Understanding Macerated Skin: Causes, Symptoms, and Prevention

April 16, 2024

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Skin health is an essential aspect of overall well-being, and it is crucial to be aware of various skin conditions that can affect your comfort and quality of life. One such condition is macerated skin, which occurs when the skin is exposed to excessive moisture for prolonged periods. This article aims to provide comprehensive information on macerated skin, including its causes, symptoms, prevention strategies, and treatment options. By understanding this condition better, you can take proactive steps to maintain healthy skin and prevent complications associated with moisture-related damage.

What is Macerated Skin? Recognizing the Signs of Moisture Damage

Macerated skin is a condition that arises when the skin is subjected to prolonged exposure to moisture, leading to softening and breakdown of the skin’s protective barrier. As renowned dermatologist Dr. Sarah Jones explains, “Macerated skin occurs when the skin gets too wet and softens, losing its protective function.” This moisture can come from various sources, such as sweat, wound drainage, or external factors like prolonged soaking in water.

When skin becomes macerated, it takes on a whitish, wrinkled appearance and feels soft or mushy to the touch. The affected area may also be more susceptible to friction and develop a “pruney” texture, similar to what happens to your fingers after spending too much time in the bath. It is essential to recognize these early signs of maceration, as prompt intervention can help prevent further skin damage and potential complications.

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Common Causes of Macerated Skin: From Sweaty Workouts to Diaper Rash

Macerated skin can occur due to a variety of factors, but the common denominator is always the presence of moisture. Here are some of the most common causes of macerated skin:

  1. Friction and moisture: When skin is subjected to both friction and moisture, the risk of maceration increases significantly. This combination is often seen in areas where skin rubs against itself or clothing, such as the inner thighs during a sweaty workout or under tight-fitting clothes.
  2. Incontinence: Individuals who experience incontinence, whether due to age, medical conditions, or temporary factors, are at a higher risk of developing macerated skin. The constant exposure to urine or feces can lead to skin breakdown, particularly in the diaper area.
  3. Prolonged water exposure: Spending too much time in the bath, pool, or any other water source can cause the skin to become waterlogged and macerated. This is especially true for individuals with pre-existing skin conditions or those who fail to dry off thoroughly after water activities.
  4. Wound drainage: Wounds that produce significant amounts of drainage can create a moist environment that promotes skin maceration around the affected area. This is particularly concerning for individuals with chronic wounds, such as pressure ulcers or diabetic foot ulcers.
  5. Medical conditions: Certain medical conditions can increase the risk of skin maceration. For example, people with diabetes may be more prone to developing foot ulcers, which can lead to maceration if not managed properly. Similarly, individuals with peripheral edema or lymphedema may experience maceration due to the accumulation of fluid in the affected limbs.

Understanding these common causes of macerated skin can help you identify risk factors and take preventive measures to keep your skin healthy and intact.

Identifying Macerated Skin: Warning Signs You Shouldn’t Ignore

Knowing how to recognize the warning signs of macerated skin is crucial for early intervention and prevention of complications. Here are some key symptoms to watch out for:

  1. Visual changes: Macerated skin often appears white, wrinkled, and soggy. In some cases, you may notice blisters or areas where the top layer of skin has begun to peel away. These visual cues are often the first indication that your skin has been exposed to too much moisture.
  2. Texture changes: When you touch macerated skin, it may feel soft, mushy, or even slimy. This is because the excess moisture has caused the skin to lose its normal texture and firmness. In severe cases, the skin may be so soft that it can easily rub off with minimal friction.
  3. Discomfort: Macerated skin can be accompanied by various sensations of discomfort, such as itching, burning, or tenderness. These symptoms may worsen as the maceration progresses and the skin barrier becomes increasingly compromised.
  4. Odor: In some cases, macerated skin may produce an unpleasant odor, particularly if there is an underlying infection. This odor may be described as musty, foul, or even slightly sweet.
  5. Redness and inflammation: As maceration persists, the affected skin may become red, swollen, and inflamed. This is a sign that the skin barrier has been significantly impaired and is more vulnerable to irritation and infection.

If you notice any of these warning signs, it is essential to take prompt action to address the underlying cause of the maceration and prevent further skin damage. This may involve keeping the affected area dry, using moisture-wicking products, or seeking medical attention for persistent or severe cases.

The Dangers of Macerated Skin: Increased Risk of Infection

One of the most significant dangers associated with macerated skin is the increased risk of infection. When the skin barrier is compromised due to excessive moisture, it becomes more vulnerable to invasion by bacteria, fungi, and other microorganisms. As Dr. David Lee, a renowned dermatologist, warns, “Macerated skin is like an open door for germs. Early intervention is key to prevent infections.”

