Why urine and stool are hard on skin
Incontinence skin protection matters because skin is not made to stay wet. Urine and stool soften the outer layer of skin, and the irritants in them, especially in loose stool, inflame it. Add rubbing from briefs, bedding or wiping, and skin can turn sore and raw quickly.
Clinicians call this incontinence-associated dermatitis, one form of moisture-associated skin damage. Skin weakened by moisture is also easier for pressure to injure, so people with incontinence who sit or lie for long periods are more likely to develop pressure injuries.
Incontinence is common, and it is nothing to hide from a care team.
What early skin damage looks like
Check the buttocks, tailbone area, groin, genitals, inner thighs and skin folds at least once a day. Look for:
- Redness or, on darker skin, an area that looks darker, purple or different from the skin around it
- Skin that is shiny, swollen, warm or tender
- Burning, stinging or itching
- A rash, especially one with small spots scattered beyond its edge, which can mean yeast
- Raw, weeping or open patches
A daily routine: cleanse, protect, keep dry
Use the specific products and steps your treating clinician recommends.
- Cleanse gently and soon. Clean the skin after each episode, as soon as you reasonably can. Lukewarm water or a no-rinse cleanser made for this purpose, with a soft cloth, is easier on skin than bar soap, hot water or scrubbing. Pat dry.
- Protect. A barrier cream, ointment or film leaves a layer that shields skin from moisture. Ask which type to use and how much, because some thick products keep briefs from absorbing well.
- Keep wetness away from skin. Use absorbent products that pull moisture away from the skin and fit well, and change them promptly.
Unless a clinician advises them, avoid doubling up briefs or pads (extra layers trap heat and moisture), powders or cornstarch, and perfumed wipes.
Choose and use absorbent products well
The right product depends on the amount and type of leakage, how mobile the person is and who is helping. A brief that is too large leaks, and one that is too tight rubs. A more absorbent product at night can protect sleep.
Coverage for absorbent products differs from plan to plan, so ask yours what it helps with.
When there is a wound nearby
A wound on the tailbone, buttocks or hip is hard to keep clean when incontinence is present. Urine or stool that gets under a dressing raises the risk of infection and breaks down the skin around the wound.
Tell the treating clinician if a dressing is getting wet, soiled or lifting at the edges. They may change the type of dressing, the way it is secured or the change schedule, and they can tell you what to do when a dressing is soiled between planned changes.
Pressure relief matters too. Our guide to a repositioning schedule at home and our page on pressure injury prevention explain how turning, cushions and skin care work together.
Talk with primary care about the incontinence itself
Incontinence is a symptom with causes, and many of them can be improved. Bring it up with a primary care clinician, who may look at:
- Urinary infection, constipation or diarrhea
- Medications that increase urine or loosen stool
- Mobility or memory problems that make it hard to reach the toilet in time
- A timed toileting schedule, pelvic floor therapy or a specialist referral
Do not cut back on fluids to reduce accidents without asking. Too little fluid concentrates urine and can lead to dehydration and constipation.
A medication review is a good place to raise these questions. Gateway arranges in-home primary care with partner clinicians across Greater St. Louis and the Metro East. To ask about wound care or primary care, send the request care form or call 314-325-0126.
Changes to report to the clinician
Call the clinician if you notice:
- Skin that is open, blistered, bleeding or weeping
- A rash that is spreading, or not improving after several days of careful care
- More pain, odor, warmth or swelling
- A dark purple, maroon or black area, or a sore over a bone
- New or suddenly worse incontinence, burning with urination, fever, or blood in urine or stool
Call 911 for sudden loss of bladder or bowel control together with new leg weakness, numbness in the groin or inner thighs, or severe back pain. Also call 911 for fever with new confusion or trouble breathing.
Common questions
How often should briefs or pads be changed?
As soon as you can after they are wet or soiled, and always promptly after stool. There is no single safe number of hours, because skin can be irritated quickly. Check on a regular schedule, and ask the clinician how to balance overnight checks against sleep.
Are baby wipes okay for cleaning adult skin?
Some are fine and some are not. Wipes with alcohol or fragrance can sting and dry out skin that is already irritated. Wipes and no-rinse cleansers made for adult incontinence care are designed to be gentle. Ask the treating clinician which cleanser they prefer.
Is this a moisture rash or the start of a bed sore?
It can be hard to tell at home, and both can be present. Moisture damage is usually shallow and spread out, while a pressure injury usually sits over a bone. Have a clinician look at any area that is open, dark, painful or not improving. Our guide to pressure injury stages describes what clinicians look for.
Would a urinary catheter protect the skin better?
That is a medical decision with real trade-offs. Catheters placed in the bladder carry their own risks, including infection, so clinicians generally reserve them for specific situations. If skin is breaking down despite careful care, ask the treating clinician what the options are, including external collection devices and changes to the toileting plan.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.
Updated October 2026