Doctors, dermatologists and paediatricians have advised parents to avoid using steroid creams to treat diaper rashes in children, warning that application of such creams in the presence of a fungal infection could worsen the skin condition.
Instead, parents are advised to use zinc-based creams to help treat diaper dermatitis, while ensuring that nappies are changed regularly and promptly, children are kept clean and dry, and good-quality diapers are used.
“The misuse of steroids is a huge problem currently,” Prof. Atiya Rehman said while giving a talk on misuse of steroids in a session titled ‘Beyond the Itch: Evaluation and Management of Intractable Pruritus in Children’ at the ‘1st Derma Summit Karachi’.
She said parents should avoid rushing to use steroids, and must first make the proper diagnosis and then move towards the solution as per doctors’ recommendations.
She gave the example of a school-going boy who was having recurrent lesions (like sores, blisters or rashes) for about a year and a half. He would apply a combination cream, which was made up of a topical steroid and an antifungal, the benefits of which remained temporary. “When he discontinued, the lesions recurred,” Prof. Rehman said.
“This is a case of tinea incognito. In Karachi, with the hot, humid weather, fungal infections are rampant,” she said.
Talking to Business Recorder on the sidelines of the conference, Prof. Dr Mohsina Noor Ibrahim, Head of Department at the National Institute of Child and Health (NICH) said parents should use creams only after qualified doctors prescribe it.
“Parents may use zinc oxide creams to help treat nappy rashes. Steroids are not a general remedy for every type of skin rashes.”
Children are different from adults and are prone to a range of skin conditions that require age-appropriate diagnosis and treatment. As the skin is the body’s largest organ, dermatologists say it is important that children’s skin problems are properly diagnosed and treated by qualified medical professionals, she added.
Doctors at the conference emphasised that preventing prolonged contact with moisture and irritants, maintaining the skin barrier and using zinc-based protective creams are safer first-line measures for uncomplicated nappy rash, while persistent or worsening rashes should be evaluated by a qualified medical professional rather than treated with steroids.
Dr Aisha Ghayas, Consultant Dermatologist at King Edward Medical University, Mayo Hospital, Lahore, said diaper dermatitis was very common, affecting children from newborn age through the early years when diapers are still being used. She explained that prolonged exposure to urine, stool and moisture, delayed diaper changes, poor-quality diaper material and a weakened skin barrier can all contribute to inflammation.
According to her, the diaper area is particularly vulnerable because it is humid and remains covered for prolonged periods, creating conditions that can cause fungal growth. A rash that appears to improve after steroid application may become worse if an underlying candidal infection is present. She also cautioned that the skin in the diaper area is delicate and relatively thin, meaning steroid-related side effects can develop more quickly there.
She advised parents who cannot immediately access a doctor not to use steroid creams indiscriminately or for prolonged periods. If a steroid is prescribed, it should be used strictly according to medical advice.
Dr Ghayas stressed the importance of protecting the skin barrier. Petroleum jelly or an appropriate moisturiser can help maintain healthy skin, while zinc-based creams have protective and anti-inflammatory properties and can help repair and shield the skin from irritants.
“If a rash does not improve promptly, medical assessment is needed, particularly if it persists for 48 hours or appears to worsen,” she said.
Dr Bhajan Lal Matlani, Consultant Dermatologist from Sehwan Sharif and Dadu, Sindh, said even mild, topical steroids can cause complications when used incorrectly, particularly on the delicate skin of the diaper area.
For uncomplicated diaper rash, zinc-based barrier creams can help protect the skin and support healing. Products containing zinc, such as Peds Cream, may be used according to the product directions or a doctor’s advice.
Zinc helps create a protective barrier between the skin and moisture and may also help reduce irritation. It does not carry the same risks associated with inappropriate or prolonged use of topical steroids.
Zinc-based oral medication is also recommended for children suffering from diarrhoea. Zinc supplementation in diarrhoea can support recovery and is recommended according to established paediatric guidelines. It should not, however, be confused with the topical use of zinc oxide creams for diaper rash, he said.
Copyright Business Recorder, 2026
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