions and it’s just nice to know other parents have gone through this.

Babs
Guest
Babs

We also have a child who suffers, but can’t do any creams without breakouts…we use California Baby exclusively. Her issue was low adrenal function, which we treat with diet. I don’t think that’s your issue, but I wanted to express that excema seems to have a lot of root causes, so don’t give up. Our daughter was almost four before we found our solution, which includes a grain free diet, if you can imagine. Follow your gut. You will find a solution.

Stefanie
Guest
Stefanie

Oh, I know what you’re going through!  The bleeding diaper rash breaks my heart break every time I see it.  Not sure if you’ve tried this or not, but our ped recommended Hydrolatum, which has to be special-ordered from the pharmacy.  It’s not expensive and isn’t a prescription, but most pharmacies don’t keep it in stock so you have to have them order it.  It DOES have parabens (but not balsam of peru), but it works so well that when my daughter’s eczema gets really bad, that’s what we use.  For the bleeding diaper rash we use Aquaphor.  Our pediatrician… Read more »

Melissa
Guest
Melissa

My son is allergic to corn and eggs and his skin was a rashy mess until we figured it out. I would strongly recommend some allergy testing. We use more steroid cream than I’d like too, but my pediatrician said the over the counter strength wasn’t powerful enough to worry about.

Charity
Guest
Charity

My 9-month old son also have allergy-induced eczema (skin-tested positive for eggs) that was so bad at first, it got infected. We use a topical steroid regularly and my pediatrician also gave us the 2 weeks on, 2 weeks off recommendation. He gets coated in Cerave (in the tub) twice a day, baths every other day, and bleach baths once per week if needed. Despite being off eggs (well, I’m off eggs since he is breastfeeding), he still gets mild flare-ups if I miss a day with the lotions. He also gets breakouts from getting sweaty, and polyester bothers him.… Read more »

PinkTrees- Shanna
Guest
PinkTrees- Shanna

my son has eczema and the only 2 things that ever made it go away was moving to the desert (kuwait) and a medication that is still in the testing phase for FDA reason in the U.S called Quadriderme (a friend who is portuguese had her mom send some from portugal to me although its made in new jersey). we used triamcinolone for almost a year and it did nothing but turn his eczema and skin into an almost hide-like texture and darkened it. we had him tested for all allergens and found he was allergic to every tree, plant,… Read more »

Nicole
Guest
Nicole

My daughter had bleeding diaper rashes and bad acne as a baby… We traced it to a fructose intolerance through noticing her diet. So she doesn’t have an allergy that would show up, just an intolerance that causes flares. For the rashes what worked for us was dyprotex, but I don’t think it is made any more. I “made” that brand by applying a&d lotion first, and then destin on top of it. For some reason the destin actually hurts her if applied directly to her skin…

home remedies for bodyrash
Guest

Skin rashes are just the signal of an internal problem or external abuse. From eating processed and chemical laden foods to cosmetics to environmental pollutants to sunscreens and there seems to be an endless supply of things which can and do cause skin rashes of all kinds.

Olivia
Guest
Olivia

You might already be doing this, but be sure to pat her dry with the towel and not rub. Patting dry leaves more moisture in the skin and is less irritating. I don’t have that type of eczema (I have a different kind on my hands only), but I have always had extremely dry skin. Rubbing with a towel makes me itch like crazy, so I always pat dry and immediately slather on lotion.

Laura
Guest
Laura

My son has eczema…his first words were “itchy mama”. And I finally found a regimen that works for him. As much as the docs try to help, each kid’s skin can react differently (I am a nurse!) Personally, I do not like the idea of constant steriod cream use, there are side effects to it– it causes skin damage over time. I only use them when a flare-up gets bad- which rarely happens now that I have a regimen that works. I bathe him about every other day (no hot water, just warm), use mild soap, and I use Curel… Read more »

Laura
Guest
Laura

Oh, and I second the Oatmeal baths too — they really help my little guy. I will often bathe him just in that and no soap as long as he is not too dirty!

BJG
Guest
BJG

I have to second Amy’s suggestion about the food allergies. My oldest son starting developing horrible ezcema when he was about 5 months old – his entire body was covered in it. We tried many many lotions to try to fix it, opting for the steriod cream as a last resort. We were told by both the pharmacist, our doctor, and a family member who is a pediatrician that the steriod should be a last resort because it can thin skin overtime. BUT, I am NOT a medical professional. Anyway – the ezcema flare ups calmed down when we discovered… Read more »

Megan
Guest
Megan

Get an allergy test! She could be allergic to some of the treatments (like colloidal oatmeal baths) that are recommended.

We had great success with Robathol bath oil and Shikai brand Childrens Robathol lotion. But I think you willhave the best results with working from the inside out. Diet, diet, diet! And I would second the recommendation to talk to your pharmicist. Those steroids can cause thinning of the skin, excess hair growth….and brain tumors! Derms can tend to be more concerned with appearances than getting at the root of the problem.

Marcie Mom
Guest

Whenever a question on eczema comes out, there’re sure to be lots of advice! I run a support group for parents with eczema children and have a blog eczemablues.com where you can find tips on managing your children’ eczema.

I just want to say, find a doctor who is more than a PD (dermatologist or specialist in children clinic in hospital), get skin prick test, always moisturize and protect your baby’s skin. And don’t get too stressed over all the advice, you’re the best parent for your child, believe in that 🙂

angela
Guest
angela

I had a weird rash that was only on the sides of my trunk, from my armpits to my waist. It was slightly itchy and dry, and the doc said eczema. When I eliminated gluten, the rash disappeared in 3 days! When I ate gluten again, it came back. Stopped eating it again… gone in another 3 days! That was enough evidence for me. Food intolerances are very tricky to pinpoint though, and you have to have a supportive family for a food to be completely eliminated. But it’s worth it!

Clueless
Guest
Clueless

We have also had pretty bad eczema in the past. I have found that California baby products don’t cause as many problems as others. Also, out pediatrician says UV light can help a great deal (I have talked to others who got similar advice). This summer we attempted to balance UV exposure to help the eczema and protection for all of the very good reasons to avoid the sun and it did seem to help a lot. We do, however, have to use the steroid cream once a week or so but he is needing it less and less.

Eryn
Guest
Eryn

Also, SO not a medical professional, but I’m another adult who’s suffered from exzema since babyhood, and after years and years and creams, and doctors, and lotions, and doctors and creams and herbal remedies, and steroids and light treatments, I decided to cut gluten for a month, and buh bye exzema out breaks. Nothing officially confirmed, but if I slip and have a slice of pizza, there it is again. I will say that the skin where I was most frequently treated with steroids does seem to be thinner than everywhere else, and I really wish when I was young… Read more »

MAV
Guest
MAV

I know this may sound crazy but the Blue Lagoon in Iceland is supposed to be a miracle cure for ezcema. I realize you’re not going to take your baby to Iceland, but they sell products online and ship internationally. I was there last year and met some people who were there for treatment and they were astonished by the results. It is something to do with the silica in the geothermal saltwater. I don’t have eczema but my skin felt like a baby’s after soaking in the waters and doing the mud masks. I swear I don’t work for… Read more »