It is quite common for urine leakage to cause burning and skin irritation. Especially if the skin is exposed to urine for long periods, for example by not changing wet pads often enough. This is sometimes called Incontinence Associated Dermatitis (IAD). Dermatitis means skin inflammation. A US study found that half of hospitalised patients with incontinence problems had IAD symptoms. If the irritation is not treated, it can lead to a fungal infection.
What is urine and how does it damage the skin?
Pee is mostly water but also contains urea, salts and proteins such as creatinine. Fresh pee has a neutral pH and a mild odour, but after coming into contact with skin bacteria, the urea breaks down into ammonia and the pee takes on a more pungent odour and becomes more corrosive. In the past. A slightly odd historical use of urine, mentioned on Wikipedia's page on the properties of urine, is that in the Middle Ages clothes were kept in a wardrobe near the opening of the loo because the ammonia in the urine killed fleas.
Our skin is an amazing barrier that protects us from damage, bacteria and dangerous substances in our environment. However, if it is exposed to moisture and corrosive substances over a long period of time, the fat in the skin and the bonding of the cells can loosen, allowing irritants to pass through. In addition, moist skin has a high level of friction, which causes mechanical damage to the skin if, for example, it is rubbed against a moist pad, a bit like walking barefoot in shoes and getting shoe chafing.
The first sign of IAD is a mild redness or rash and possibly swelling. In later stages, the skin may have broken down and ulcers may form. There will be itching, stinging or pain. The itching may also be due to a fungal infection.
How can I prevent and treat skin irritation?
First of all, avoid exposing your skin to urine for long periods of time, e.g. by changing your incontinence pad when it feels wet or preventing urine leakage by using an incontinence aid.
Clean the genital area regularly with mild, pH-balanced intimate soap. There are also protective barrier creams that form a moisture barrier. They protect the skin while keeping it soft, smooth and moisturised. Wear soft and comfortable underwear to avoid chafing. Avoid overly tight clothing that traps moisture.
If you have both itching and smelly discharge, you may have a fungal infection. This can often be treated with over-the-counter anti-fungal medicines. If that doesn't help, or if you have pain and sores that don't heal, seek medical attention.