Protecting Skin in Continence Care: A Practical Routine for Carers

Skin exposed to urine or faeces for long periods can become red, sore and broken. This is called incontinence-associated dermatitis (IAD), and it's common in aged care and home care. The good news: a consistent routine prevents most of it.

Why skin breaks down

• Moisture softens the outer layer of skin so it damages easily.
• Irritants in urine and especially faeces attack the skin.
• Friction from rubbing, wiping and bedding adds to the damage.

1. Change promptly

Check and change continence products regularly and as soon as possible after soiling. Use a product with the right absorbency so moisture is drawn away from the skin.

2. Cleanse gently

• Use a pH-balanced, no-rinse cleanser or soft disposable wipes rather than soap, which dries the skin.
• Use lukewarm water, not hot.
• Pat the skin dry. Don't rub.
• Wear disposable gloves and change them between cleaning and applying products.

3. Protect with a barrier product

A thin layer of barrier cream or film shields the skin from moisture and irritants. More isn't better: a thick layer can clog the continence product and stop it absorbing.

4. Check the skin every day

Look at the buttocks, groin, inner thighs and skin folds during each change. Watch for redness, shininess, rash or broken skin, and tell the nurse or GP early. IAD can be mistaken for a pressure injury or a fungal infection, which are treated differently.

5. Reduce friction and pressure

• Use breathable underpads rather than plastic sheets directly under the skin.
• Avoid layering several pads, which traps heat and moisture.
• Reposition regularly if the person spends long periods in bed or a chair.

When to get help

Seek advice from a nurse or GP if skin is broken, bleeding or weeping, if a rash spreads, or if redness doesn't improve within a couple of days of better care.

IAD or pressure injury?

Both cause red, damaged skin around the buttocks, so they're easily confused. As a general guide, IAD tends to be diffuse, shiny or blotchy with poorly defined edges where skin has been in contact with urine or faeces. Pressure injuries usually sit over a bony area such as the tailbone or hips and have more defined edges. Because treatment differs, ask a nurse to assess any new skin damage.

A simple routine for every change

1. Explain what you're doing and protect the person's privacy.
2. Clean your hands and put on gloves.
3. Remove the soiled product and cleanse gently from front to back.
4. Pat dry, paying attention to skin folds.
5. Change gloves, then apply a thin layer of barrier product.
6. Fit a clean, correctly sized product.
7. Check the skin and record any changes.

Nutrition and hydration matter too

Well-nourished, well-hydrated skin is more resilient. Restricting drinks to reduce leakage can make urine more concentrated and irritating, and increase the risk of infection and constipation, so speak to a health professional before cutting back fluids.

Frequently asked questions

What is incontinence-associated dermatitis?

Incontinence-associated dermatitis (IAD) is skin inflammation caused by prolonged contact with urine or faeces. It shows as redness, soreness, rash or broken skin around the buttocks, groin and thighs.

Should I use soap and water for continence care?

Regular soap can dry and irritate the skin. A pH-balanced, no-rinse skin cleanser or soft wipes are gentler, followed by patting dry.

How much barrier cream should I use?

Use a thin, even layer. A thick layer can block the continence product's absorbent surface, so it leaks or keeps moisture against the skin.

When should I see a nurse or GP about skin damage?

Seek advice if the skin is broken, bleeding or weeping, if a rash spreads or looks infected, or if redness doesn't improve within a couple of days of better care.

Related guides

• Pads, Pull-Ups or All-in-Ones? Choosing the Right Continence Product
• Povidone-Iodine Dressings Explained: How They Work and How They're Used
• Nitrile vs Vinyl vs Latex Gloves: How to Choose the Right Disposable Glove

Sources and further reading

• Continence Health Australia
• Australian Commission on Safety and Quality in Health Care
• healthdirect Australia

Last reviewed: October 2026 by the Innovation Project team.

This article is general information only and isn't a substitute for advice from a doctor, nurse or other health professional who knows your situation.