Moisture-associated skin damage (MASD) is an umbrella term to describe the trauma that occurs when there is prolonged exposure to moisture. Incontinence-associated dermatitis (IAD) is an MASD condition caused by urinary and/or faecal incontinence. It often causes significant pain and has a negative impact on an individual’s quality of life. Prompt diagnosis of IAD is key to successful management, but the early symptoms of erythema and redness may not be obvious in those with a dark skin tone. Delays in assessment and treatment mean that maceration, infection and the development of pressure ulcers become more of a risk. This is compounded by the lack of education and awareness of the significance of skin tone in relation to wound care. This article is based on published research, together with the practical experience of healthcare professionals at the Complex Wound Clinic (CWC) in North West London. The aim is to highlight the importance of considering skin tone when managing IAD. This can be achieved by using a validated skin tone assessment tool which shows a range of six skin tones. The importance of skin tone is a critical subject as the latest 2021 Census data shows that in England and Wales, 18% belong to a black, Asian, mixed or other ethnic group (Gov.UK, 2021 Census data).