Incontinence dermatitis is an inflammation of the skin caused by urine or stool irritating and drying it out. It can cause redness, flaking, and irritation of the skin and can `be found on sensitive areas such as the groin, lower back, around the neckline of a shirt or bra, under breasts or in armpits.
Incontinence dermatitis is common among people with urinary incontinence who wear tight-fitting clothing without proper ventilation. Incontinent people often wear clothes improperly, which may trap heated urine leading to blisters on their skin. The dryness leads to scaly patches on your skin, known as ichthyosis digitiform (fish scale appearance).
It is not known how many people are affected by incontinence dermatitis. If appropriately prescribed, incontinence products can reduce the risk of incontinence dermatitis. Although it is not entirely preventable, incontinence dermatitis may be kept under control with proper care and treatment. It generally affects women more than men as women tend to wear tight-fitting clothing more often than men do.
Incontinence can be treated with absorbent pads (undergarments or underwear) that act like a diaper allowing people to retain urine and stool within themselves rather than using the toilet where neither can be emptied manually. This helps reduce the risk of skin irritation from urine and faeces. Use incontinence pads or undergarments to absorb urine and stool, and do not allow urine or stool to remain on the skin, which can irritate and dry it out. Change absorbent garments according to the manufacturer's instructions. Products should be changed more often if you have problems with incontinence or are at risk for skin breakdown.
People with incontinence dermatitis should avoid wearing tight-fitting clothing that traps warm, moist air against the skin (often found in leotards and body sexy wear). Clothes that are too tight can trap moisture against your skin, causing it to itch, burn and peel.
It is important to find clothing that fits properly and allows your skin to breathe. Clothing that restricts your skin's ability to breathe (tight, too-small clothes, or clothes that are too tight in the waist and legs) leads to ichthyosis dermatitis.
This condition can result in redness and scaling, which can be so severe that it takes away the area of skin where the urine is soaked.
Incontinence dermatitis is often treated with care products, but it is not preventable. Preventing the signs of incontinence dermatitis can be achieved with proper care. It is essential to change clothing, bed linen and incontinence pads when they become wet or soiled. According to the manufacturer's instructions, incontinence pads may be changed more often if you have problems with incontinence or are at risk for skin breakdown.
If you wear diapers because of urinary incontinence, do not use baby powder to keep your skin dry, as it can make it worse. Use a talcum-free powder instead. Do not use shower gels that contain perfume as they can irritate the skin of people with incontinence dermatitis.
There are many treatments for incontinence dermatitis. These include:
Products with triclosan (such as Diffucaps, Dacro, Allergenec and others) have an active corticosteroid, which is designed to be anti-inflammatory and antifungal. Triclosan has also been shown to reduce skin infections caused by fungi. Some studies indicate that they do not minimise other skin problems or cause cancer. However, they may increase the risk of contact dermatitis in those allergic to pesticides. So far, there are no long term studies on these materials and their effect on the skin.
There are also products in liquid form containing the antifungal agent ketoconazole (such as Lotrimin, Lotrisone and others). This medication is taken by mouth and applied to the skin. Ketoconazole has been shown to decrease the incidence of fungal infections. It has not been shown to prevent other infections or reduce or prevent ichthyosis digitiform. Some people may be allergic to this medication. The medication is available without a doctor's prescription if used as directed. Ketoconazole has not been approved by the US Food and Drug Administration for use on children under 18 years of age.
High-power laser therapy has been studied to reduce the severity of incontinence dermatitis. Persons with mild incontinence may not see improvement. However, persons with more severe cases may see a significant improvement in their condition.
A variety of products are available to help with incontinence dermatitis, including all-natural and over-the-counter products. They can be purchased at many pharmacies, grocery stores and drug stores. These products often contain oils, herbal extracts and plant oils: tea tree oil, neem leaf extract or balsam fir needle oil (also known as wintergreen oil).
A variety of treatments are available to prevent and treat incontinence dermatitis.
Treatment options include:
The best way to prevent incontinence dermatitis is to manage your incontinence. This can help avoid, or at least reduce, the constant rubbing and friction of urine and faeces against the skin. You may need to change your lifestyle or diet, like avoiding spicy foods and drinks. The better you take care of your skin by bathing regularly, protecting it from irritation and wearing clothes that allow it to breathe, the less itchy you will be.
A healthy diet can also help prevent many types of infections.
Ichthyosis is a hereditary disorder in which skin is dry and thickened but not covered in scales or warts. Ichthyosis occurs in all races and can be mild or severe. Less common types of ichthyosis include:
- Ichthyosiform erythroderma (waxy type).
- Keratoderma blennorrhagicum (blistering form).
- Scleritis-ichthyosis (symmetrical style).
- Hidradenitis suppurativa with ichthyosis.
One of the first treatments for for ichthyosis is a regular bath with special soap, which helps prevent the skin from drying out and cracking.