Incontinence-associated dermatitis (IAD) is an inflammatory skin condition that occurs when the skin is exposed to urine or stool and leads to secondary infection, pain, or skin lesions. Incontinence-associated dermatitis (IAD) is physically painful and emotionally upsetting and often confused with pressure ulcers. Reported prevalence rates (i.e., the percentage of a population that has a condition; in IAD studies, the figure often is calculated from admission data) vary from 5.6% to 50%. Incidence rates (i.e., the number of new cases that develop during a specific time period, usually four weeks for IAD) vary from 3.4% to 25%. Incontinence usually has many causes, is not completely understood, and includes psychological and physiological factors. Recent evidence indicates that approximately 20% of acute care patients are incontinent and that 42.5% of incontinent patients have some type of skin injury.
Although the pathophysiology of IAD is not completely understood, disturbance of the skin’s acid mantle as a protective barrier is thought to play a key role. It is a daily challenge for health professionals in hospitals, nursing homes, and community care to maintain healthy skin in patients with incontinence. Strategies include prevention of incontinence, use of containment products, regular skin assessment, proper differential diagnosis, development of effective treatment protocols, and staff education.