Oct 28, 2024
Dealing with urinary incontinence can be tough, especially when it affects your skin. Irritation, rashes, and infections are common and are often referred to as incontinence-associated dermatitis (IAD), but with the right care, it can be managed.1
In this article, we’ll cover why skin care is so important for those experiencing incontinence and share practical tips to prevent skin damage. Whether you’re caring for yourself or a loved one, we have some tips to help keep skin healthy, comfortable, and protected.
Why Does Urine Burn and Irritate Skin?
Can pee burn your skin? Yes, exposure to urine can cause burning and itching.1 The delicate areas near your bottom, genitals, and the perineum (the area between your genitals and anus) can all be affected by incontinence.2
That’s because moisture from urine-soaked pads, sheets, or underwear increases your skin's pH and breaks down its protective barrier, causing irritation, rashes, and even infections.2,3
This kind of skin damage is called incontinence-associated dermatitis (IAD), a type of moisture-associated skin damage (MASD), which leaves skin more prone to infection.4
Beyond moisture, a couple of other things can cause IAD, like friction from pads, underwear, or sheets. Also, as you age, your skin becomes thinner, more fragile and more prone to breaking down.1,5
But IAD is manageable, and it’s possible to reduce discomfort with an easy daily routine.
How Do You Prevent a Urine Skin Rash?
Skin protection for incontinence comes down to a few simple steps: cleanse, moisturize, protect, and choose the right product.
What matters most is consistency and being gentle with your skin at every pad or underwear change. Let’s go through the steps.
Step 1: Cleanse Gently
When managing your skin health with incontinence, it’s important to use gentle, soap-free cleansers.2 These products cleanse without causing dryness or irritation.2
A gentle skin cleanser cleanses and protects your skin in one easy step.
Step 2: Moisturize and Protect
Moisturizers are important for keeping your skin hydrated.2 But hydrating and protecting are two different jobs, so it helps to think of this step in two parts.
While a moisturizer locks moisture in, a barrier cream sits on top and shields skin from urine.5 Choose a barrier cream for incontinence that’s made with ingredients like zinc oxide, dimethicone, or petroleum jelly (petrolatum).5
Using both products together is recommended for IAD5 and to keep your skin healthy and comfortable. But it's a good idea to first check with a pharmacist or your healthcare provider to see which creams or lotions are safe for you, especially if you have already broken or damage.
Step 3: Choose the Right Incontinence Products
Choosing skin-friendly incontinence products can make a huge difference to your comfort. Look for breathable incontinence pads to help reduce moisture contact with your skin.1 Some are designed for “rapid absorption,” using various technologies to draw moisture away from the surface and deep into the pad.
Getting the absorbency level right matters, too. A product that's not absorbent enough means your skin is exposed to moisture, while one that's too high could pull natural moisture from your skin and dry it out.
Products that fit properly and allow for airflow can also reduce the risk of skin irritation.
But even with the right products, it’s important to make a habit of changing your pads often to keep your skin dry and comfortable.
For skin-friendly options, explore TENA's Sensitive Care range. These products feature the 5 in 1 SkinComfort™ Formula that keeps you dry and comfortable while protecting skin in intimate areas.
What to Look Out For: Rash, Infection, or Something Else?
A skin rash from urine exposure looks like a sore, red patch.1 The color might be light pink or a deeper red, and the skin could be a little swollen, warm, or tender.1 It could also sting or itch.1
Sometimes, secondary infections can happen.1 If it's a yeast infection, the rash might be bright red and bumpy, and tends to get really itchy.6,7 It might extend into nearby skin or tuck into the skin folds.8 A bacterial infection has a different appearance: it’s a patch with a golden crust.6
But you don’t have to figure out which is which on your own. If your skin is bothering you or getting worse, let your doctor know, so you can get the right diagnosis and treatment.
Skin Care Tips for Caregivers Supporting Someone with Incontinence
Caring for the sensitive, intimate skin of a loved one asks a lot of you. It’s about balancing the need for skin health while maintaining their dignity. Here are some caregiver hygiene tips to help you succeed:
Building a Daily Hygiene Routine
Establishing a calm, predictable routine helps the person in your care feel settled and respected. At the same time, your cleansing routine for protecting sensitive intimate skin doesn't have to be complicated.
Every time you change a pad or underwear, gently clean the skin that’s been in contact with urine.5 A no-rinse cleanser makes things easier and is kinder to skin than soap and water.5
After cleansing, avoid rubbing the area; pat dry instead.5 Rubbing can irritate skin that’s already tender.5
Once the skin is dry, moisturize and finish with a thin layer of barrier cream for extra protection.5
What to Do If Skin Looks Red or Sore
Spotting redness or soreness early helps you address the problem before it escalates.
Change the pad more often to reduce the time your loved one’s skin is exposed to moisture.9 It also helps to expose the skin to the air between changes, even if it's just for a short while.9
Check the absorbency level of the pads you're using. Switching to one that’s breathable with a higher absorbency can help.9
Once their skin is clean and dry, applying a thin layer of barrier cream creates a shield against wetness.5
When to See a Doctor About Skin Irritation from Urine
If an area remains red or the skin looks worse, like a bed sore or infection developing, it’s best to have it checked out by a doctor.1 Some other signs not to ignore include:
- Persistent rashes1
- Broken skin1
- Weeping1
- Bright red and bumpy texture that’s itchy6,7
- Spreading rashes8
- Crusty patches6
- Pain, tenderness or warmth1
FAQs
Why Does Urine Burn My Skin?
