Treatment of Perianal Erythematous Rash from Incontinence

Primary Treatment Approach

Zinc oxide is the evidence-based first-line treatment for incontinence-associated dermatitis (IAD) affecting the perianal area, and should be applied to protect the skin from further exposure to urine and feces 1

Consider fungal infection if there are satellite lesions, pustules, or if the rash fails to improve with barrier protection alone, and local fungal skin infections may be associated with peristomal or perianal leakage and can be treated with topical antifungal agents 1
Foam dressings may be used to absorb drainage and lift moisture away from skin, whereas gauze can worsen maceration 1
For patients with persistent symptoms despite proper barrier use, culture the area to identify fungal or bacterial superinfection before adding antimicrobials 1