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Incontinence Associated Dermatitis Risks & Prevention

written by: Leigh A. Zaykoski • edited by: Leigh A. Zaykoski • updated: 2/28/2010

Incontinence associated dermatitis occurs due to frequent skin exposure to urine and feces. Without proper treatment, this condition will rapidly deteriorate into something more serious.

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    Dermatitis is an inflammation of the skin that occurs due to exposure to an irritant. Skin affected by dermatitis may develop redness and blisters, with itchy skin one of the major symptoms of this condition. Incontinence associated dermatitis results from constant exposure to urine and feces. This condition is much more serious than a simple case of diaper rash.

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    Prolonged exposure to urine and feces occurs in several different groups of people. Elderly people with bowel and bladder incontinence may wear adult diapers, resulting in exposure to urine and feces. Disabled people with bowel and bladder problems may also require adult diapers or incontinence pads, creating a moist, warm, and irritating environment for the skin around the anus and genitals. Dr. Mikel Gray indicates that exposure to soiled incontinence products raises the pH of the skin and also increases the amount of perspiration produced in these areas. Friction also contributes to the development of this skin condition.

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    Visual characteristics of incontinence associated dermatitis lead to proper diagnosis. While burning and itching cause problems for patients affected with this condition, doctors do not use them as diagnostic criteria. Characteristics of this condition include the following:

    • Signs of inflammation in the folds of the skin
    • Erythema (redness) of the skin that is a very bright red
    • Skin erosion

    Patients with this condition often have yeast infections of the skin and have a greater risk for pressure ulcers.

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    Pressure ulcers can develop with continued irritation and moisture of the perianal and perigenital skin. Pressure ulcers, also called bed sores, result in the breakdown of the skin. These sores occur due to constant pressure and moisture on the skin. Several groups of people have an increased risk for bed sores. They include people with fragile skin; people who spend a lot of time in wheelchairs; people with diabetes and vascular diseases; people with mobility issues; people with mental disabilities; elderly people; and people with urinary and fecal incontinence.

    Medical professionals classify pressure sores by their severity. Stage one pressure sores consist of reddened areas of the skin that do not whiten when they are pressed. Stage two pressure sores consist of an open sore in the skin, with red skin around the opening. Stage three pressure sores have a crater-like appearance due to the breakdown of the skin. Stage four pressure ulcers extend deep into the body’s tissues, affecting the muscles, tendons, bones, or joints.

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    Prevent dermatitis related to incontinence by taking several precautions. Change adult incontinence products frequently to prevent prolonged exposure to urine and feces. Wash the skin around the anus and genitals thoroughly to prevent the accumulation of bacteria and digestive enzymes. Consult a physician about further steps you can take to prevent this problem.

    You can also prevent bed sores related to this condition. Make sure you change position at least every two hours to avoid putting prolonged pressure on the skin. Use medical supplies designed to reduce skin pressure, such as foam pads and pillows. Use skin-protecting creams that create a barrier between the skin and areas of pressure. Taking these steps will reduce the risk of developing pressure ulcers.