Women's incontinence products are routinely marketed alongside barrier creams, pH-balanced cleansers, and skin protection guidance. Men's products are marketed around one thing: the dry-layer technology inside the pad. The message to men is that the pad handles everything and the story ends there.
It does not end there. The pad reduces contact time with urine. It does not eliminate it. When contact is prolonged, the skin reacts in a specific and well-documented way. The clinical response to that has existed for decades. Men are simply not being told about it.
What IAD actually is
Incontinence-associated dermatitis (IAD) is what happens when skin is exposed to urine long enough to break down. Healthy skin sits at a pH of 4.5-6.2, an acidic environment that acts as a barrier against bacteria and infection. Prolonged urine contact shifts that pH into the alkaline range. That shift activates the digestive enzymes present in urine, which begin breaking down the epidermal barrier itself.
As Holroyd (2021) documents, the result is skin that is overhydrated, alkaline, and structurally compromised. The clinical presentation includes redness, erosion, secondary fungal or bacterial infection, and significant pain. None of this is inevitable. All of it is preventable.
Why men are at higher risk than they are told
The Prostate Cancer UK 2023 survey found that 87% of men had worn a pad for longer than they wanted to, and half had worn one for two or more hours beyond their preferred change point (Prostate Cancer UK, 2023). Consequences included rashes, fungal infections, pressure sores, and ulcers. Extended wear is precisely the scenario in which IAD develops.
For larger men the risk compounds further. Skinfold areas in the groin, perineum, and lower abdomen create warm enclosed environments where moisture accumulates. Full detail in if you are a larger man.
What barrier products actually do
Barrier creams form a physical layer between skin surface and moisture. They do not treat IAD once it has developed. They prevent it from occurring. The clinical standard is zinc oxide or dimethicone-based formulations. Both are available without prescription and have been used in clinical continence care for years.
pH-balanced cleansers serve a different but complementary function. Soap is alkaline. Using soap on skin already stressed by urine contact makes the pH problem worse. Cleansers with a pH close to that of healthy skin, combined with a moisturising component, protect barrier integrity.
What to use and when
Barrier cream. Apply a thin layer of zinc oxide or dimethicone cream to the perianal and perineal skin before fitting a pad. Reapply at every change. Do not apply thickly; a thick layer interferes with pad absorption.
pH-balanced cleanser. Use instead of soap at every pad change. Products labelled as perineal cleansers or continence wash cloths are formulated for this purpose. Available from all major UK pad manufacturers and most pharmacies.
Away from home. The full routine is not always practical. A lunchtime change in an office toilet cubicle does not allow for water, cleanser, and a barrier cream application. pH-balanced perineal wipes are the right substitute. Alcohol-free, fragrance-free, and ideally impregnated with a light barrier agent, one wipe cleans and protects in a single step. Individual sachets from TENA, iD, MoliCare, and most pharmacies fit in a wallet. A practical alternative that works just as well and looks completely neutral in a bag: Dude Wipes unscented. Marketed as a male grooming product, available from most supermarkets and Amazon, pH-balanced, alcohol-free, and considerably larger than standard clinical wipes. The unscented version specifically, the standard Dude Wipes contain fragrance which is worth avoiding on already-stressed perineal skin. They are a practical substitute for daytime changes away from home, not a permanent replacement for the full routine. The full routine at morning and evening changes remains the standard.
Frequency. At every pad change, without exception. If wearing a pad for longer than two hours, which the Bladder Health UK data confirms is common, apply barrier cream or use a wipe before leaving the house and cleanse and reapply at the earliest opportunity.
Skinfold areas. Pay specific attention to the groin and perineum. Perspiration alone is enough to maintain a moist environment between leakage episodes.
This is clinical maintenance, not skincare. The chemistry applies to every man using absorbent pads regardless of leakage volume. The products cost less than the pads.