How do I Prevent or Manage Incontinence-Associated Dermatitis?

You can use the same steps for both IAD prevention and management.

Use the acronym A-C-P-R-O to guide you along. You can discuss with your doctor or nurse to learn more.

A – Assess

Check for IAD at all skin at risk of, or in contact with urine and/or faeces (eg: genitals, groins, buttocks and nearby skin folds).

Check skin condition:

• Daily
• When changing incontinence aids.
• When cleansing the skin.

C – Cleanse

Use skin cleansers that are specially formulated for incontinence cleansing.

• "No-rinse" reduces skin trauma from repeated washing and drying.
• "pH-balanced" preserves your skin's natural acidity, which is important for maintaining healthy skin.
• Soft non-woven disposable wipes reduce skin trauma and improve hygiene.
• Avoid cleaning with regular soap often depletes skin acidity, while using water alone can cause swelling, worsening IAD.
• Avoid using non prescribed oil based cream or lotion.
• Cleanse your skin gently at least once per day, and after every episode of incontinence.

• For females: Clean from front to back in one direction, avoid cleaning back and forth to prevent urinary tract infection.
• For males: Retract foreskin (if uncircumcised) and clean from the tip of the penis to the back in one direction, avoid cleaning back and forth to prevent urinary tract infection.
• Dab dry the skin thoroughly after cleaning.

P – Protect

• Apply a thin layer of skin protectant over all skin at risk of contact with urine and/or faeces after cleansing. Skin protectants are products which form a barrier between your skin and incontinence waste to prevent IAD. This barrier prevents further injury and allows the skin beneath it to recover.
• Use sliding sheet when positioning to prevent friction and shear.
• Regular repositioning to relieve pressure and allow ventilation of the skin.
• Manage incontinence to reduce your skin's contact with urine and/or faeces, lowering your risk of developing IAD.
• Speak to your healthcare provider about relieving incontinence or reducing skin contact with incontinence waste. Some ways may include medication changes, bladder or bowel training, and the use of urinary or faecal catheters.

R – Restore

• Apply moisturisers only as directed by your healthcare provider.
• Most skin cleansers and protectants already contain moisturisers. Extra moisturisation may not be required.

O – Observe

Consult your healthcare provider if you observe the following:

• No improvement in IAD after 3 to 5 days of treatment.
• Worsening of IAD (eg: increase in skin redness, pain, wounds).
• Signs of infection at IAD area.
• Persistent rashes at the perineal/groin area to exclude fungal infections.

Your healthcare provider may adjust the course of treatment or refer you to a specialist for further follow-up.