Understanding the differential diagnosis between moisture-associated skin damage (MASD) and pressure ulcers (PU) ensures appropriate management and interventions are instigated at the earliest opportunity. Most damage occurring to the buttocks or sacrum is attributed to pressure, shear, excessive moisture or a combination of these factors. MASD caused by excessive moisture to the sacrum/buttock area is recognised as incontinence-associated dermatitis (IAD); its occurrence is an identified risk factor in the development of PUs. Treatment for IAD should therefore focus on both IAD management and pressure ulcer prevention.