Help! Why Does My Baby Have Bleeding Diaper Rash and what Can I Do?

When you prepared yourself for being a parent, you probably thought about changing dirty diapers, maybe even with a little dread. (How early can I potty train?) But what you likely didn’t imagine was bleeding diaper rash.

Trust us — you’re not the first parent to see blood in your baby’s diaper, and you won’t be the last. It may cause panic, but don’t worry — we’re going to help you get to the bottom (pun intended) of your baby’s bloody diaper rash.

Causes of bleeding diaper rash

Diaper rash — or diaper dermatitis, in medical terms — is usually the result of a combination of:

• moisture from urine and poop
• friction from a diaper
• irritation to a baby’s super- sensitive skin

Sometimes, when bleeding is involved, your baby may have bacteria or fungus living on their skin that’s causing severe irritation.

Let’s look at some of the possible causes so you can move forward with the right treatments.

Irritants or allergies

What it is: Diaper rash caused by either irritant and allergic dermatitis is fairly common.

• Irritant is the type of diaper rash your baby gets when their skin gets irritated from stool or pee or due to how the diaper rubs against their skin.
• Allergic is when they have a reaction to the diaper itself, wipes used, or moisturizers applied to the skin.

When you’ll see it: Diaper dermatitis of either type usually rears its ugly head between about 9 and 12 months of age.

Where you’ll see it: It usually causes irritation and redness on areas where the diaper rubs the most against your baby’s skin, like the insides of their thighs, the labia (girls) or scrotum (boys), or the lower belly. You may see little bumps that bleed, redness, and scaling skin in these areas. Allergic dermatitis looks different because it’s usually all over where the diaper touches. With both of these types of rashes, the skin folds, such as the thigh creases, are less affected.

Candida infection

What it is: A Candida albicans infection is basically like diaper rash invited yeast to its party. Candida yeast loves to grow in warm, wet places like your baby’s diaper. Let’s consider this guest uninvited.

When you’ll see it: Your baby’s diaper rash may start out as mild, then start to get really red and irritated over the course of a few days.

Where you’ll see it: Candida infections usually cause red, moist, and sometimes bleeding areas around the thigh folds and sometimes between the buttocks. Then, you’ll see red dots (pustules) that seem to radiate from the red areas.

Infantile seborrheic dermatitis

What it is: And you thought cradle cap was just on the head! Sorry to say that infantile seborrheic dermatitis (what most docs call cradle cap) can go to the diaper area and skin folds, too.

When you’ll see it: This usually rears its ugly head in the first few weeks after your baby is born.

Where you’ll see it: Babies with seborrheic dermatitis usually have pink- or yellow-colored scales on their inner thighs and lower bottom. Sometimes, the scales are just below their belly button. They usually aren’t itchy, but in rare cases the irritation to the scaly areas can cause bleeding.

Psoriatic diaper rash

What it is: This is an inflammatory skin condition that can cause itchy plaques that may bleed.

When you’ll see it: Psoriatic diaper rash can happen at any time in diaper- wearing babies.

Where you’ll see it: Psoriasis in babies almost always involves the folds of their skin. This includes their thigh folds and butt crack. You may also see red, angry-looking psoriasis plaques on other parts of their body like the scalp, around the belly button, and behind the ears.

Bacteria

What it is: Bacteria, like Staphylococcus (staph) and Streptococcus (strep), can cause diaper rash.

When you’ll see it: These bacteria can cause illness throughout childhood — so bacterial diaper rash can happen at any time during your baby’s diaper-wearing years. It’s more rare than a yeast diaper rash, though.

Where you’ll see it: These bacteria tend to thrive in the warm, moist environment of your baby’s diaper area and rarely spread beyond. The rash may appear as yellow scabs or sores, possibly with draining pus. In particular, perianal strep rash — a rash found around the anus — can bleed.

Langerhans cell histiocytosis

What it is: This is a really, really rare cause of bleeding diaper rash. The condition occurs due to an excess of Langerhans cells (immune system cells in the outer skin layers) that cause lesions that commonly bleed.

When you’ll see it: The condition usually occurs at any time from birth to age 3.

Where you’ll see it: This causes lesions in skin folds, right around the anus or in the thigh-meets-groin fold. A baby can have yellow or reddish-brown crusts that bleed.

Treatment and prevention of bleeding diaper rash

Your main goal when treating bleeding diaper rash is to keep your baby’s booty as dry as possible. You can help heal the rash — it just may take some time and dedication to your baby’s backside.

Treatments for bleeding diaper rash are also often preventatives for future outbreaks. Here are some at-home treatments that also help prevent diaper rash:

• Change baby’s diaper as soon as they’re wet and especially after they’ve pooped. This may mean changing your baby’s diaper once a night, even if they’re already in the sleeping-through-the-night stage.
• Leave the diaper off for a while before putting one back on, so your baby’s skin can dry. Let your baby have “tummy time” naked on a towel.
• Don’t put the diaper on too tight. Super-tight diapers increase friction. When your baby takes a nap, you can place them on a towel or loosely put on a diaper so their skin can dry. This makes yeast less likely to come around.
• Refrain from using baby wipes or switch to ones for sensitive skin. Sometimes, these wipes have added fragrances or cleansers that make diaper rash worse. Instead, try a soft wash cloth with water alone. If the stool is really hard to remove, you can use mild soap.
• Apply ointments at every diaper change to reduce irritation. Examples include zinc oxide (Desitin) or petroleum jelly (Vaseline).
• Wash cloth diapers in hot water with bleach and rinsing well to kill off unwanted germs. Another option is to boil the diaper for 15 minutes in hot water on a stove to ensure the bacteria is gone.
• Soak your baby’s bottom in a combination of warm water and 2 tablespoons of baking soda 3 times a day.
• Apply an over-the-counter antifungal ointment like Lotrimin (with your pediatrician’s OK) to the rash if it’s yeast related.

Usually, you can expect to see some improvements in about three days after you start treating your baby’s bleeding diaper rash. Be sure to enlist other caregivers, such as those at a nursery or day care, to keep the prevention game plan going.

When to see a doctor

Sometimes, you need to call your child’s pediatrician before treating bleeding diaper rash at home. Call right away if:

• Your baby also has a fever.
• The rash seems to be spreading to other areas of their body, like their arms, face, and head.
• Your baby is starting to develop larger, irritated ulcers on their skin.
• Your baby can’t sleep due to irritation and discomfort.

If you feel like you’ve tried everything, but aren’t seeing any improvement in your baby’s bleeding diaper rash, call your child’s pediatrician. They may need to prescribe stronger oral or topical medicines to get the rash wiped out for good.

The takeaway

Diaper rash is very common in babies, and sometimes the irritation is severe enough to bleed. It’s important that you don’t blame yourself if this happens.

Taking steps to change your little one’s diapers frequently and keep them dry can help to prevent future diaper rash incidences. If things don’t get better after about three days of at-home treatments, it may be time to call your child’s doctor.

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