Silicone Barrier Spray Versus Zinc Oxide Ointment for Incontinence-Associated Dermatitis

June 9, 2026 updated by: Taoyuan Armed Forces General Hospital

Effectiveness of Structured Skin Care Using Silicone Barrier Spray Compared With Zinc Oxide Ointment for Incontinence-Associated Dermatitis in Long-Term Care Residents: A Randomized Controlled Trial

Incontinence-associated dermatitis (IAD) is a common skin condition among long-term care residents and is caused by prolonged exposure to urine or feces. IAD can lead to skin irritation, discomfort, impaired skin integrity, and an increased risk of secondary complications. Structured skin care, including cleansing and barrier protection, is recommended for the prevention and management of IAD.

This randomized controlled trial evaluated the effectiveness of a silicone barrier spray compared with zinc oxide ointment as part of a structured skin care program for residents with mild IAD in a long-term care facility. Participants were randomly assigned to receive either silicone barrier spray or zinc oxide ointment following routine skin cleansing. Clinical severity of IAD and skin barrier function were assessed at baseline, Day 7, and Day 14 using standardized clinical and biophysical measurements, including IAD severity score, skin hydration, transepidermal water loss, skin pH, and skin temperature. The study aimed to determine whether silicone barrier spray provides comparable or improved outcomes compared with conventional zinc oxide ointment in the management of mild IAD.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Incontinence-associated dermatitis (IAD) is a common form of moisture-associated skin damage resulting from prolonged exposure of the skin to urine and/or feces. The condition is particularly prevalent among residents of long-term care facilities because of advanced age, reduced mobility, cognitive impairment, chronic illness, and urinary or fecal incontinence. IAD is associated with erythema, discomfort, pain, impaired skin barrier function, and an increased risk of secondary complications, including pressure injuries and skin infections.

Maintenance of skin barrier integrity is a fundamental component of IAD prevention and treatment. Current international guidelines recommend structured skin care programs consisting of routine cleansing, moisturization, and barrier protection. Zinc oxide-based ointments are among the most commonly used barrier products because they provide effective protection against moisture and irritants. However, zinc oxide formulations may be difficult to apply and remove, can leave residue on the skin, and may increase friction during repeated cleansing procedures.

Silicone-based barrier films represent an alternative approach to skin protection. These products form a transparent, breathable, water-resistant layer on the skin surface and may reduce friction while preserving epidermal barrier function. Sprayable silicone barrier formulations may provide additional practical advantages, including rapid application, uniform coverage, reduced physical contact with damaged skin, and improved ease of use for caregivers. Such characteristics may be particularly valuable in long-term care settings where frequent skin care interventions are required.

Despite increasing clinical use of silicone-based barrier products, direct randomized comparisons between sprayable silicone barrier films and traditional zinc oxide ointments remain limited. Furthermore, objective evaluations of skin barrier recovery using biophysical measurements have not been extensively investigated in long-term care populations with IAD.

The purpose of this study was to compare the effectiveness of a silicone barrier spray and zinc oxide ointment when incorporated into a structured skin care program for long-term care residents with mild incontinence-associated dermatitis. In addition to evaluating clinical improvement, the study investigated changes in skin barrier function using objective biophysical assessments. The findings of this study are intended to provide evidence to support clinical decision-making regarding barrier protection strategies and to improve skin care practices for vulnerable older adults residing in long-term care facilities.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
    • Taoyuan City
      • Longtan, Taoyuan City, Taiwan, 325
        • Taoyuan Armed Forces General Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Resident of a long-term care facility.
  • Diagnosis of mild incontinence-associated dermatitis (IAD), classified as GLOBIAD Category 1.
  • Ability to provide informed consent personally or through a legally authorized representative.
  • Willingness to participate in the study and comply with study procedures.

Exclusion Criteria:

  • Incontinence-associated dermatitis (IAD) classified as GLOBIAD Category 2.
  • Presence of skin erosion, skin loss, open wounds, or active skin infection in the assessment area.
  • Known allergy or hypersensitivity to silicone-based barrier products or zinc oxide preparations.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Silicone Barrier Spray
Participants received a silicone-based barrier spray after structured skin cleansing and moisturizing care throughout the 14-day study period.
Device: Silicone Barrier Spray
A silicone-based skin barrier spray (Brava® Skin Barrier Spray, Coloplast A/S, Denmark) was applied to the perineal skin after each cleansing episode as part of a structured skin care regimen. The spray forms a transparent, breathable, water-resistant protective film designed to reduce moisture-related skin damage and friction while maintaining skin barrier integrity. Participants received the intervention throughout the 14-day study period following routine cleansing and moisturizing care.
Active Comparator: Zinc Oxide Ointment
Participants received zinc oxide ointment after structured skin cleansing and moisturizing care throughout the 14-day study period.
Drug: Zinc Oxide Ointment
A traditional zinc oxide-based barrier ointment applied to the perineal skin after routine cleansing and moisturizing care. The ointment forms a protective barrier that helps reduce skin exposure to moisture, irritants, and friction associated with urinary and fecal incontinence. The intervention was administered as part of a structured skin care protocol throughout the 14-day study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Incontinence-Associated Dermatitis Severity Score
Time Frame: Baseline (Day 1), Day 7, and Day 14
Clinical severity of incontinence-associated dermatitis assessed using the modified Ghent Global Incontinence-Associated Dermatitis Monitoring Tool (GLOBIAD-M). Scores ranged from 0 (normal skin) to 2 (more severe dermatitis), with lower scores indicating improvement in skin condition.
Baseline (Day 1), Day 7, and Day 14

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Skin Hydration
Time Frame: Baseline (Day 1), Day 7, and Day 14
Skin hydration measured using stratum corneum capacitance at affected skin sites.
Baseline (Day 1), Day 7, and Day 14
Transepidermal Water Loss (TEWL)
Time Frame: Baseline (Day 1), Day 7, and Day 14
Skin barrier function assessed by measuring transepidermal water loss (g/m²/h) using a closed-chamber evaporimeter.
Baseline (Day 1), Day 7, and Day 14
Skin pH
Time Frame: Baseline (Day 1), Day 7, and Day 14
Skin surface pH measured at affected skin sites using a flat-surface electrode device.
Baseline (Day 1), Day 7, and Day 14
Skin Temperature
Time Frame: Baseline (Day 1), Day 7, and Day 14
Skin temperature measured at affected skin sites using a skin assessment device.
Baseline (Day 1), Day 7, and Day 14

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Taoyuan Armed Forces General Hospital

Investigators

  • Principal Investigator: Po Jen Hsiao, MD, PhD, Taoyuan Armed Forces General Hospital
  • Study Chair: Hsieh Chih Tsai, PhD, National Taiwan University of Science and Technology
  • Study Director: Po Chung Chen, MD, MS, Taoyuan Armed Forces General Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2023

Primary Completion (Actual)

November 30, 2023

Study Completion (Actual)

November 30, 2023

Study Registration Dates

First Submitted

June 4, 2026

First Submitted That Met QC Criteria

June 4, 2026

First Posted (Actual)

June 10, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 9, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TYAFGH-D-112032

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be made publicly available because the informed consent and ethics approval did not include provisions for public data sharing. Data contain potentially identifiable information from residents of a long-term care facility, and sharing is restricted to protect participant privacy and confidentiality.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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