Sparling K, Frieden IJ, Butler DC, et al.
Journal of the American Academy of Dermatology. Date of publication 2025 Aug 23;volume ():.
1. J Am Acad Dermatol. 2025 Aug 23:S0190-9622(25)02677-5. doi:
10.1016/j.jaad.2025.08.051. Online ahead of print.
Incontinence-associated dermatitis: Not just babies.
Sparling K(1), Frieden IJ(2), Butler DC(3).
Author information:
(1)University of Arizona, College of Medicine, Phoenix, Arizona. Electronic
address: ksparling@arizona.edu.
(2)Department of Dermatology, University of California, San Francisco, San
Francisco, California.
(3)Division of Dermatology, University of Arizona, College of Medicine, Tucson,
Arizona.
Irritant diaper dermatitis (IDD) is frequently observed in young children but
can affect individuals throughout their lifespan. The broader term
incontinence-associated dermatitis (IAD) is used to describe inflammatory skin
reactions from prolonged exposure to urine and/or feces. This review compares
IAD and IDD in pediatric and geriatric populations, focusing on their
pathogenesis, clinical considerations, and management. Both conditions involve
prolonged bodily fluid exposure disrupting the skin barrier, making infants and
older adults particularly susceptible due to their age-related skin
characteristics. Factors such as fecal enzyme activity and diet in infants, and
medications and comorbidities in older adults, also influence presentation.
Particularly for IAD in the geriatric population, accurate diagnosis and
differentiation from other conditions like pressure injuries and intertriginous
dermatitis is crucial. Management prioritizes prevention, which includes
frequent absorbent product changes and barrier creams. If the condition
develops, treatment varies with severity, from barrier applications for mild
cases to topical steroids for severe cases. Antifungals or antibiotics may be
required for cases with superimposed infections. Future initiatives should
concentrate on overcoming the difficulties related to IAD and IDD, such as
alleviating physical discomfort, mitigating economic impact, and developing
standardized terminology and research specifically tailored to geriatric care.
Copyright © 2025 American Academy of Dermatology, Inc. Published by Elsevier
Inc. All rights reserved.
DOI: 10.1016/j.jaad.2025.08.051
PMID: 40854496
Conflict of interest statement: Conflicts of interest Dr Butler serves as a
consultant for Sanofi, Leo, True Botanicals, and Galderma, and as an advisor for
Leo and Boehringer Ingelheim. Dr Frieden serves as a consultant for Pfizer,
Novartis, NobelPharma, Apogee Therapeutics, and Verrica. Author Sparling has no
conflicts of interest to disclose. None of these relationships are relevant to
the topic of this work.
