How to Prevent Incontinence Associated Dermatitis

How to Prevent Incontinence Associated Dermatitis

  • On August 6, 2018

Incontinence associated dermatitis (IAD) is not a condition that is commonly spoken about. Even individuals with incontinence are often unaware of the causes and symptoms.

When discussed, incontinence associated dermatitis is often called “diaper rash”, “moisture lesions” or “perineal rash”. The condition is actually a well-recognised risk factor for pressure ulcer development. It can be defined simply as an inflammation of the skin that occurs when urine or stool comes in contact with the perineal or peri genital skin. As there is a large number of patients affected, IAD resents a huge financial burden for healthcare systems. It is estimated that prescriptions for barrier products cost the UK £3.27 million each year.


Are you worried you have incontinence? Read our advice blog to find out which incontinence symptoms you shouldn’t ignore.


How Urine and Faeces Affects the Skin

Individuals with both faecal and urine incontinence are the most at risk of developing IAD. Skin inflammation, overhydration of the epidermis and increase in skin PH are the main causes of incontinence associated dermatitis. The skin acts as a barrier between internal and external environments. It protects the body from exposure to irritants and toxic materials. Constant contact with moisture from urine and faeces compromises the efficiency of the skin’s moisture barrier. The urea in urine can be broken down by the skin bacteria to form a highly alkaline ammonia, shifting the PH of the skin to disrupt the barrier. The excessive moisture from faeces and urine can also overwhelm normal moisture regulation, leading to overhydration and disruption of the stratum corneum structure, which may present as maceration. Beekman and colleagues (2011) evaluated 141 nursing home residents with both urinary and faecal incontinence and reported a 22.5 prevalence rate. Inflammation is another common cause of Incontinence Associated Dermatitis. When the skin is frequently exposed to moisture, it can become inflamed. It is thought that having a poor skin condition and a fever are also risk factors for incontinence associated dermatitis.


What are the Symptoms of Incontinence Associated Dermatitis?

It is important to know how to differentiate between IAD and other causes of skin damage. Incontinence Associated Dermatitis often affects the labia in women and the scrotum in men. It can also affect the inner thigh and buttocks in both sexes. Inflammation follows areas of skin exposed to urine or stool and the borders of the inflamed skin are irregular. While IAD causes brighter red inflammation of affected skin, darker red discoloration of the skin or a purplish discoloration can indicate deep tissue injury. The inflamed skin glistens or appears to have a glow under direct lighting, which is associated with damage to the skin’s moisture barrier. In lighter skin tones, IAD appears initially as erythema which can range from pink to red. In patients with darker skin tones, the skin may become paler, darker, purple, dark red or yellow. The affected area often has poorly defined edges and may be patchy over large areas. In the most severe cases, erosion of the epidermal and dermal layers of the skin occurs. When incontinence associated dermatitis is ignored, it can lead to excoriation and skin breakdown, which may become infected by the skin flora. Moisture lesions on the skin can vary in size, colour and shape. Due to the underlying inflammation, areas of IAD where skin intact may feel warmer and firmer than the rest of your skin.


Maintaining a Good Skin Care Routine

Keeping a good skincare regime is essential, as it protects vulnerable skin. As bacteria thrive in a warm, moist environment, it is important to ensure the skin is clean and dry. A major function of healthy skin is the maintenance of a physical barrier against the external environment. Soap can actually affect the PH level of the skin, increasing the risk of bacterial and fungal colonisation. Friction from cleaning skin then drying it can also be harmful. You therefore need to use special incontinence cleansing products. A structured skin care regime comprises three elements: cleansing the skin, application of a moisturizer and application of a skin protector. This barrier prevents the entry of harmful substances and pathogens, and provides a well-developed immunological defence mechanism. Cleansing the skin of the perineal region should involve a product whose PH allows the maintenance of an acid environment, with the PH value between 5.4 and 5.9. You can purchase many products such as foams and milk that provide an effective alternative to traditional methods. Incontinence cleansing wet wipes feature a moisturising composition that deodorises skin an d fights bacteria. Bed bath wipes also offer a method for cleansing all parts of the body for individuals with delicate or sensitive skin. Alternatively, dry wipes that have not been pre-moistened provide effective cleaning by wetting with warm water. You can also use dry wipes alongside your choice of cleansing foam. Most skin cleansers in the market are designed to match the PH of the skin, thus not stripping it of sebum. Skin subject to constant humidity requires other care, which consists of applying a moisturizer and a barrier cream. In the presence of faecal matter, it is advisable to wash the region with warm water and dry the skin well before application of a washing product.


The following products are popular choices for managing Incontinence Associated Dermatitis:


Clinisan Skin Cleansing Foam 400ml

-Gentle moisturising skin cleansing foam

-Fast solution to protecting and conditioning the skin

-Ideal for sensitive skin


You can purchase Clinisan Skin Cleansing foam here.



Clinisan Bodywash Advance 500ml

-Works as a cleanser, hair shampoo and bath foam


-Contains emollients and chlorhexidine for killing bacteria




Shop Clinisan Bodywash Advance now for an effective bodywash and cleanser.



Tena Wash Cream

-Replaces soap and water

-Cleanses, restores and protects delicate skin

-Surfactant-free emulsion



You can purchase Tena Wash Cream here.


Tena Wet Wipes



-Alcohol free


You can buy Tena Wet Wipes here. 



Are you unsure of which type of incontinence wipe is for you? Read our Guide to Choosing Incontinence Wipes for tips and advice.


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