What to do in case of a nappy rash that bleeds?

The nappy rash, or diaper dermatitis, is an inflammation of the skin located on the buttocks, groin, and thighs. It is generally caused by prolonged exposure to moisture, by friction, due to wearing nappies or ill-fitting underwear, or by an allergenic substance, for example, a fragrance present in wipes or soaps. The nappy rash is characterised by the appearance of redness on the affected area, which can sometimes accumulate to form more or less extensive patches. In some cases, they are accompanied by flaking, itching, and burning sensations. Often affecting infants and children, the nappy rash is not serious in itself. However, in the absence of management, it can progress and become severe, leading to blisters, foul-smelling secretions, and sometimes bleeding. These are of course not comparable to a haemorrhage but they can last a few days and be a source of concern.

A nappy rash that bleeds is not to be taken lightly and requires a medical consultation.

Although nappy rash is a harmless condition in its early stages, this is not the case for a rash that has progressed to the point of bleeding. At this stage, it is too late to try to soothe it yourself. If you're dealing with a bleeding nappy rash, your only option is to consult a healthcare professional to obtain appropriate treatment. This could be a paediatrician if the bleeding nappy rash is affecting an infant, a general practitioner, or a dermatologist: the key is to seek medical advice.

Depending on the severity of the inflammation of the nappy rash, the doctor may prescribe dermocorticoids, such as 1% hydrocortisone, to reduce inflammation, as well as local antifungals (nystatin, clotrimazole, miconazole) if a candida infection is suspected. In the case of a bacterial superinfection, the application of a local antibiotic, such as mupirocin, may be necessary. A healing and protective ointment based on zinc oxide is also often recommended to promote skin repair and limit irritations due to contact with urine and faeces.

In addition to treatment, a rigorous hygiene routine is essential to allow the skin to regenerate and prevent recurrences. The area affected by nappy rash should thus be cleaned twice a day with warm water and a gentle cleanser, ideally without soap or fragrance, to remove all irritating substances. This cleansing is then followed by a thorough yet gentle drying, carried out by patting the skin with a clean towel. Of course, soiled nappies or underwear should be changed frequently to limit moisture, approximately every two hours, and, when possible, it is beneficial to leave the skin exposed to air to accelerate healing.