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Preventing incontinence-associated dermatitis in older people

Dermatitis around the anus

Incontinence can contribute to anxiety and depression, cause an increase in urinary tract infections and increase the risk of falls. The greatest risk, however, is skin damage caused by incontinence-related dermatitis. It is a multifaceted condition so a full assessment is vital.

The skin of older people is particularly vulnerable because of age-related changes, including thinning of the dermis and epidermis, which makes it more fragile and prone to damage from washing and drying.

The skin also becomes dry because of a decrease in sebum production, loses elasticity because of flattening of the dermo-epidermal junction, and healing time is increased because cells are replenished more slowly.

Healthy skin has a so-called acid mantle formed by a mixture of sebum and sweat. This maintains a pH of 4.4-5.5. Exposure to urine and faeces can damage

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