What is Incontinence-associated dermatitis?

Incontinence-associated dermatitis or IAD is the redness and irritation of the skin when it is continuously in contact with irritant agents or substances like urine or stool. When the surface meets excessive moisture that compromises the skin protection or barrier, it becomes prone to irritations like IAD or if not taken care of, to possible significant infections.

This IAD or inflammatory skin condition associated with incontinence is particularly prevalent in elders. It usually affects the thighs (upper part), genital areas and lower back side (the bottoms). The commonly affected area, known as the perineal area, is why IAD is sometimes also called perineal dermatitis.

Due to incontinence associated dermatitis fungus can develop around the genitals or vaginal area causing skin irritation, mostly around those delicate areas where the skin folds and where the skin is in contact with urine or stool. A common cause of IAD is secondary candidiasis (noninvasive skin infection) which occurs due to the friction of the skin when in contact with those irritant substances and due to the often use of disposable or reusable plastic/absorbent underwear, briefs or adult diapers.

This incontinence associated dermatitis or skin irritation is caused by the epidermis loss due to long periods of urine or stool exposure, also after scratching on those affected areas where the skin is in contact with the irritating substances.

It can be detected as redness, inflammation, itching or burning of the skin in those areas in constant contact with urine and stool and where the diapers or briefs touch the surface.

The continuous pressure on blood supply tissues and friction (shear) cause skin irritation when exposed to urine or stool. That constant skin rubbing in opposite direction when walking or moving or the slight pressure or contact between the wet area and underwear or diapers are a common cause of Incontinence-associated dermatitis.

The barrier that protects (separates) our body from the environment and any external agent is our skin. That is why it’s so important and vital to take good care of it and keep it clean, moist and hydrated, also protected and dry in this incontinence cases, so irritation (IAD) or infections won’t occur.

This IAD is common among urine or fecal incontinence patients, and it can worsen if the skin is not taken care of when it comes to patients that have to stay in bed for more extended periods of time due to immobility issues.

To help avoid and prevent skin irritations and IAD the patients’ perineal area should be cleaned on a daily basis and after every incontinence episode to keep it dry and free from irritants substances. Cleaning the area with soft circular movements and keeping the skin moisturized, with skin barrier protection and clean and dry absorbent briefs.

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