Best For Sensitive Skin: Desitin Maximum Strength Baby Diaper Rash Cream

Let’s talk diaper rash creams.

We rank diaper rash in varying degrees of severity—think of it like fires. There are minor fires. And then you have the three and four alarm files.

Desitin has helpful a helpful graphic (see below) to illustrate the different severity levels of diaper rash.

In this article, we offer our recommendations for diaper rash based on severity: moderate, severe and very severe.

After testing 13 over-the-counter diaper rash remedies on actual baby butts and consulting with pediatricians who fight the diaper rash battle every day, we pick Destin’s Maximum Strength Original Paste as the best for moderate diaper rashes on babies with sensitive skin.

Around for over 40 years, Desitin is a diaper rash cream that often tops pediatrician surveys for diaper rash creams. Our informal poll of pediatricians also confirmed Desitin is still among the top diaper rash creams recommended to parents.

Desitin comes in several varieties: Rapid Relief Cream, and Maximum Strength Original Paste. Maximum strength has a whopping 40% zinc oxide, beating out Balmex and other zinc oxide options.

Based on reader feedback, Desitin is probably best used when the rash is getting out of hand (moderate to severe) and your baby has sensitive skin.

What is the downside to Desitin? Desitin isn’t called “paste” for nothin’!

It is stickier than Balmex—and that makes it harder to apply, in our tests. And the smell? Well, let’s just say it funkier than Balmex. But Desitin is excellent and earns our recommendation for its overall effectiveness.

Best For Severe Rashes: Boudreaux’s Butt Paste Maximum Strength

Sometimes, you have to bring in the big guns. If your little one’s diaper rash goes from mild to severe overnight, we suggest the oddly named but potent Boudreaux’s Butt Paste. Based on our testing, it works effectively to stop severe diaper rash. Boudreaux is available in three formulas, including maximum strength with 40% zinc oxide (which is what we are recommending for this article).

Boudreaux’s ingredients are simple. The original formula contains:

• Zinc oxide (16%). The maximum strength has 40% zinc oxide.
• Castor oil.
• Mineral oil.
• Paraffin
• Peruvian Balsam
• White Petrolatum (petroleum jelly).

The Natural version switches out the mineral oil and petrolatum and adds aloe vera, beeswax, carnauba wax, citric acid, and hydrogenated caster oil. It’s pricier than the regular version, however.

The only complaints we hear are that Butt Paste itself is an unappealing beige color (like putty) and a few babies have had a skin reaction to it, based on reviews posted to parenting message boards.

Best For Quick Relief: Aquaphor Baby Diaper Rash Paste

This diaper rash cream is relatively new to the market—and our readers tell us it is a winner.

Aquaphor combines a mix of 40% zinc oxide with shea butter . . . and the result is a diaper rash cream that quickly knocks down the rash and soothes skin. We would also recommend this for babies with sensitive skin, as it is fragrance and paraben free.

The downside? It is somewhat pricey per ounce when compared with other creams on the market.

Best For Moderate Rashes: Balmex

Balmex Diaper Rash Cream is our choice as the best cream for moderate diaper rash.

The best diaper rash creams create a moisture barrier that keeps baby’s skin from being irritated (moisture + diaper + skin = diaper rash). After testing, we believe the best diaper rash cream is more creamy than sticky, making it easier to apply.

Balmex contains one of the most effective moisture barriers: zinc oxide. Balmex has 11% zinc oxide as its active ingredient plus inactive ingredients like beeswax, mineral oil and microcrystalline wax. Balmex also claims one special ingredient: evening primrose extract, which the company claims helps “inhibit enzymes in stool that are known to irritate skin.”

Balmex is priced reasonably and comes in jars up to 16 oz. or tubes sized for carrying in your diaper bag.

Does it work? Our readers swear by it, according to our message boards and email feedback. Parents tell us they like the creamy texture; it’s not as sticky as many other zinc oxide diaper rash cream—and we would agree with this after road-testing several diaper rash creams ourselves for this article. The scent isn’t bad either.

Best For Very Severe Rash: Triple Paste

Triple Paste Medicated Ointment is a life saver, said our testers that had to knock out severe diaper rash. This is the go-to product if you have severe diaper rash and nothing else seems to work.

