Incontinence and skin care

In keeping with the theme of the month of love, we thought this would be a great time to talk about a little bit of “self love.” Quite literally, in the form of loving your own skin and how to take care of your skin when you have incontinence. “Healthy skin is sexy skin.”

The skin is the largest organ of one’s body, with a total area of about 20 square feet. It protects us from infection, insulates our body from heat and cold, regulates our body temperature, produces Vitamin D and provides sensation. This is why it is important to take care of and love your skin.

Too much wetness from urine and fecal matter can irritate our skin. Damage is far more likely to occur when the skin is saturated by these bodily fluids. Products like our new Incontrol Elite Hybrid diaper will draw the wetness from urine away from your skin which in turn helps to keep your skin healthy. However, when there is wetness there is the potential for damage, especially when it is liquid feces (diarrhea). When the skin is too damp there is very little flexibility, and when the skin rubs against incontinence products, clothing or linen the irritation can get worse.

Changes in the pH of your skin from urine and feces can also cause irritation in the skin and allow bacteria and yeast to grow. Everyone with incontinence, be it urinary, fecal or both, is at risk of developing skin breakdown due to the factors mentioned above. Health care professionals call this “Incontinence Associated Dermatitis” or “IAD” and it can be very painful and disrupt your daily routines.

Signs of problems with your skin:

The first signs of problems with your skin can be a pale pinkish to deep red appearance. The skin may burn, feel itchy and may be painful. Sometimes the skin will feel rough or appear cracked. It may even have blisters.

Yeast infections are also very common. A yeast infection is a reddish, spotty rash and can be very itchy. Medicated creams or powders are available to treat these. Talk to your doctor about the best treatment.

Skin care products:

“Healthy skin is sexy skin” and taking care of your skin is the first line of defense against skin problems. There are two types of skin care products:

• Cleansers
• Barriers

Cleansers:

Skin cleansers clean the skin better than any soap can. Skin cleansers will not dry your skin like ordinary soaps. Use the skin cleanser in combination with a soft wash cloth or a cleanser which is already in a soft wipe. Clean the skin as soon as possible after each episode of incontinence. Cleansers may perform the following function:

• Remove urine or stool
• Reduce burning and stinging
• Soothe
• Disinfect
• Eliminate odor
• Provide protection

Cleansers are available in foam, spray, lotion or wipes. If using public washrooms, wipes like the Abena Moist Skin Cleansing Wipes may be convenient to carry with you. They have a pleasant cleansing and moisturising effect. Abena Wet wipes are a wiping and washing solution in one product, essential where the use of water is limited or not an option at all. They are Ideal for a variety of tasks from hand washing, to patient cleansing and after use they can be easily disposed of in a litter bin with very low impact on the environment.

Other cleansers can be Rinse or No-Rinse. Rinse cleansers should be applied and then washed off with water. No-Rinse cleansers do not have to be rinsed off with water, and some may also produce an extra protective layer which is helpful when battling skin irritation. If there are signs of irritation, redness or odor, they should be used after every incontinence episode. No-Rinse formulas that are pH balanced are preferable and you should avoid fragranced versions if you have sensitive skin.

Barriers:

Barriers protect your skin from urine and fecal matter. Use a urine and fecal barrier rather than a moisturizer in the perineal area to prevent skin irritation. They perform the following function:

• Provide a coating on the skin that urine and feces cannot penetrate.
• Some barriers are formulated to help reduce friction from linen, clothing or incontinence pads.

Barrier products are available in creams, ointments, wipes, and barrier films like the Abena Skincare Ointment Barrier Cream which is a fantastic cream, for those with sensitive and eczema prone skin. It can be used daily without irritation and is water based and cloth diaper safe.

Another good product is the Abena Zinc Ointment with 20% Zinc Oxide, water-in-oil emulsion, and is effective as a barrier for decubitus and incontinence. It has a disinfecting and repairing effect and contains Allantoin, which has a calming effect on the skin.

Barriers are very beneficial, especially if you have fragile skin or have frequent incontinence. Use after cleansing if there is skin soreness or redness, and use a barrier that does not have sensitizers such as fragrance or lanolin. Products which are designed to provide urine and fecal protection will mention this on their label. The active ingredients list is important to help you to understand the level of barrier protection you will receive. Experts suggest products with dimethicone at 1% or higher and it must be listed in the active ingredients list.

If your skin is already dry or irritated, products containing any type of alcohol can dry your skin out and irritate it further. Note: Baby powder and corn starch are not barrier products.

Skin care products:

Wet Wipe/Wash Cloth - A non-irritating cleanser in handy, disposable wipes. Gently dissolves irritants.

Perineal Cleanser - Soapless, non-irritating cleansers. They will gently dissolve and remove feces and urine. Many contain deodorizers in their formulas. Specifically seek out a perineal cleanser formulated especially for delicate skin.

Moisturizing Cream/Lotion - Protective moisturizer formulated especially for the perineal area.

Barrier Cream/Ointment - Barrier creams are designed to protect the skin from irritation caused by stool, urine, or excessive moisture. While many of the products have a lanolin or petrolatum base, caregivers of individuals at risk of skin breakdown from pressure ulcers due to immobility should seek the advice of a nurse specialist in the selection of appropriate products.

Film Forming Skin Protectorate - Packaged in the form of wipes, aerosol spray, pump spray, and on applicator sponges. When the film dries, a clear invisible barrier is left to protect the skin from irritation.

Antibacterial/Antifungal Cream - Cream application with non-prescription strength ingredients to topically treat bacterial or fungal skin infections.

Where to get help?

Skin problems can normally be prevented simply with the use of appropriate products. However, problems can still arise. Your nurse continence advisor, nurse, physician, nurse practitioner, physiotherapist or pharmacist will be able to assist or offer suggestions. This is a common problem – do not be hesitant or embarrassed to ask for help.

One of the most important things to remember is to keep your skin hydrated by drinking plenty of water, which also helps to keep your whole system healthy.

Remember, "Healthy skin is sexy skin!" and with the right products, a good diet and plenty of water your skin will be clean, healthy and sexy!