Incontinence Skin Care: Protecting Skin When Using Pads

In short: Incontinence skin care means checking the skin at each change, cleansing gently, drying carefully and changing pads when full, with barrier products chosen on a pharmacist’s or nurse’s advice. Sore or raw skin needs a doctor or nurse promptly, because wet skin can become infected or develop into a pressure ulcer. This guide covers each step for carers.

Why incontinence skin care matters

Good incontinence skin care matters because skin that stays wet becomes sore and breaks down more easily. An NHS trust leaflet describes moisture associated skin damage, also called incontinence associated dermatitis, as soreness and blistering where skin has been exposed to wetness over a long period. The wetness can come from urine, faeces, sweat or wound fluid, and it often shows in skin folds and creases (leaflet read November 2026).

Another NHS formulary document says there is a strong link between incontinence and moisture associated skin damage. For carers this is useful, because the damage is often preventable with simple, steady routines. This guide builds on our guide to choosing incontinence pads and focuses on the skin: cleansing, barrier products, how often to change, and when to ask for help.

Everything here is general information about incontinence skin care. A nurse, pharmacist or GP can look at the skin and advise on a particular person.

Spotting early signs of moisture-associated skin damage

Check the skin at every change, because the first signs are easy to miss and treatment works best early. The NHS trust leaflet lists these signs: skin that feels wet, irritated or sore, patches of sore skin sometimes with blisters or erosions, and a smell from the sore area, which may indicate a fungal or other infection.

Look in the places where skin touches skin or where a pad sits: the groin, buttocks, the creases of the thighs and the lower back. On white skin, early irritation may look red. The NHS says on black or brown skin, discolouration from pressure damage may look purple or blue, so rely on touch as well as sight. Warm, spongy or hard areas, pain and itching are all worth noting.

Tell the person what you are checking and why. Some people feel embarrassed, and a calm, matter-of-fact approach helps them stay involved in their own care. If they say the skin feels sore or wet, take it seriously, even if it looks fine.

Gentle cleansing after leaks

Gentle cleansing is the core of incontinence skin care: cleanse promptly after each leak, using a pH-balanced product or plain warm water, then dry the skin carefully. Age UK says washing regularly and drying carefully with a soft towel helps keep skin healthy. The NHS trust leaflet adds that harsh soaps can disrupt the skin’s pH and says to dry well between folds.

For skin that is already vulnerable or sore, one NHS formulary document prefers soap-free, pH-balanced foam cleansers and advises against ordinary soap and water or cleansing wipes, because they can damage the skin further. It says gentle soap and warm water are acceptable only where skin is completely healthy and there is no risk of excoriation. That document is written for clinicians, and local advice differs, so ask a continence nurse or district nurse what they recommend for the person you care for.

• Use warm, not hot, water and a soft cloth or cleansing cloth made for the purpose.
• Avoid scrubbing and use light strokes.
• Dry thoroughly, including between skin folds, before putting on a clean pad.
• Do not use talcum powder. The NHS trust leaflet and Bladder and Bowel UK both advise against it, and the charity says talc clogs the pad.
• Use only sterile wipes on broken skin, according to the NHS trust leaflet. If skin is broken, ask a nurse rather than managing alone.

For personal care routines more generally, see our guide to personal hygiene in care homes, which also helps families at home.

Barrier products in incontinence skin care

A barrier product can protect skin from urine and faeces, but the right one depends on the person’s skin and the pads they use, so ask a pharmacist or continence nurse. One NHS formulary document says that durable barrier creams give a barrier from body fluids and should be considered before the skin shows signs of redness or damage.

The main catch in incontinence skin care is for people who wear pads. Bladder and Bowel UK says to avoid creams with pads as far as possible, to use only prescribed creams in a very thin layer on the affected area, and to choose water-based rather than oil-based creams, because oil-based creams can reduce a pad’s absorbency. The NHS trust leaflet likewise says not to use oil-based products when a continence pad is in use. The formulary document says that thick pastes and ointments are occlusive and are not recommended for preventing damage unless clinically justified.

When you ask a pharmacist about incontinence skin care, it helps to say:

• What kind of pad or pants the person wears, and whether leaks are of urine, faeces or both.
• Whether the skin is intact, red, sore or broken.
• Any known skin allergies, and any creams already in use.
• Whether you need a cleanser, a barrier cream or a barrier film, and whether it can be used with the pad.

Ask whether a product is suitable for use under a pad before you buy it, and apply only a thin layer. We do not name products on this site. Do not share creams or cleansers between people. The formulary document says foam cleanser cans should be labelled for one person only.

Changing frequency and a good fit

Change a pad when it is full or nearly full, and straight away after faeces, rather than at a fixed time or the moment it is wet. Bladder and Bowel UK says products do not need to be changed as soon as urine is passed, and that if a pad is soiled with faeces it should be removed as soon as possible and skin hygiene attended to straight away (leaflet read November 2026).

Sitting in a very wet pad for long periods is the risk to avoid, so make sure each change happens often enough for the person. A wetness indicator, where fitted, can help you decide. Night-time needs differ, and our guide to night-time incontinence routines for carers covers overnight changes and checks.

