Incontinence-associated dermatitis (IAD) is a common form of irritant contact dermatitis caused by prolonged skin contact with urine. Moisturizing and restoring the skin barrier function are vital to treating IAD.
Incontinence-associated dermatitis (IAD) is a form of irritant contact dermatitis that can occur when the skin is in prolonged contact with urine. IAD is an inflammation of the skin, and it can affect the skin on both the upper thighs, abdomen, and the genital area.
IAD can cause redness, itching and pain in the skin, and, if left untreated, IAD can develop into lesions, blisters or even pressure sores and skin infections. IAD can cause considerable irritation and discomfort and be emotionally upsetting for those affected by IAD and their caregivers.
Who might get IAD?
IAD can affect anyone with urinary incontinence. The exact prevalence of IAD is unknown, but it has been suggested that almost half of all Americans who suffer from incontinence also suffer from IAD.
What causes IAD?
IAD is caused by a combination of chemical and physical skin irritation due to prolonged exposure to urine. The skin surface’s excessive exposure to moisture (urine) leads to skin maceration. Macerated skin is more prone to bacterial and fungal infections, as bacteria and fungus thrive in a damp environment.
The prolonged exposure to urine also causes a rise in the skin pH that weakens the skin barrier function. Urine contains the waste product urea and prolonged skin exposure to this urea in the urine causes a rise in skin pH, leading to a weakened skin barrier function. The skin barrier is the body’s outermost layer of protection against the surroundings. When the skin barrier function is weakened, the skin becomes more prone to injuries from friction and irritants.
How to manage IAD
As with other dermatological conditions, IAD often causes significant discomfort and reduced quality of life. It is a painful condition that may burn and itch. It also increases the risk of severe skin infections with, for example, the fungi candida albicans and the bacteria staphylococcus aureus.
Treatment of IAD is challenging, and the condition often recurs. Key strategies are cleansing, moisturizing, and restoring the skin barrier function. Fortunately, many new skincare products combine moisturizing and restoration of the skin barrier and may have added ingredients that soothe itchy skin.