Adult Diaper Rash: Causes, Symptoms, Treatment & Home Remedies

Introduction

Diaper rash is not just a concern for babies. It can occur in adults too, and can be just as uncomfortable and frustrating. Adult diaper rash can occur due to several reasons such as incontinence (loss of urine or stool control), high moisture, or irritation to chemicals, and can get superimposed fungal (Candida albicans) or bacterial infections¹.  

Adult diaper rash is common, however, it is completely manageable with proper hygiene practices, topical creams, and antifungal or antibacterial treatment, though severe or chronic rashes may require medical attention¹. In this article, we will explore the causes, symptoms, effective treatments, and easy home remedies that may help to soothe the skin and prevent further rashes. 

What is an Adult Diaper Rash?

Adult diaper rash (or irritant contact dermatitis), is a simple term used for inflammation of skin that develops in areas covered by diapers, pads or incontinence briefs. While there can be a combination of factors causing this condition, it most commonly occurs when your skin is exposed to prolonged moisture due to contact with stool or urine for a long period of time (thus considered as a form of incontinence-associated dermatitis). This may lead to redness (erythema), maceration, soreness, itchiness, and erosion on your skin². However, if you notice papules (bumps) or pustules (pus-filled boils) on your skin along with erythema and erosion, it may suggest a secondary fungal or bacterial infection which occurs as a complication to adult diaper rash^2,3. 

Studies⁴ have shown that approximately 50% of adults with faecal or both (faecal and urinary incontinence) show diaper rash within two weeks. 

Causes of Adult Diaper Rash

Are you wondering what causes diaper rash in adults? In adults what is commonly called diaper rash often represents irritant or allergic contact dermatitis. It mostly occurs in individuals with incontinence due to excessive contact of skin with urine or stool, causing breakdown of skin barrier from prolonged moisture contact or pH disruption of skin, leading to inflammation. Other contributing factors include^1,2,5: 

• Excessive moisture buildup (due to sweating, or inadequate air circulation) 
• Allergic reaction to detergents used 
• Friction from ill-fitting or tight clothing or diapers 
• Infrequent diaper changes 
• Sensitivity to any of the fragrances or chemicals or material of the diaper 
• Poor hygiene or improper cleaning of genital area 
• Secondary infections by organisms that thrive in moist environments. Candida albicans (a fungus) is the most common secondary infection in diaper rash. Bacterial infections include Staphylococcus aureus, Group A Streptococcus and Pseudomonas infections, though they are less common in adults⁶. 

By understanding the common causes of diaper rash, you can take preventive steps and choose the right care to keep your skin healthy and comfortable^1,5. 

Symptoms of Adult Diaper Rash

Diaper rash adult symptoms include^1,5,7: 

• Redness of the skin or erythema and irritation of skin in the diaper area 
• The skin may show blisters and then peel, leaving ulcers 
• Sensation of itching, burning, or discomfort 
• Warmth or tenderness of the skin. 
• Peeling, cracked, or scaly skin may be noticed in individuals with fungal superinfection³ 
• In severe cases, open sores or secondary infection with pus or foul odour. 
• Swelling in the affected region generally suggests the presence of secondary infection 
• Secondary fungal infections with Candida show characteristic glossy erythematous patches and satellite pustules³. 

Recognising these symptoms early can help prevent the rash from worsening and ensure timely treatment. 

Treatment for Adult Diaper Rash

To treat diaper rash effectively, you can follow these simple home remedies for diaper rash in adults which can be remembered with the pneumonic “ABCDE”^8,9: 

• Air: The area of your skin should be exposed to air as much as possible. Removing your diaper may minimise the friction and contact with moisture. 
• Barrier: Application of creams that contain zinc oxide or petroleum may help to create a barrier between your skin and the diaper, serving as a protective layer and reducing contact with urine and stool. 
• Cleansing: The skin in contact with the diaper should be cleaned gently and thoroughly with water and gentle cleansers. 
• Dry Diaper: You should change your diaper frequently or as soon as it is soiled. This reduces the moisture on the skin which can lead to a diaper rash. Moreover, studies have shown that individuals using disposable, breathable and absorbable diapers are found to have a lesser incidence of diaper rash compared to reusable cloth diapers⁸. 
• Education: Diaper rash can be prevented by following simple diaper hygiene techniques such as washing your hands before and after every diaper change, using a soft cloth for cleaning, avoiding the use of irritants (such as fragrances or alcohol) in cleaning agents, use of proper fitting diapers, and monitoring for secondary infections. 
• Medication: Antibiotics and antifungal medication may be prescribed by the doctor if infection is confirmed. Low potency topical corticosteroids (such as hydrocortisone 0.5%) may be considered in moderate to severe inflammation. Consult your doctor and use as directed with caution, especially if you have infected skin¹. 

By following the simple ABCDE steps, you can effectively reduce the risk of adult diaper rash and maintain healthy, comfortable skin^8,9. 

Treatment for Diaper Rash from a Yeast or Fungal Infection

Diaper rashes caused by yeast or fungal infection (commonly Candida) need special care as they may not improve with simple measures. The classical sign of fungal infection by Candida albicans is bright red erythema with satellite pustules. This helps to distinguish it from irritant dermatitis. Its treatment focuses on keeping the area clean, reducing moisture, and using antifungal medicines¹. 

