Adult diaper rash: What you need to know

Diaper rash can be uncomfortable and painful, but most cases can be treated using over-the-counter (OTC) and home remedies. It typically begins as small, pink patches of irritated skin and progresses to larger patches of red, raised, painful bumps with a surrounding rash.

Rashes that are severe, do not respond to basic care, or last more than 3 days may have developed as a result of infections or underlying medical conditions. Examples include yeast infections and long-term skin conditions, such as psoriasis and eczema.

In this article, we look at the causes and symptoms of adult diaper rash, as well as options for prevention and treatment.

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Anyone can develop diaper rash at any age. It is most common in babies and infants because diapers trap moisture and bacteria near the skin.

For the same reason, adults who wear pads or specially designed briefs with absorbent padding may also develop diaper rash.

People may need to use adult diapers or pads in a variety of situations, including when they are:

• having trouble using or accessing the bathroom
• struggling with bowel or bladder control
• working in jobs that require long periods of time without being able to go to the bathroom
• living with conditions such as Alzheimer’s disease that affect their ability to remember to go to the bathroom

Using adult diapers, incontinence underwear, or pads can lead to diaper rash in adults.

The specific causes related to using these products include:

• skin irritation from trapped heat and moisture
• skin barrier damage from chafing or rubbing
• inflammation caused by the ammonia in trapped urine or the enzymes in stools, which damage skin tissues when in close contact with the skin
• allergic reactions to dyes, perfumes, or materials in the diaper, underwear, or pad
• fungal infections, most commonly Candida albicans
• bacterial infections, most commonly Staphylococcus aureus
• flare-ups of chronic skin conditions, such as psoriasis and eczema

Not everyone who gets diaper rash wears or uses diapers. Diaper rash and the infections associated with it can also be caused by:

• poor genital hygiene
• allergic reactions or flare-ups related to chemicals, dyes, or fragrances found in detergents used to wash underwear
• chronic or severe chafing or rubbing
• allergic reactions to dyes, perfumes, or other substances found in personal hygiene wipes or lubricants

Diaper rash can develop anywhere on the groin, buttock, thighs, and hips.

Minor to mild cases of diaper rashes can cause:

• pink patches or spots of skin
• patches or spots of dry skin
• itchiness
• small, red, raised bumps not connected by an underlying rash

Moderate cases of diaper rash often cause:

• large areas of a pinkish to bright red rash
• larger, red, raised bumps that are scattered and sometimes connected by the underlying rash
• itchiness and tenderness

Severe or untreated diaper rash can lead to:

• large patches of bright red, inflamed skin that may appear burnt
• very large bumps or welts that sometimes fill with fluid and ooze
• extreme itchiness and burning
• pain and tenderness
• pain when sitting or when putting on underwear or clothing

A diaper rash that occurs alongside a flare-up of another skin condition, such as psoriasis, eczema, or atopic dermatitis, may have similar symptoms as the underlying condition.

When an infection is the cause of diaper rash, it may also result in:

• fever
• blisters that ooze pus
• whole body aches and pains
• exhaustion

In most cases, the best way to treat adult diaper rash is to change briefs and pads frequently and as soon as possible after soiling them.

People with diaper rash should also:

• change briefs or pads if they become even slightly wet
• gently wash the affected area a few times a day with lukewarm water and hypoallergenic soaps or cleansers
• pat the skin dry with a towel instead of rubbing it
• thoroughly rinse off all soaps after bathing
• use non-irritant cleansers and personal hygiene wipes that do not contain fragrances, added dyes, or alcohols
• wear briefs and pads as infrequently as possible

A person can also encourage airflow by:

• allowing the area to air dry after bathing or cleaning
• using specialized briefs with micropores
• avoiding wearing briefs that are too tight

Ointments and creams containing zinc oxide and petroleum jelly can help relieve symptoms. A person can apply these products to the entire area daily.

People who find that zinc oxide creams are too sticky once they dry can apply a thin layer of a lubricating gel or cream, such as lanolin or petroleum jelly, on the top.

If a diaper rash does not improve with basic hygiene and OTC creams or ointments, a person should see a doctor. People should also seek advice if their rash is severe or lasts longer than 3 days.

A combination of poor hygiene and skin irritation is responsible for most cases of diaper rash, but several underlying medical conditions can cause similar symptoms.

For people with fungal infections, a doctor may prescribe topical antifungal medications, such as ciclopirox, nystatin, or a type of imidazole.

Most antifungal creams need to be applied twice daily for 7 to 10 days. People with severe fungal infections may need to take oral medications in addition to using creams.

If a bacterial infection is causing the rash, a doctor will prescribe antibacterial creams, such as those containing bacitracin or fusidic acid. A person will usually need to apply the creams two or three times a day for 7 to 10 days.

People who have underlying skin conditions, such as psoriasis and eczema, may need to use corticosteroid creams and ointments during flare-ups.

The best way to prevent diaper rash is to change briefs frequently and as soon as possible after they become wet or soiled.

Washing the entire area daily with a hypoallergenic cleanser or soap can also help reduce the risk of irritation. It is better to pat the skin dry or let it air dry rather than rubbing it.

Applying moisturizers or medicated creams before putting on briefs or pads can also reduce the risk of chafing and help to soothe inflamed skin.

Products and natural remedies are available in stores and online and include:

• Calmoseptine
• Penaten
• coconut oil
• aloe vera
• cod liver oil
• calamine creams
• lanolin
• cornstarch

Adult briefs and pads are continually being improved to make them more comfortable and to decrease the chance of diaper rash.

Products that should help to reduce the risk of irritation and infection include:

• hypoallergenic briefs and pads
• superabsorbent briefs and pads made using sodium polyacrylate
• breathable briefs and pads with tiny holes called micropores that increase airflow and reduce humidity
• reusable cotton briefs

Most cases of adult diaper rash resolve within 1 or 2 days with basic hygiene and the use of zinc oxide and lubricating creams.

However, severe diaper rashes and those caused by underlying medical conditions usually require treatment to avoid permanent skin damage and other health complications.

A person should speak to a doctor about rashes that:

• last longer than 3 days after using home remedies
• are very painful
• are accompanied by a fever or flu-like symptoms
• blister, peel, ooze, bleed, or leak pus
• are accompanied by pain when urinating or passing a stool