Incontinence

Updated 10 May 2018

How to manage dermatitis associated with incontinence

Adult diapers can increase the risk of developing incontinence-associated dermatitis.

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People who have incontinence may experience incontinence-associated dermatitis (IAD) at some point. 

IAD occurs when moisture from urine or stool remains on the skin, causing the tissue to break down. This can be a painful and costly situation as well as difficult to identify, which increases chances of infection and chronic wounds.

Diagnosis and immediate treatment are important when dealing with IAD.

What exactly is IAD?

The condition is caused by inflammation of the skin when the area around the anus or genitals is exposed to urine or stool for long periods of time. The American Journal of Clinical Dermatology explains how elderly people – particularly those living in long-term care facilities – are at a higher risk of both incontinence and this irritating condition. 

IAD is often confused with pressure ulcers and other skin conditions, but the growing amount of research in the field is making it easier for doctors to diagnose the condition more accurately and efficiently. 

How does IAD happen? 

It was previously believed that the moisture from the urine and stool were the cause of the dermatitis occurring around the genitals and anus area. Further research, however, has proved this theory false. It has been proven that what actually causes the skin condition is what is contained in these fluids. The alkaline substances in urine, for instance, damage the tissue of your skin, making it more vulnerable to abrasion.

Symptoms of IAD include:

  • Itchy skin
  • Burning sensation 
  • Pain
  • Tender and warm skin
  • Redness and inflammation of the skin

If you are experiencing any of these symptoms, speak to your doctor as soon as possible. They should ask about your incontinence in order to diagnose your skin condition properly. Symptoms can be unclear at times; it is therefore important to rule out certain conditions that have the same symptoms as IAD:

How can it be treated? 

  • Change your absorbent pads/diapers regularly, even if they are dry, in order to maintain good hygiene. Typically people use four to six pads daily.
  • Wash the area with a cleanser that balances your skin’s pH level.
  • Properly moisturise your skin, use hydrogel or petroleum-based products to protect your skin. 
  • Your doctor may be able to recommend a product that cleanses, moisturises and protects simultaneously. 

If you’ve developed any infection as a result of IAD, your doctor may have to prescribe an antifungal or oral antibiotic medication. 

In order to manage IAD, there needs to be proper management of incontinence. Make sure you consult your doctor to discuss management strategies for both conditions. The only way to reduce your risk for IAD is to be diligent in your treatment plan. 

Image credit: iStock

 

Ask the Expert

Incontinence Expert

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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