26 February 2019

5 tips to prevent incontinence-associated dermatitis

Nurses and caretakers are trained to look out for and manage dermatitis caused by incontinence. But how do you manage the situation if you only suffer from mild urinary incontinence?

Incontinence can have far-reaching effects on aspects of your daily life, like your self-esteem and normal routine. But, apart from that, it can also affect your skin.

Incontinence-associated dermatitis (IAD) is a term used to refer to inflammation of the skin caused by the frequent contact with urine (urinary incontinence) or stools (faecal incontinence).

The bacteria in urine or stools can gradually weaken the skin’s protective barrier. This leads to inflammation of the skin, which can cause a painful rash.

IAD is something caretakers and nurses are made aware of when they care for a bedridden patient with incontinence. But what about those who don't experience incontinence to the extent that they require diapers and aren't bedridden?

Even a tiny amount of urine can cause skin irritation. It is therefore important to watch out for any signs of dermatitis, which may include itching, burning, redness and a rash.

Here are five tips on how to prevent IAD:

1. Clean your skin as soon as urinary contact occurs

Urine that comes into contact with the skin weakens its protective barrier, and the longer urine stays in contact with the skin, the more likely it is that it will become irritated. Avoiding this is easier said than done as you don’t always have access to full washing facilities during the day. You can, however, pack the essentials in your work bag – ensure that you are fully stocked on unscented wet wipes and a barrier cream that will sooth, moisturise and fix the skin’s protective barrier.

If you are able to shower, wash with lukewarm – not hot – water and a gentle soap.

woman in shower

2. Maintain your skin’s pH level

To ensure a healthy skin, it’s important to maintain a slightly acidic pH level of 5.5. This helps to keep the skin’s acid mantle intact, allowing it to heal when damage occur. Soaps or shower gels that are too harsh or fragranced can strip the acid mantle. Use gentle, unscented soaps and lotions, especially around the areas that come into contact with urine and underwear.

Body lotion

3. Invest in absorbent pads

Products for urinary absorption are becoming more discreet and you shouldn’t feel embarrassed about using them. These will trap urine and minimise contact between urine and the skin. Use products that are specifically aimed at incontinence, as menstrual pads are not designed to absorb urine.

urinary incontinence pads

4. Choose underwear wisely

Wear clothes that will minimise friction on the skin. Natural, breathable fabrics such as cotton will also keep sweating at bay, which can worsen skin irritation.

cotton underwear on white background

5. Keep protecting the skin’s barrier

Use petroleum-based moisturisers or cream that contains zinc oxide to reduce any chafing, especially when you exercise. It's important to keep the skin moisturised to maintain its protective barrier. 

Woman holding tube of ointment

Image credit: iStock


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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