This cream uses cornstarch as a drying agent. It has 12.8% zinc oxide, which is less than other severe diaper rash creams that top out at 40% zinc oxide. Our testers said they liked the cornstarch and reduced zinc oxide formula, which they felt was effective yet gentle.

Why Trust Us

We’ve been rating and reviewing products for the home and families since 1994. We do extensive research, evaluating products with an eye toward quality, ease of use and affordability. When we purchase a product for hands-on testing, we do so with our own money. 

Here’s another key point: we don’t take money from the brands we review. No free samples, no sponsors, no “partnerships.” Our work is 100% reader-supported!

How we picked a winner

We evaluate diaper rash creams and ointments with hands on inspections—yep, we squirted this stuff on a boatload of baby butts. Since you have to spackle this stuff on like frosting on a wedding cake, the best diaper rash creams have to be easy to apply without being too sticky. Scent and consistency also played a role in our rankings—the less scent, the better.

We also gather significant reader feedback (our book, Baby Bargains has over 1 million copies in print). Besides interviewing parents, we also regularly talk with pediatricians and dermatologists to see which brands are most trustworthy. For example, our warning about possible allergic reactions to “all natural” diaper rash creams that contain lavender came after we discovered reports of such reactions among pediatricians.

7 Things No One Tells You About Diaper Rash Cream!

1. Don’t let your baby sit in a dirty or wet diaper.

The most common cause of diaper rash is irritation from sitting in pee or poop. You can easily check a disposable diaper for pee by pinching it to see if it’s wet. And we all know babies usually poop during or after eating. Stay on top of it, especially with toddlers who may not like to be interrupted during play. Better an interruption than a case of painful diaper rash.

2. There are a variety of causes for diaper rash besides just contact with urine and poop.

These include bacterial or yeast infections, new foods in the diet, antibiotics, irritation from wipes or detergent, and already sensitive skin (eczema for example).

This is an important take-home message: while your garden-variety diaper rash is caused by a baby who sits too long in pee or poop, there can be more serious infections caused by bacteria or yeast. More on this in a minute.

3. Apply a barrier cream or ointment.

First, clean the area well with warm water or a diaper wipe. Allow baby’s bum to dry, then apply a thick barrier to the entire rashy area. Replace with a clean diaper. See above for our top picks for diaper rash cream.

A good piece of advice from the Mayo Clinic website on diaper rash: “Don’t try to scrub off this protective layer completely at the next diaper change, as that could hurt the skin more. If you do want to remove it, try using mineral oil on a cotton ball.”

4. Air out your baby’s bum.

Don’t rush to put baby back in a diaper if you don’t have to. Let them hang out au naturelle for a bit. Some parents will even use a hair dryer on the coolest setting to dry baby’s skin before re-diapering.

5. Avoid powders.

Yes, you may have seen babies get “powdered up” with talcum or cornstarch powder, but that practice is a thing of the past. Doctors warn that babies can inhale the powder, leading to breathing problems and other health concerns. Bottom line: no baby powder.

6. Some “natural” solutions do work.

Try aloe vera or lanolin (you may have some left over from nursing). One suggestion: Corona Ointment, which is made of lanolin. Dr. Ari Brown, pediatrician and co-author of Baby 411, notes that even though Corona Ointment is made for horses, the ointment’s active ingredient (lanolin) has worked well for her patients. It’s relatively inexpensive and Corona’s 14 ounce jar is also handy, compared to lanolin designed for babies that usually comes in one ounce tubes.

7. If over-the-counter remedies don’t work, see your doctor to call in the big guns.

“Not working” means your baby’s rash doesn’t get better after a few days using an over-the-counter cream like the ones we recommend above. Or the diaper rash gets more severe, bleeds or oozes, causes pain when baby pees or poops—or if baby has a fever. These are red flags—it’s time to call your doc.

When treating diaper rash, the natural assumption is baby’s diaper rash is caused by pee and poop in contact with skin. But if barrier treatments don’t improve the situation, you should check in with your doctor to see if the rash is caused by yeast infection or bacterial infection. Your doc may suggest a prescription medication to clear it up.