Adult Nappy Rash / Incontinence Associated Dermatitis

What is Adult Nappy Rash (Incontinence-Associated Dermatitis) and What Does It Look Like?

Adult nappy rash, also known as Incontinence-Associated Dermatitis (IAD), occurs in the bottom area. It is most commonly found in individuals who are bedbound, sit for long periods, have limited mobility, or require incontinence products such as adult nappies or pads.

If you are a user of incontinence products, or if you care for someone who uses them, you may notice signs of adult nappy rash. These signs include red, inflamed skin that may feel hot to the touch. The skin might also appear spotty, and small blisters could form. In some cases, these symptoms can worsen, leading to significant discomfort and pain.

Managing adult nappy rash on top of incontinence may seem daunting. However, it’s reassuring to know that it can be treated and managed, allowing individuals to continue with their daily activities without much stress.

Causes of Adult Nappy Rash / Incontinence-Associated Dermatitis

Adult nappy rash can be triggered by various factors, including:

• Dampness due to wet pads or nappies.
• Warm barrier environment created by incontinence products.
• Lack of exposure to fresh air.
• Poor hygiene practices.
• Incontinence leading to prolonged moisture contact with the skin.
• Skin infection from bacteria.
• Rubbing of incontinence pads or nappies against sensitive skin.
• Use of harsh soaps, detergents, or bubble baths.
• Alcohol-based wipes that irritate the skin.
• Bacterial infections on the skin.
• Allergic reactions to certain products.

Common Symptoms of Adult Nappy Rash / Incontinence-Associated Dermatitis

Recognising the symptoms early is crucial in preventing the rash from worsening. Common symptoms include:

• Pink or red areas around the bottom.
• Dry or peeling skin.
• Small, raised bumps on the skin.
• Itching or burning sensations.
• Tenderness or pain in the affected area.

How to Prevent Adult Nappy Rash / Incontinence-Associated Dermatitis

Preventing adult nappy rash is important for maintaining skin health and comfort. Here are some helpful prevention tips:

1. Change wet bedding, clothing, or incontinence pads as soon as they become damp.
2. Clean and dry the bottom area thoroughly, always wiping from front to back. Use water, fragrance-free wipes, or a gentle body wash to avoid further irritation.
3. Offer regular baths or showers, but avoid hot water and limit bathing to twice a day to prevent skin from drying out.
4. Gently pat the skin dry with a soft towel, avoiding any vigorous rubbing.
5. Allow fresh air to reach the skin whenever possible. For bedbound individuals, frequent turning may help relieve pressure and improve air circulation.
6. Avoid harsh soaps, bubble baths, and lotions that may irritate the skin.
7. Do not use talcum powder, as it may worsen the condition.
8. Ensure the incontinence products being used are appropriate for the level of incontinence. If the incontinence pads or nappies leave you feeling wet, it may be time to switch to a more absorbent product.

When to Seek Medical Advice

If the rash persists despite following the self-care tips mentioned above, it's essential to seek guidance from a pharmacist or healthcare provider. Bladder and bowel incontinence may be symptoms of treatable medical conditions, so consulting a physician is recommended for further evaluation.

The rash should usually clear up in around 3 days if you follow the self-care advice above. If the rash doesn’t clear up after following self-care advice, then do contact your local pharmacist or health care professional for advice.

Bladder and bowel incontinence may be caused by conditions which can be treated medically. Please consult your physician for medical advice and guidance.

 Reference:

1. National Association for Continence - https://www.nafc.org/bhealth-blog/how-to-prevent-and-treat-adult-diaper-rash
2. https://www.wakefieldccg.nhs.uk/fileadmin/site_setup/contentUploads/Connecting_Care/Partners_website_documents/Care_Home_Resources/Self_Care_Guides_for_staff/Adult-Nappy-Rash-v1..pdf