• Good hygiene practices: Keep the diaper area clean by washing the area with lukewarm water and mild, fragrance-free, non-abrasive, pH balanced cleansers and change diapers frequently. It is important to note that use of soap frequently may worsen your skin irritation. 
• Antifungal creams or ointments: Nystatin and azoles are considered first-line treatment for diaper rashes. Topical application of nystatin may show improvement of symptoms in several days to a week. Azoles (such as Clotrimazole, Miconazole, Ketoconazole) may take around 1-2 weeks to help reduce your symptoms, depending on the severity of your case. Take your medication as prescribed and use as directed by your doctor. 

If your rash is severe, painful, or does not improve after a few days of antifungal application, your doctor may suggest oral antifungal medicines if needed to help relieve your symptoms¹. 

Complications of Untreated Diaper Rash

An untreated diaper rash can lead to^1,2,5,7: 

• Skin infections: Fungal infections (caused by Candida albicans) are most common, while bacterial infections (caused by Staphylococcus aureus, Group A streptococcus) are less common⁶. 
• Erosion of skin: Severe erosions or skin breakdown may be seen. Ulceration may occur in the presence of secondary infection or increased pressure. 
• Pain and discomfort: Your rashes may cause burning an itching sensation 
• Spread of infection: If left untreated, your rashes may spread to other parts of your body such as back, abdomen. 

You are more likely to develop these complications if you have a weak immune system or if you suffer from any chronic health conditions^1,5,7. 

How to Prevent Adult Diaper Rash

Simple tips that you can follow to reduce diaper rash adults symptoms include^1,5,9: 

• Change your diapers frequently as soon as they are wet or soiled to reduce chances of moisture exposure. 
• Wash your hands before and after every diaper change. 
• While cleaning the diaper area, gentle cleaning should be done from front to back and aggressive scrubbing of skin should be avoided. 
• Pat the skin dry, rather than aggressive rubbing of the genital area. 
• Use diapers that are made of material which is skin-friendly and breathable. These diapers should have moisture absorbing properties as well to reduce the risk of rashes. 
• Do not use diapers that are ill fitting. Diapers that are too tight may cause an irritation to your skin leading to diaper rash. 
• Do not use diapers that contain alcohol or perfume. These agents may dry out and irritate the skin near the diaper area. 

Always monitor your skin for signs of redness and irritation and seek medical advice early to prevent any further complications. 

When to Seek Medical Help?

You should see a doctor if your rash is not showing any improvement with treatment after 2 to 3 days, or if your rash spreads to other regions of your body such as your arms, face, abdomen. If you develop a fever or notice any pimples, sores filled with pus or large bumps, it is best to consult your doctor and seek prompt medical care for your condition⁵.  

Conclusion

Adult diaper rash is a common yet manageable problem that can cause discomfort and irritation, if it is not treated in time. By recognizing the early signs, practicing good hygiene, and following simple care practices such as the “ABCDE” approach, you may effectively manage and reduce the risk of rashes. 

In most cases, these steps are sufficient to relieve symptoms, but if the rash becomes severe, spreads to other areas, or does not improve within a few days, it is important to seek medical advice. Timely medical advice ensures proper treatment and prevents complications, keeping your skin healthy and comfortable. 

Frequently Asked Questions (FAQs)

References

1. Benitez A, Mendez MD. Diaper Dermatitis [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559067/ 
2. Connolly M. Incontinence Associated Dermatitis (IAD) – Best Practice Principles [Internet]. 2018. Available from: https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0015/424401/Incontinence-Associated-Dermatitis-IAD-Best-Practice-Principles.pdf 
3. Talapko J, Juzbašić M, Matijević T, Pustijanac E, Bekić S, Kotris I, et al. Candida albicans—The Virulence Factors and Clinical Manifestations of Infection. Journal of Fungi [Internet]. 2021 Jan 22;7(2):79. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7912069/ 
4. Bliss DZ, Funk T, Jacobson M, Savik K. Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence. Journal of Wound, Ostomy and Continence Nursing [Internet]. 2015 [cited 2019 Apr 24];42(5):525–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5068913/ 
5. Atherton DL. The aetiology and management of irritant diaper dermatitis. 2001 Dec 21;15(s1):1–4.  Available from: https://pubmed.ncbi.nlm.nih.gov/11720071/ 
6. Baren JM, Goldman RD, Al E. Pediatric emergency medicine [Internet] – Irritant Diaper Dermatitis. Philadelphia: Saunders / Elsevier, Cop; 2008. Available from: https://www.sciencedirect.com/science/article/abs/pii/B9781416000877501276 
7. Better Health VIC. Nappy rash [Internet]. Vic.gov.au. 2012. Available from: https://www.betterhealth.vic.gov.au/health/HealthyLiving/nappy-rash 
8. Wesner E, Vassantachart JM, Jacob SE. Art of prevention: The importance of proper diapering practices. International Journal of Women’s Dermatology [Internet]. 2019 Sep;5(4):233–4. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6831759/ 
9. American Academy of Dermatology Association. How to treat diaper rash [Internet]. www.aad.org. Available from: https://www.aad.org/public/everyday-care/itchy-skin/rash/treat-diaper-rash 
10. Mohsen S, Dickinson JA, Ranjani Somayaji. Update on the adverse effects of antimicrobial therapies in community practice. Canadian Family Physician [Internet]. 2020 Sep;66(9):651. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7491661/ 
11. Alotiby A. Immunology of Stress: A Review Article. Journal of Clinical Medicine [Internet]. 2024 Oct 25;13(21):6394–4. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11546738/ 
12. MedlinePlus. Candida infection of the skin: MedlinePlus Medical Encyclopedia [Internet]. medlineplus.gov. Available from: https://medlineplus.gov/ency/article/000880.htm 

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