Best Zinc Oxide Diaper Cream

What does zinc oxide do in a diaper cream?

It is the active ingredient, and a federal rule says what that means. Zinc oxide diaper creams are over-the-counter drugs sold under FDA’s skin protectant monograph, which defines the category in one sentence. A skin protectant is “a drug product that temporarily protects injured or exposed skin or mucous membrane surfaces from harmful or annoying stimuli, and may help provide relief to such surfaces.” Zinc oxide is one of the active ingredients the rule lists, alongside petrolatum, lanolin, mineral oil and others that appear in these creams’ inactive lists. That is why every page here prints a Drug Facts panel with zinc oxide on top as the active ingredient, and why Triple Paste’s pages print “skin protectant” beside it.

The rule also fixes the warnings. A skin protectant’s label carries “for external use only,” “when using this product do not get into eyes,” and “stop use and ask a doctor if condition worsens, symptoms last more than 7 days or clear up and occur again within a few days.” The directions on all four pages are the same shape: change wet and soiled diapers promptly, cleanse the area and let it dry, apply liberally with each change and especially at bedtime. The rule describes a barrier, and so do the pages. What the cream does is sit between skin and a wet diaper.

Which strength is which page for?

The four creams split into two tiers, and the brands say what each is for. Triple Paste’s All-In-One is 12.8 percent, sold for “daily protection,” “prevention with every diaper change” and “mild to moderate rash.” Desitin’s Daily Defense is 13 percent, sold for everyday use. Triple Paste’s 3X Max is 40 percent, “3 times more zinc oxide than our Original diaper cream,” sold as “targeted treatment” for “moderate to serious rash.” Desitin’s Maximum Strength is also 40 percent, and its page says it “contains the maximum level of zinc oxide available without a prescription.”

This guide ranks within the everyday tier first, because that is the cream a household buys over and over, and because the two 40 percent pages say they are for a rash that has already arrived. Which tier a particular child needs is a question the pages answer only in their own words, and this guide does not add to them. Best Diaper Cream for Sensitive Skin ranks the same question by skin claims instead of strength, and Fragrance-Free vs. Unscented explains why the fragrance line on each page below is worth reading.

Our pick: Triple Paste All-In-One Diaper Rash Ointment

Triple Paste’s page says the most about the everyday cream it is selling. The Drug Facts panel gives 12.8 percent zinc oxide as the active and ten inactive ingredients, white petrolatum first. The page states “fragrance-free, paraben-free, talc-free,” calls the formula “hypoallergenic and safe for sensitive skin,” and says it is “awarded with the Seal of Acceptance™ by the National Eczema Association,” the one third-party mark any page here claims. The association’s own product directory lists both Triple Paste ointments. It is sold as a 2 ounce tube, a 3 ounce tube, and 8, 10 and 16 ounce jars, which is the widest run of sizes on this list.

One caveat. “Hypoallergenic” and “pediatrician recommended” are words the page uses without a test or a source behind them, and the seal is recorded as the brand’s claim, since the association’s directory could not be queried by exact product with the tools available.

Runner-up: Desitin Daily Defense Zinc Oxide Cream

Desitin’s Daily Defense is the other everyday cream, at 13 percent, and its page describes it as “fragrance-free, hypoallergenic, dermatologist-tested.” It publishes its full Drug Facts list, which runs to sixteen inactive ingredients, including aloe leaf extract, dimethicone and a preservative, where Triple Paste’s runs to ten. It is second because its record carries no certification claim and has not yet been checked for one, which the table above says plainly.

Also consider: Triple Paste 3X Max Diaper Rash Ointment

The 3X Max is Triple Paste’s 40 percent ointment, “made with 40% non-nano zinc oxide and a nourishing blend of oat extract, glycerin, and beeswax,” sold for “moderate to serious rash.” Its inactive list shows no fragrance, and it claims the same National Eczema Association seal as the All-In-One. The page makes no fragrance-free statement in words, which its record says rather than assumes. It comes in a 2 ounce tube, a 6 ounce tube and a 12 ounce jar.

Know before you buy: Desitin Maximum Strength Original Zinc Oxide Paste

Desitin’s Maximum Strength is also 40 percent zinc oxide and makes the plainest strength claim of the four, “the maximum level of zinc oxide available without a prescription.” Its inactive list includes cod liver oil, lanolin and beeswax, and it includes “Fragrance,” which is the reason it sits last. The page describes the paste as “hypoallergenic and pediatrician tested” and gives no scent family or intensity for the fragrance it lists. A household that wants the 40 percent tier without a fragrance has the Triple Paste above it.

What we left out

Boudreaux’s Butt Paste, in its 16 percent Original and 40 percent Maximum Strength, was read for this guide. Both pages publish a Drug Facts list and the same directions as the creams above, and neither states a package size, so there is no record to key a pick to. Burt’s Bees’ diaper rash ointment page could not be read with the tools available. Neither absence says anything about either product.

How we researched this

Every product fact in this guide comes from each brand’s own website, read on the date each record shows. Nothing was retrieved from a retailer listing. Strengths, inactive ingredients, fragrance statements and the words each page uses for its own tier are quoted from the manufacturer and are the manufacturer’s own claims; the one certification is recorded as a claim, since the issuer’s directory could not be queried by exact product with the tools available, and Desitin’s records have not yet been checked for one. FDA’s skin protectant rule is the source for what the category is and what its labels must say. Runlow has not tested any of these creams and makes no claim about how any of them performs on a particular child’s skin. No prices are shown. Every retailer link goes to a search results page for the exact product, not a specific listing, so it stays accurate regardless of what’s currently in stock. How many changes a day that cream has to cover is a question for the Diaper Calculator.