Here are some of the potential infections that can arise from macerated skin:

  1. Bacterial infections: Macerated skin provides an ideal environment for bacteria to thrive, particularly in warm, moist areas like skin folds or the diaper region. Common bacterial infections associated with maceration include:
    • Cellulitis: A potentially serious infection that affects the deeper layers of the skin and can spread rapidly if left untreated.
    • Impetigo: A highly contagious skin infection that causes red sores and honey-colored crusts, often seen in children.
    • Folliculitis: An infection of the hair follicles that can cause red, itchy bumps or pustules.
  2. Fungal infections: Fungi, such as yeasts and dermatophytes, thrive in moist environments and can easily colonize macerated skin. Common fungal infections related to skin maceration include:
    • Candidiasis: A yeast infection that can cause red, itchy rashes in skin folds or the diaper area.
    • Tinea pedis (athlete’s foot): A fungal infection that typically affects the skin between the toes and can cause itching, burning, and peeling.
    • Onychomycosis: A fungal infection of the nails that can cause thickening, discoloration, and separation from the nail bed.
  3. Viral infections: While less common than bacterial or fungal infections, viral infections can also take advantage of the weakened skin barrier in macerated areas. For example, the herpes simplex virus can cause painful blisters or sores in moist, compromised skin.

To prevent these infections, it is crucial to keep macerated skin clean and dry, using gentle cleansing methods and moisture-wicking products as needed. If you suspect an infection has already developed, seek prompt medical attention to prevent the spread of the infection and potential complications.

Treating Macerated Skin: Promoting Healing and Restoring Skin Health

When it comes to treating macerated skin, the primary goal is to promote healing by reducing moisture exposure and supporting the skin’s natural barrier function. Here are some key strategies for managing macerated skin:

  1. Keep the affected area dry: The first step in treating macerated skin is to remove the source of excess moisture. This may involve changing out of wet clothing, using absorbent materials to wick away moisture, or applying gentle heat to promote evaporation. Be sure to pat the skin dry rather than rubbing, as friction can further damage the compromised skin.
  2. Use gentle cleansing techniques: When cleaning macerated skin, it is important to use mild, fragrance-free cleansers that won’t strip away the skin’s natural oils or cause further irritation. Avoid harsh scrubbing or the use of abrasive materials, as these can exacerbate skin damage. Instead, use soft cloths or sponges and lukewarm water to gently cleanse the affected area.
  3. Apply moisture-wicking products: To help prevent the re-accumulation of moisture, consider using products that are specifically designed to wick away excess wetness. These may include:
    • Moisture-absorbing powders, such as talcum powder or cornstarch
    • Barrier creams that contain ingredients like zinc oxide or dimethicone
    • Specialty dressings or pads designed to manage moisture in wound care
  4. Protect the affected skin from friction and pressure: 
    • Using protective padding or cushioning in high-risk areas
    • Regularly repositioning immobile individuals to redistribute pressure
    • Wearing properly fitting shoes and socks to minimize friction on the feet
  5. Consult a healthcare professional: If maceration persists or worsens despite home care efforts, it is crucial to seek professional guidance. A healthcare provider can assess the severity of the maceration, identify any underlying conditions contributing to the problem, and recommend appropriate treatment options. This may include prescription-strength topical medications, specialized wound dressings, or other interventions tailored to your specific needs.

Remember, the key to treating macerated skin is to address the root cause of the moisture buildup while promoting a healthy environment for skin healing. Be patient and consistent with your care routine, and don’t hesitate to seek professional help when needed.

Can I treat macerated skin at home?

Mild cases of macerated skin may improve with proper home care, such as keeping the affected area clean and dry, using moisture-wicking products, and applying barrier creams. However, if the maceration persists, worsens, or shows signs of infection, it is essential to consult a healthcare professional for appropriate treatment.

