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Parents and caregivers should call a doctor if a bright red diaper rash lasts longer than 48 hours or is accompanied by a strong odor of urine, which may indicate dehydration (Cincinnati Children's Hospital, 2012).
1 Friction: Most diaper rash is caused by friction that develops when sensitive baby skin is rubbed by wet diapers. 2  This results in a red, shiny rash on exposed areas. 3  Irritation: The skin under the diaper gets red from irritants such as feces, urine, or cleaning agents.he rash is located on skin underneath the diaper area. The skin is red and irritated. It may appear all over your baby's bottom or genital area, or only in certain places. It may or may not involve the folds of the skin.