“Many patients suffer in silence, not because help doesn’t exist, but because embarrassment stops the conversation.”

Did you know skin problems are common for people living with incontinence? We asked Dr. Maria Panourgia, a consultant geriatrician, working in Milton Keynes University Hospital, for simple, effective ways to keep skin healthy. Find out what the experts recommend.

Choosing the right incontinence product to protect skin health

Fiona Ecarnot: « What advice do you give patients when choosing an incontinence product to protect the skin?« 

Dr. Maria Panourgia: « Many patients already have experience with absorbent products, often from caring for young children. The principles haven’t changed. Comfort is key. The product should not be bulky, should absorb moisture effectively, and should allow freedom of movement.

For people who are mobile, pants products are often the best option. They are easy to use and feel more natural—similar to regular underwear. For people who are bedridden or have limited mobility and rely on caregivers, products that are easy to put on and remove are more appropriate.

Fit is essential. Products should fit snugly without being tight or bulky. Bulky products can create pressure points and increase the risk of skin damage. Equally important is absorption: urine needs to be absorbed and locked inside the pad so moisture does not return to the skin.

Finally, the layer closest to the skin must be skin-friendly—hypoallergenic and breathable. When the skin can breathe, temperature stays lower, and that reduces bacterial growth, which is crucial for preventing infections. »

Why using the wrong product can damage the skin?

Fiona Ecarnot: « How can using the wrong product—such as menstrual pads—lead to skin complications?« 

Dr. Maria Panourgia: « Menstrual pads and urinary pads are designed for very different purposes. Menstrual products are made to absorb thicker fluids, such as blood, which behaves differently from urine. Urine is much more liquid and requires a different absorption mechanism.

Menstrual pads are not designed to absorb the volume of urine or prevent moisture from returning to the skin. This can lead to leakage, odors, and prolonged skin exposure to moisture. Additionally, urine has a higher pH than the skin. Menstrual pads are not designed to manage this pH imbalance, which can disrupt the skin barrier and lead to irritation and dermatitis.

Urinary pads, on the other hand, are engineered to absorb urine while respecting the skin’s natural pH. The skin is a living system, and it needs protection.

Despite this, around 36% of women still use menstrual pads for urinary incontinence. This is often due to stigma, embarrassment when buying urinary products, or cost concerns. However, in the long term, treating skin infections and dermatitis is far more expensive—physically and financially—than using the correct product from the start. »

The role of skin-friendly materials and protective care

Fiona Ecarnot: « Are there benefits to using skin-friendly materials or protective components like zinc?« 

Dr. Maria Panourgia: « Absolutely. Protecting the skin is a daily, ongoing task for people with urinary incontinence. Constant moisture can cause maceration, irritation, and incontinence-associated dermatitis. Warm, damp conditions also encourage bacterial and fungal growth, making infections more likely and harder to treat.

Barrier creams—especially those containing zinc oxide—are essential. They create a protective layer that shields the skin from moisture and irritation. Moisturizing creams are also important to keep the skin resilient and healthy.

Prevention is always easier than treatment. »

Daily care: what patients and caregivers should do?

Dr. Maria Panourgia: « Pads should be changed as soon as they become wet. This can be challenging, especially for patients with dementia or those in long-term care settings, so caregivers must be particularly attentive.

Urinary pads contain super-absorbent materials that turn liquid into a gel and lock it inside the pad—even under pressure. This technology is effective, but it only works properly if pads are changed regularly.

Good care includes:
– Using the correct urinary product
– Changing pads frequently
– Applying barrier creams
– Moisturizing the skin at every change

Skin should also be checked regularly. Redness, irritation, or areas where a patient repeatedly touches or scratches can be early signs of dermatitis. For people with very sensitive skin, more frequent checks are essential.

Hygiene matters. Clean the area gently with odor-free, hypoallergenic products. Dry the skin by gently patting—never rubbing—to avoid damaging the skin’s protective layer. »

Why incontinence-related dermatitis often goes untreated?

Fiona Ecarnot: « Why do you think many people don’t seek treatment for incontinence-related skin problems?

Dr. Maria Panourgia: « It’s a combination of stigma and lack of awareness. Fewer than half of patients report these issues to their doctors. Even though they may speak more openly with healthcare professionals than with others, many still feel uncomfortable admitting the problem.

Urinary incontinence affects a very intimate area—both physically and socially. For people who are otherwise active and independent, it can be especially difficult to talk about. »

What healthcare providers can do better?

Dr. Maria Panourgia: « Healthcare professionals need to start the conversation and normalize it. Urinary incontinence is common. It affects both women and men and becomes more frequent with age, childbirth, or pelvic floor damage.

When patients understand that this is a normal, manageable condition, they feel safer asking for help. Early discussions about the right products and skin care can prevent serious complications later—reducing the need for antibiotics or antifungal treatments.

Prevention benefits both patients and the healthcare system. »

Improving education for patients and caregivers

Fiona Ecarnot: « How can we improve education and awareness among caregivers? »

Dr. Maria Panourgia: « Around 80% of caregivers are not trained to recognize incontinence-related dermatitis. Unlike pressure ulcers, which are widely documented with visual guides, there is very little practical material available for skin irritation related to incontinence.

We need simple tools: visual guides, short videos, clear instructions. Caregivers should be able to recognize early signs, apply basic treatment like zinc cream, and know when to escalate the issue to a healthcare professional.

Untreated skin irritation can severely limit a person’s life—preventing them from leaving the house, socializing, or even thinking clearly. In vulnerable patients, such as those with dementia, irritation can lead to delirium or serious infections.

Education improves quality of life and reduces healthcare costs. »

The bigger picture: quality of life and social reintegration

Fiona Ecarnot: « What do you wish more patients understood about the link between incontinence and skin health?« 

Dr. Maria Panourgia: « Many people simply don’t connect the two. Because of stigma, they suffer in silence. Urinary incontinence does not define intelligence, productivity, or value. People can live full, active lives and still experience this condition.

When managed properly—with the right products, skin care, and support—people can continue working, socializing, and living with dignity.

We openly discuss many other health conditions today. Urinary incontinence should be no different. It is a medical condition, and solutions exist. »

When preventive skin care should begin

Dr. Maria Panourgia: « Preventive care should begin immediately—ideally before irritation appears. The perineal area is already prone to moisture and limited airflow, even without incontinence.

Once urinary incontinence is present, hygiene and skin protection become even more important. If irritation develops despite proper care, medical review is necessary to rule out infection and start appropriate treatment.

Prevention is always the first step. Treatment comes later—when prevention has failed. »