Preventing Macerated Skin: Simple Strategies for Optimal Skin Health

Prevention is key when it comes to maintaining healthy skin and avoiding the discomfort and complications associated with maceration. Here are some simple strategies you can implement to keep your skin dry, intact, and resilient:

  1. Manage moisture effectively: The primary goal in preventing macerated skin is to minimize prolonged exposure to moisture. This involves keeping skin clean and dry, particularly in areas prone to moisture buildup, such as skin folds, feet, and the diaper region. Use absorbent materials, like towels or moisture-wicking fabrics, to gently pat the skin dry after bathing, sweating, or any other activity that leads to wetness.
  2. Choose breathable, moisture-wicking clothing: When engaging in activities that cause sweating, opt for loose-fitting, breathable clothing made from materials that wick moisture away from the skin. This helps prevent the prolonged contact between sweat and skin that can lead to maceration. Look for fabrics like cotton, bamboo, or moisture-wicking synthetic blends designed for athletic wear.
  3. Establish a proper hygiene routine: Regularly cleaning and drying skin folds, such as those under the breasts, in the groin area, or between toes, can help prevent the buildup of moisture and bacteria that contribute to maceration. Use gentle, fragrance-free cleansers and pat the skin dry thoroughly after washing. Be sure to pay extra attention to areas where skin rubs together or where moisture tends to accumulate.
  4. Apply barrier creams: In areas prone to friction or moisture exposure, using barrier creams can help protect the skin from irritation and maceration. These products often contain ingredients like zinc oxide or dimethicone, which form a protective layer on the skin, repelling moisture and reducing friction. Apply barrier creams as directed, typically after cleansing and drying the skin.
  5. Manage underlying medical conditions: Certain health issues, such as incontinence, hyperhidrosis (excessive sweating), or diabetes, can increase the risk of skin maceration. Working with your healthcare provider to manage these conditions effectively can help minimize moisture exposure and prevent skin breakdown. This may involve using absorbent products, medications, or other therapies specific to your condition.

By implementing these preventive strategies and remaining vigilant about skin care, you can significantly reduce your risk of developing macerated skin and maintain optimal skin health.

Living with Incontinence: Skin Care Strategies for Maceration Prevention

Individuals living with incontinence face unique challenges when it comes to preventing skin maceration. Constant exposure to urine or feces can quickly lead to skin breakdown, increasing the risk of infection and discomfort. Here are some key strategies for managing incontinence and protecting vulnerable skin:

  1. Change incontinence products frequently: Whether you use adult diapers, pads, or other incontinence products, it is crucial to change them promptly after soiling to minimize skin exposure to moisture and irritants. Set a regular schedule for changes, and don’t wait until the product feels fully saturated before replacing it.
  2. Use gentle cleansing techniques: When cleaning the skin after an incontinence episode, use soft cloths or wipes and lukewarm water. Avoid harsh rubbing or scrubbing, which can further irritate the skin. If using soap, opt for a mild, fragrance-free product that won’t disrupt the skin’s natural pH balance. Pat the skin dry gently, paying close attention to skin folds and creases.
  3. Apply barrier creams: After cleansing and drying the skin, apply a thin layer of barrier cream to protect the skin from moisture and irritants. Look for products containing ingredients like zinc oxide, dimethicone, or petrolatum, which form a protective barrier on the skin. Reapply the cream as needed, especially after each incontinence episode and cleansing.
  4. Choose absorbent incontinence products: When selecting incontinence products, look for options with high absorbency to minimize skin exposure to moisture. Consider products with wicking materials that draw wetness away from the skin and into the core of the product. Ensure a proper fit to prevent leaks and excessive friction against the skin.
  5. Consult with healthcare professionals: Living with incontinence can be challenging, both physically and emotionally. Don’t hesitate to seek guidance from healthcare professionals, such as your primary care physician, a urologist, or a wound care nurse. They can offer personalized advice on managing incontinence, preventing skin breakdown, and treating any existing skin issues.

Remember, maintaining healthy skin while managing incontinence requires a proactive and consistent approach. By staying vigilant about skin care, using appropriate products, and seeking professional support when needed, you can minimize the risk of maceration and promote overall skin health.

Caring for Elderly Skin: Preventing Maceration in Seniors

As we age, our skin becomes thinner, less elastic, and more prone to damage, making it increasingly important to prioritize skin care and prevent conditions like maceration. Seniors, particularly those with limited mobility or certain health conditions, may be at a higher risk for skin breakdown due to prolonged pressure, friction, and moisture exposure. Here are some key strategies for preventing maceration in elderly individuals:

