• The child has had this condition for more than 7 days, or treatment has not lead to improvement after 7 days.
• The child has another skin condition that causes the skin to be red or purplish.
• The child has an infection or signs of infection such as fever, nausea, vomiting, swelling of the lymph nodes, or fast heart rate.
• The affected skin is on a region of skin that dose not make contact with the diaper.
• The skin has been broken or is bleeding, oozing or secreting pus.
• The skin has an onion like appearance on any region.
• The child has symptoms such as constant fatigue, or excessive crying.
• Liver disease, HIV or immunosuppression (weakened immune system) from medications or from health conditions.