This tends to happen when your skin has been exposed to urine for a while.1 The moisture shifts the skin's pH and wears down the barrier that normally protects it.2,3
Once that barrier is weaker, your skin becomes more prone to soreness, rashes, and sometimes infection.2,3
If your skin is burning after leakage, change your incontinence product immediately and keep the area clean and dry.11
Can Urine Cause a Skin Rash?
Yes, prolonged contact with urine can cause a condition called incontinence-associated dermatitis (IAD).1
You might notice redness, warmth, burning, pain and sometimes blistering in your genital and perineal areas.1
Keeping the skin dry with frequent pad changes and using a barrier cream consistently can prevent it from getting worse.1
Why Do Incontinence Pads Irritate My Skin?
This can happen when your skin is exposed to constant moisture if your pads aren't breathable, or from friction if they don't fit well.1,9
Choose fitted pads that absorb moisture quickly and change them regularly to prevent irritation.1,9
What Cream is Good for a Urine Skin Rash?
Barrier creams help with urine-related skin rashes because they provide a protective layer against moisture.5 Look for ones with zinc oxide or petroleum jelly.5
If you already have a rash or broken skin, it’s best to speak to a pharmacist or your healthcare provider before using a new product.
Is It Normal to Have a Skin Reaction to Incontinence Pads?
Skin irritation while wearing incontinence pads is common, and it’s usually because of friction or trapped moisture rather than the pad material itself.1,9 Fragrances can also cause skin reactions.9
Wearing a breathable, skin-friendly incontinence product can help. If a rash spreads beyond where your pad covers you or there’s blistering, it’s advisable to speak to your doctor.9
How Do I Know if My Skin Rash is a Yeast Infection?
A yeast infection on the skin shows up as a bright red, raised rash that’s itchy, sometimes with small spots around the edges.6,7 It’s best to get a diagnosis from your doctor, though.
How Often Should I Change Incontinence Pads to Protect My Skin?
To keep your skin healthy, change your pads as soon as you can after leakage, and at regular intervals throughout the day.1
A damp pad left in place too long can lead to skin irritation.1 If you're in doubt, your doctor or nurse can help you set up a changing routine based on your usual leakage pattern.
What is the Best Skin Care Routine for Someone With Incontinence?
Gently cleanse the area with a soap-free, pH-balanced cleanser, pat dry instead of rubbing, then apply moisturizer followed by a barrier cream.1
Try to do this at every pad change, not just once a day. Consistency matters more than the products themselves.
When Should I See a Doctor about Skin Irritation From Urine?
It’s best to see a healthcare provider if a rash is painful, has broken open, or is persistent.1 Signs of infections like heat, a golden crust, or weeping skin need attention as well.1,6
Visiting your local pharmacy is a good first step. A pharmacist or a nurse can help with ongoing skin care and product choices. They will also advise when it’s best to see a doctor.
References
1. Healthline. ‘What Is Incontinence-Associated Dermatitis and How Is It Treated?’. 2017. Accessed 23 September 2024. Available from: https://www.healthline.com/health/overactive-bladder/incontinence-associated-dermatitis
2. MedlinePlus. ‘Skin care and incontinence’. 2024. Accessed 23 September 2024. Available from: https://medlineplus.gov/ency/article/003976.htm#:~:text=Your%20provider%20can%20recommend%20barrier,yeast
3. Owen EJ, Heylen RA, Stewart K, Winyard PG, Toby A. The Multi‐Factorial Modes of Action of Urease in the Pathogenesis of Incontinence Associated Dermatitis. Skin Health and Disease. 2024 Mar 2;4(3).
4. American Nurse. ‘Moisture-associated skin damage: The basics’. 2022. Accessed 23 September 2024. Available from: https://www.myamericannurse.com/moisture-associated-skin-damage/
5. Banharak S, Panpanit L, Subindee S, Narongsanoi P, Sanun-aur P, Kulwong W, et al. Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review. Journal of Multidisciplinary Healthcare [Internet]. 2021 Oct;14(14):2983–3004. Available from: https://www.dovepress.com/getfile.php?fileID=75215
6. Owen EJ, Heylen RA, Stewart K, Winyard PG, Jenkins ATA. Detecting and monitoring incontinence associated dermatitis: Does impedance spectroscopy have a part to play? Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 2023 Mar 7;095441192311591.
7. Cleveland Clinic. Candidiasis Fungal Infection: Causes & Treatment [Internet]. Cleveland Clinic. Cleveland Clinic; 2025. Available from: https://my.clevelandclinic.org/health/diseases/23198-candidiasis
8. Campbell JL, Coyer FM, Mudge AM, Robertson IM, Osborne SR. Candida albicans colonization, continence status and incontinence-associated dermatitis in the acute care setting: a pilot study. International Wound Journal. 2016 Aug 1;14(3):488–95.
9. Kottner J, Joachim Dissemond. Incontinence-Associated Dermatitis in Older Adults: A Critical Review of Risk Factors, Prevention and Management. Drugs & Aging. 2025 Jul 4;42(8).