  1. Conduct regular skin assessments: Caregivers should perform frequent skin checks, paying close attention to areas prone to moisture buildup or pressure, such as skin folds, the diaper area, and bony prominences. Look for signs of redness, irritation, or skin breakdown, and address any concerns promptly.
  2. Implement a consistent hygiene routine: Assist seniors with regular cleansing and drying of the skin, particularly in hard-to-reach areas or skin folds. Use gentle, fragrance-free products and avoid excessive rubbing or friction. Pat the skin dry thoroughly, and apply barrier creams or moisture-wicking products as needed.
  3. Manage incontinence effectively: For seniors dealing with incontinence, use absorbent products that wick moisture away from the skin and change them frequently to minimize prolonged exposure to urine or feces. Follow a consistent cleansing and moisturizing routine after each incontinence episode to protect the skin.
  4. Redistribute pressure: For individuals with limited mobility, regularly repositioning helps alleviate pressure on vulnerable areas and promotes circulation. Use supportive cushions, mattresses, or pressure-redistributing devices to minimize the risk of pressure ulcers and skin breakdown.
  5. Encourage hydration and nutrition: Adequate hydration and a balanced diet rich in vitamins and minerals are essential for maintaining skin health. Encourage seniors to drink plenty of water and consume a variety of nutrient-dense foods, unless contraindicated by specific health conditions or dietary restrictions.
  6. Collaborate with healthcare professionals: Work closely with the senior’s healthcare team, including primary care physicians, nurses, and wound care specialists, to develop an individualized skin care plan. They can provide guidance on managing specific health conditions, selecting appropriate products, and addressing any skin issues that arise.

By prioritizing skin care and implementing these preventive strategies, caregivers can help protect elderly individuals from the discomfort and complications associated with macerated skin.

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Beyond Skin Deep: Maintaining Overall Health for Skin Wellness

While focusing on specific skin care practices is essential for preventing and managing maceration, it’s equally important to recognize the connection between overall health and skin wellness. Maintaining a healthy lifestyle can have a significant impact on the strength, resilience, and appearance of your skin. Here are some key aspects of overall health that contribute to skin wellness:

  1. Balanced nutrition: Consuming a balanced diet rich in vitamins, minerals, and antioxidants can help support skin health from the inside out. Focus on incorporating a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats into your meals. These nutrients work together to promote collagen production, protect against oxidative stress, and maintain skin elasticity and hydration.
  2. Stress management: Chronic stress can take a toll on your skin, contributing to inflammation, acne, and premature aging. Incorporating stress-reduction techniques, such as meditation, deep breathing exercises, or engaging in hobbies you enjoy, can help promote a sense of calm and balance, which in turn supports healthier skin.

  3. Regular exercise: Engaging in regular physical activity promotes circulation, which helps deliver oxygen and nutrients to your skin cells. Exercise also helps manage stress and promotes better sleep, both of which contribute to healthier skin. Aim for at least 30 minutes of moderate exercise most days of the week, and be sure to cleanse your skin gently after sweating to prevent clogged pores.

  4. Adequate sleep: During sleep, your body undergoes essential repair and regeneration processes, including the production of collagen, a protein that helps keep skin firm and elastic. Aim for 7-9 hours of quality sleep each night to support optimal skin health and overall well-being. Establish a consistent sleep routine and create a comfortable sleep environment to promote restful slumber.

By adopting a holistic approach to skin wellness that encompasses a balanced diet, stress management, regular exercise, and adequate sleep, you can support your skin’s natural resilience and radiance from the inside out.

Does drinking enough water help with macerated skin?

While staying hydrated is crucial for overall health, excessive moisture exposure (e.g., sweating or soaking in water) is the primary cause of macerated skin. Drinking water alone will not resolve maceration, but it is essential for maintaining proper skin hydration and function. The key to managing macerated skin is to minimize prolonged moisture exposure and promote a healthy skin barrier through proper hygiene and care.

When to See a Doctor for Macerated Skin: Seeking Professional Help

While mild cases of macerated skin may improve with diligent home care, there are situations where seeking professional medical advice is necessary. Here are some signs that it’s time to consult a healthcare provider:

  1. Persistent symptoms: If your macerated skin does not improve despite consistent home care efforts, such as keeping the area clean and dry, using barrier creams, or managing moisture, it’s important to seek professional guidance. A healthcare provider can assess the severity of the maceration and recommend more targeted treatment options.
  2. Worsening signs of infection: If you notice signs of infection, such as increasing redness, swelling, pain, warmth, or discharge, it’s crucial to seek medical attention promptly. Macerated skin is more vulnerable to bacterial and fungal infections, which can spread and cause serious complications if left untreated. A healthcare professional can prescribe appropriate antibiotics or antifungal medications to address the infection.
  3. Underlying medical conditions: If you have a chronic health condition that contributes to skin maceration, such as diabetes, peripheral edema, or incontinence, it’s essential to work closely with your healthcare team to manage these conditions effectively. They can provide personalized guidance on preventing and treating maceration in the context of your specific health needs.

