Adult diaper rash often occurs as a result of wearing adult diapers, incontinence briefs, or pads. Diaper rash begins as small, pink patches of irritated skin and progresses to larger patches of red, raised, painful bumps with a surrounding rash.

Diaper rash can be uncomfortable and painful, but most cases can be treated using over-the-counter (OTC) and home remedies. 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.

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

Home remedies

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 alcohol
• 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.

Other treatment

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.

When to seek help

Most cases of diaper rash will clear up after a few days of home treatment. However, it’s important to remember that elderly adults are more likely to experience infections. This is due to a weakening immune system. Any serious symptoms should be reported to a doctor.

See your doctor if the following occurs:

• rash worsens and doesn’t improve after three days, even after home treatment
• oozing, bleeding, or puss comes from the affected area
• rash is accompanied by fever
• burning or pain while urinating or during a bowel movement

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

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 three 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 and use 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.

Prevention

The best way to prevent adult diaper rash is to clean and change dirty diapers as soon as possible. This prevents moisture from turning into a rash.

• Gently clean the area covered by the diaper with a washcloth, such as Prevail Washcloths, every time you change the diaper.
• Once a day, wash the entire diaper area more thoroughly.
• Allow the diaper area to air out and dry.
• Also apply a moisture barrier ointment to the buttocks and other sensitive areas before putting on a clean diaper.
• Treating diaper rash at the first signs of irritation can also help prevent the rash from becoming more serious.

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