I tried every nappy rash cream that I could get my hands on. We had hours of nappy off time 'letting the skin breathe'. I used plain water for bum wiping, then I graduated onto using oats-soaked-in-a-sock to make skin-soothing water. At a very low point I even tried applying a paste of raw egg whites. Nothing helped.
Until I stumbled across this YELLOW Metanium cream. The purple-tube Metanium is for everyday use and doesn't help in a nappy rash crisis. DO NOT BUY THE PURPLE ONE. The yellow tube is for topical treatment of red, sore nappy rash - which in our household was caused by teething.
When babies are teething the huge quantities of extra saliva they swallow can actually cause their wee to become more acidic (and have a strange, pungent smell) - this can causes soreness of the skin in the nappy area.
If you use the yellow Metanium cream and the red nappy rash doesn't improve after just a couple of applications, then see your local pharmacist or GP as it is probably 'Thrush' - a red rash caused by yeast microbes. The pharmacist / doctor will prescribe an antifungal cream and the rash will clear up fast. Nappy rash due to Thrush will not get better on its own - even the wonderful yellow Metanium cream doesn't work on Thrush.
Now, after telling you how great the yellow Metanium is, I should balance up with warning you that it is a little tricky to apply. It will stain anything it touches - it is really hard to wash off hands and clothing (which is probably what makes it such a great treater of nappy rash!) I apply it by squeezing a pea-sized amount onto a piece of tissue / baby wipe and using that to rub over the affected skin. I find that yellow Metanium cream really dries my finger tips out (again this must be what makes it so effective in the clammy nappy region) so that's why I avoid getting it on my hands when applying it. Oh and because it is in a metal tube, the casing can crack and leak (staining everything yellow!) if it is carried around loose in the bottom of your changing bag. You have been warned...
Yellow Metanium cream is available from Boots, other chemists and from large supermarkets for about £3 for a 30g tube, which will last ages. Make sure you have some ready before teething-induced nappy rash strikes.