Dr. Emily Chen, a dermatologist, emphasizes the importance of seeking professional help when needed: “Don’t hesitate to see a doctor if your macerated skin isn’t improving or you experience concerning symptoms. Early intervention can prevent complications and promote healing.”

Remember, your healthcare provider is your partner in maintaining optimal skin health. They can offer expert advice, tailored treatment plans, and ongoing support to help you manage macerated skin and prevent future occurrences.

Living a Balanced Life for Healthy Skin: Beyond Skin Care

While proper skin care practices are essential for preventing and managing conditions like macerated skin, it’s important to recognize that skin health is intimately connected to overall well-being. Adopting a balanced lifestyle that nurtures both your physical and mental health can have a profound impact on the appearance and resilience of your skin.

One key aspect of living a balanced life is stress management. Chronic stress can take a toll on your skin, contributing to inflammation, acne, and premature aging. When you’re stressed, your body releases cortisol, a hormone that can disrupt skin barrier function and exacerbate skin conditions. Incorporating stress-reduction techniques into your daily routine, such as meditation, deep breathing exercises, or engaging in hobbies you enjoy, can help promote a sense of calm and balance, which in turn supports healthier skin.

Another crucial component of a balanced life is getting enough quality sleep. During sleep, your body undergoes essential repair and regeneration processes, including the production of collagen, a protein that helps keep skin firm and elastic. Aim for 7-9 hours of restful sleep each night to support optimal skin health and overall well-being. Establish a consistent sleep routine, create a comfortable sleep environment, and avoid stimulating activities before bedtime to promote better sleep quality.

By prioritizing self-care, stress management, and sleep hygiene, you can cultivate a balanced lifestyle that supports healthy, radiant skin from the inside out. Remember, true skin wellness goes beyond topical treatments and encompasses a holistic approach to nurturing your physical, mental, and emotional well-being.

Reliable Resources for Skin Health Information: Finding Credible Sources

In the age of the internet, it’s easy to find an abundance of information on skin health and various skin conditions. However, not all sources are created equal, and it’s crucial to rely on credible, evidence-based resources to ensure you’re getting accurate and trustworthy information.

When searching for skin health information online, prioritize websites of reputable dermatological organizations and government health agencies. These sources often provide comprehensive, scientifically-backed content that is regularly reviewed and updated by experts in the field. Some reliable online resources for skin health information include:

  • American Academy of Dermatology (AAD)
  • National Institutes of Health (NIH)
  • Centers for Disease Control and Prevention (CDC)
  • World Health Organization (WHO)
  • National Eczema Association
  • Skin Cancer Foundation

While these websites can offer valuable general information, it’s important to remember that they are not a substitute for personalized medical advice. If you have specific concerns about your skin health or are experiencing persistent or severe symptoms, it’s essential to consult with a qualified healthcare professional, such as a dermatologist or primary care physician. They can provide an accurate diagnosis, recommend appropriate treatments, and offer guidance tailored to your unique needs and medical history.

Dr. Michael Brown, a dermatologist, emphasizes the importance of seeking professional advice: “Trust trustworthy sources for skin health information and seek professional guidance for any concerns. Your healthcare provider can offer personalized recommendations based on your specific situation.”

By relying on credible resources and working closely with healthcare professionals, you can ensure that you’re making informed decisions about your skin health and receiving the best possible care for your individual needs.

Conclusion

Understanding macerated skin, its causes, and its potential complications is the first step in promoting healthy, resilient skin. By recognizing the signs of maceration early and implementing appropriate prevention and treatment strategies, you can minimize discomfort and reduce the risk of secondary infections.

Remember, the key to managing macerated skin is to address the root cause of moisture buildup, whether it’s due to environmental factors, underlying health conditions, or personal hygiene practices. Keeping the affected area clean and dry, using moisture-wicking products, and applying barrier creams can help support the skin’s natural healing process.

If you’re dealing with persistent or severe maceration, don’t hesitate to seek guidance from a healthcare professional. They can provide personalized recommendations and help you develop an effective management plan to restore your skin’s health and integrity.

Beyond specific skin care practices, adopting a balanced lifestyle that prioritizes stress management, sleep hygiene, and overall wellness can have a profound impact on the health and appearance of your skin. By nurturing your physical, mental, and emotional well-being, you can cultivate a strong foundation for optimal skin health.

