Incontinence Skin Care Guide

People with incontinence are at risk of skin problems in the areas where urine and/or feces may be in contact with skin. This can lead to skin irritation and breakdown around the buttocks, hips, genetics and the area between the rectum and the pelvis. 

Not only can these irritation be extremely uncomfortable, they can also potentially lead to worse conditions including bedsores especially if they have not been eating well, received or are receiving radiation therapy in the area or spend extended periods of time in bed, in a chair or in a wheelchair.

Moisture alone may cause skin problems including redness, peeling and yeast infections. Fecal matter adds additional elements that lead to skin irritation and discomfort.

Taking care of the skin and using ongoing established practices will help keep skin irritation under control providing more comfort for the patient. 

Adult diapers, briefs, protective underwear and pads are designed to keep the wearer comfortable and secure while providing clean bedding and clothing. They may keep urine and feces close to the skin so it is important to use an incontinence product with the correct absorption for the patient as well as taking special care of the skin by changing the garment after an episode and cleaning and maintaining the sensitive skin. 

Once the diaper, protective underwear, pad or undergarment is changed there are three key steps or areas of skin care to consider - cleaning, moisturizing and protecting. There are many great products that are designed for incontinence skin care that do not include abrasive, irritating or drying agents such as soap or alcohol.

Cleansing

Once the soiled garment is removed then the next step is a thorough cleaning off all the areas of skin that may have been in contact with urine and/or feces.

Cleansing can be done in a bath or shower or even in bed. In-bed bathing is made much easier by using no-rinse skin cleansers available in liquids, foams or disposable wipes and washcloths. Here is a link to a previous entry that details the steps for complete in-bed bathing. 

It is helpful to use a cleanser designed specifically for incontinence care as they will clean without causing additional irritation. They will also help deodorize as they clean. Diluted soap in water can be used also, but soap by its nature can cause irritation.

Moisturizing

Once skin has been cleansed then using a moisturizing lotion or cream will will help keep skin healthy. Moisturizers are generally available in lotions and creams. Lotions are usually more viscous and liquid than creams and tend to absorb more quickly into the skin. Creams are a bit thicker and will sit on top of skin longer and absorb more slowly. 

Skin lotions or creams will help prevent and treat chaffed, chapped and cracked skin. Some even include added formulations that include Dimethicon that provides additional protection. 

Apply moisturizers liberally and make sure you cover all the areas of the skin  that may have or may become in contact with urine or feces. 

Protecting

Protecting the sensitive skin with a moisture barrier will help keep irritating moisture and contaminates from urine and feces from coming in contact with skin. Moisture barriers are usually an ointment that have a petrolatum base. Ointments are thicker than creams and help the protective layer sit on top of the skin. 

Moisture barriers have several different varieties to choose from depending on your unique situation. Some are a clear ointment. Some may contain protective agents such as zinc oxide that will leave a white color in the ointment. They may have other additional ingredients that help sooth and condition skin such as vitamin A and/or E, aloe, or lanolin.

There are even some protective barriers that have antimicrobial or antifungal agents included in them. These will help treat and cure minor fungal skin infections caused by moisture and warmth. 

Some patients will also benefit from the use of a powder with antifungal medication to treat yeast infections. These powders are applied prior to the use of a moisture barrier. 

Even when moisturizers and ointments are used it is still important to clean the skin after each episode. This is the best practice to ensure other treatments are effective and the patient is comfortable.

Caregivers and users of these products should consider wearing protective gloves when using and applying these products. Gloves come in a number of materials with vinyl gloves or nitrile gloves being the most popular as they do not contain latex. 

By adhering to a regular skin cleansing and care regiment many discomforts and more serious health issues including bed sore can be avoided. Please speak with your doctor immediately if open, weeping or bed sores begin to develop as these are serious conditions that should be addressed immediately.