Fit matters as much as timing in incontinence skin care. Age UK says that if skin becomes red or sore, you should check that pads fit well and are not rubbing. The NHS formulary document says disposable pants must be the correct size to prevent them digging in to the skin, and that body-worn pads should be held in place by snug-fitting pants. Our guide to incontinence pants or pads explains how to choose and size them.

If the skin keeps breaking down despite good practice, ask the local NHS continence service to review the product. Bladder and Bowel UK says to contact a healthcare professional if products leak regularly or sore skin develops, ideally six to eight weeks before the next delivery is due if you receive NHS products.

When damaged skin may become a pressure ulcer

Wet, damaged skin is a risk factor for pressure ulcers, so redness that does not fade or a sore over a bony area needs professional attention. The NHS lists swollen, sweaty or broken skin among the risk factors for pressure ulcers, along with difficulty moving, fragile skin, poor circulation and reduced sensation.

The NHS says early signs of a pressure ulcer are discoloured patches that stay the same colour when pressed. The area may feel warm, spongy or hard, and may be painful or itchy. Ulcers most often form over bony areas such as the heels, elbows, hips and tailbone, and can sometimes appear within a few hours. Moisture damage and pressure damage can occur together, and only a professional can tell them apart.

Our guide to bed sores and pressure ulcers explains prevention in more detail. For someone who spends long periods in bed or a chair, the NHS suggests checking skin daily, changing position regularly and asking a GP for a risk assessment if you care for someone at home and think they are at risk. Do not treat bed-bound people’s pressure care as a casual purchase. Ask an occupational therapist or district nurse before choosing any mattress or cushion.

When to seek help for red or broken skin

Contact a GP, district nurse or continence nurse as soon as skin is raw, blistered, broken or smelly, and get urgent help if there are signs of infection. Age UK says if skin becomes raw, you should contact a doctor or nurse straight away, as this could lead to a skin infection.

• Speak to a pharmacist or nurse soon if the skin stays red or sore for more than a short time, or if pad changes and gentle cleansing are not improving it.
• Ask a nurse or GP to look promptly if there is a smell from the area, which the NHS trust leaflet says may indicate infection. Also tell them if the person is eating or drinking less than usual.
• Get an urgent GP appointment or call NHS 111 if the skin is hot, swollen or red, there is pus, a high temperature, or severe or worsening pain. This is the NHS advice for suspected pressure ulcers and applies sensibly to any worsening sore, though a nurse should decide.

An NHS formulary document says severe moisture damage can be referred to a tissue viability service, and that damaged or infected skin may need prescribed treatment from a nurse or prescriber. You can also ask the GP or continence service for an assessment, which may open the way to NHS-supplied products. See free incontinence products from the NHS for how eligibility works.

Scotland, Wales and Northern Ireland

Services are organised locally, so the way continence and tissue viability services are arranged and accessed may vary by area. Ask your GP practice or local health board or trust how to reach them. For confidential advice, the Bladder and Bowel UK helpline number in its leaflets (read November 2026) is 0161 214 4591.

Frequently asked questions

What is incontinence-associated dermatitis?

It is a form of moisture associated skin damage. An NHS trust leaflet describes it as soreness and blistering where skin has been exposed to wetness for a long time, from urine, faeces, sweat or wound fluid. It often appears in skin folds and creases and can become infected.

Is soap and water safe for incontinence skin care?

Gentle soap and warm water are acceptable where skin is completely healthy, according to one NHS formulary document. For vulnerable or sore skin it prefers soap-free, pH-balanced cleansers. Ask a nurse what suits the person, and dry carefully afterwards, especially in skin folds.

Can I put barrier cream under an incontinence pad?

Ask a pharmacist or continence nurse first. Bladder and Bowel UK says to avoid creams with pads where possible, use only a very thin layer of a prescribed, water-based cream, and avoid oil-based products because they reduce absorbency. Do not use talcum powder.

How often should an incontinence pad be changed?

Change it when it is full or nearly full rather than the moment it is wet, says Bladder and Bowel UK. Change at once after faeces and attend to the skin. Check at each change, and ask a nurse if skin becomes sore.

What should I do if the skin is red or sore?

Check the pad fits and is not rubbing, cleanse gently and keep the skin dry. If it stays red or sore, or if skin becomes raw, contact a doctor or nurse straight away, as Age UK advises, because raw skin could lead to infection.

How can I tell moisture damage from a pressure ulcer?

They can look alike and can occur together. A pressure ulcer often starts as a patch that stays the same colour when pressed, over a bony area. Ask a GP, district nurse or tissue viability nurse to look rather than guessing.

When is sore skin an emergency?

Seek an urgent GP appointment or call NHS 111 if skin is hot, swollen or red, there is pus, a high temperature, or severe or worsening pain. Call 999 or go to A&E if the person is confused, drowsy or has difficulty speaking.

Official sources

• NHS: Urinary incontinence treatment
• NHS: Pressure sores
• Age UK: Incontinence
• Royal Wolverhampton NHS Trust: Moisture associated skin damage and incontinence associated dermatitis (2025)
• NHS Tayside: Skin integrity and continence guidelines (December 2024)
• Bladder & Bowel UK: Pads and containment products

This page is general information, not legal, medical or financial advice. The Care Panel is an independent guide and is not part of any government body or care provider. Last checked 9 November 2026.

Related: How to choose incontinence pads · Bed sores and pressure ulcers · Night-time incontinence routines for carers

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.