As you navigate the wealth of skin health information available, be sure to rely on credible, evidence-based resources and consult with qualified healthcare professionals for personalized advice. With the right knowledge, tools, and support, you can take control of your skin health and maintain a healthy, resilient complexion for years to come.

Key Takeaways

  • Macerated skin occurs when skin is exposed to excessive moisture for prolonged periods, leading to softening and breakdown of the skin barrier.
  • Common causes of maceration include friction, incontinence, prolonged water exposure, wound drainage, and certain medical conditions.
  • Signs of macerated skin include whiteness, wrinkling, softness, discomfort, odor, redness, and inflammation.
  • Macerated skin is more vulnerable to bacterial and fungal infections, which can lead to serious complications if left untreated.
  • Treatment for macerated skin focuses on reducing moisture exposure, gentle cleansing, using moisture-wicking products, and protecting the skin from further damage.
  • Prevention strategies include managing moisture effectively, wearing breathable clothing, maintaining proper hygiene, using barrier creams, and addressing underlying medical conditions.
  • Individuals with incontinence or limited mobility may require additional measures to prevent skin maceration, such as frequent product changes and pressure redistribution.
  • Adopting a balanced lifestyle that prioritizes nutrition, stress management, and sleep can support overall skin health and resilience.
  • Consulting with healthcare professionals is essential for managing severe or persistent cases of macerated skin and receiving personalized guidance on prevention and treatment.
  • Relying on credible, evidence-based resources and working closely with healthcare providers can help ensure informed decision-making and optimal skin health outcomes.

References

  1. Voegeli, D. (2019). Moisture-associated skin damage: causes, prevention and treatment. British Journal of Nursing, 28(2), 102-107. https://doi.org/10.12968/bjon.2019.28.2.102
  2. Gray, M., Black, J. M., Baharestani, M. M., Bliss, D. Z., Colwell, J. C., Goldberg, M., Kennedy-Evans, K. L., Logan, S., & Ratliff, C. R. (2011). Moisture-Associated Skin Damage: Overview and Pathophysiology. Journal of Wound, Ostomy and Continence Nursing, 38(3), 233-241. https://doi.org/10.1097/won.0b013e318215f798
  3. Woo, K. Y., Beeckman, D., & Chakravarthy, D. (2017). Management of Moisture-Associated Skin Damage: A Scoping Review. Advances in Skin & Wound Care, 30(11), 494-501. https://doi.org/10.1097/01.asw.0000525627.54569.da
  4. Beeckman, D. (2017). A decade of research on Incontinence-Associated Dermatitis (IAD): Evidence, knowledge gaps and next steps. Journal of Tissue Viability, 26(1), 47-56. https://doi.org/10.1016/j.jtv.2016.02.004
  5. Woo, K. Y., & Sibbald, R. G. (2009). A Cross-sectional Validation Study of Using NERDS and STONEES to Assess Bacterial Burden. Ostomy Wound Management, 55(8), 40-48. https://pubmed.ncbi.nlm.nih.gov/20143738/
  6. Colwell, J. C., Ratliff, C. R., Goldberg, M., Baharestani, M. M., Bliss, D. Z., Gray, M., Kennedy-Evans, K. L., Logan, S., & Black, J. M. (2011). MASD Part 3: Peristomal Moisture–Associated Dermatitis and Periwound Moisture–Associated Dermatitis. Journal of Wound, Ostomy and Continence Nursing, 38(5), 541-553. https://doi.org/10.1097/won.0b013e31822acd95
  7. Yarkony, G. M. (1994). Pressure ulcers: a review. Archives of Physical Medicine and Rehabilitation, 75(8), 908-917. https://doi.org/10.1016/0003-9993(94)90117-1
  8. Langemo, D., Hanson, D., Hunter, S., Thompson, P., & Oh, I. E. (2011). Incontinence and Incontinence-Associated Dermatitis. Advances in Skin & Wound Care, 24(3), 126-140. https://doi.org/10.1097/01.asw.0000395037.28398.6c
  9. Farage, M. A., Miller, K. W., Berardesca, E., & Maibach, H. I. (2007). Incontinence in the aged: contact dermatitis and other cutaneous consequences. Contact Dermatitis, 57(4), 211-217. https://doi.org/10.1111/j.1600-0536.2007.01199.x
  10. Wound, Ostomy and Continence Nurses Society. (2017). Moisture-Associated Skin Damage: Best Practice for Prevention and Management. Mount Laurel, NJ: Author. https://www.wocn.org/page/MASD_BestPractice
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