What’s the skinny on incontinence skin care?
Skin care is essential for people who cannot control their bladder or bowels. One of the major complications of urinary and fecal incontinence is skin damage. Excessive moisture in or around the buttocks, hips, genitals, and the perineal area between the pelvis and the rectum can lead to redness, peeling, irritation, fungal and bacterial infection, maceration and other issues. Even diapers – one of the most commonly used products among incontinent patients, whether they are infants or adults – can worsen these complications. Briefs, undergarments, diapers and so on and so forth keep bed sheets and clothes dry and clean, but they also keep the skin in continual contact with urine and stool, causing incontinence dermatitis – also known as diaper rash.
People with incontinence cannot do without diapers; fortunately there is undergarment that comes with a wetness indicator that alerts the caregiver as to when the diaper has been soiled and must be changed. The skin should be cleaned immediately after urination or defecation. This task can be made easier by using a no-rinse perineal skin cleanser, preferably one that is soap-free to avoid dryness and irritation. It’s important to note that the skin should not be too moist, but it shouldn’t be too dry either; extremes are never healthy. A moisturizing cream with dimethicone – a water repellent – can help to strike a proper balance.
Additionally, products made with zinc oxide, lanolin, or petrolatum – whether they are creams, lotions, ointments, sprays, or towelettes – can create a protective barrier on the skin that seals moisture out. These types of products are especially helpful in preventing and treating yeast infections, in particular if they contain an antifungal. These skin care products are very useful but not a substitute for watchfulness. The skin should be cleaned anew after each and every single incontinent episode, and the product – cream, lotion, cleanser, &c – reapplied as well.
Keep in mind that incontinence may be related to another condition that keeps patients bedridden or confined to a wheelchair, and which may cause another skin problem in the form of bed sores. Bedridden patients should be helped to change position at least every two hours, their sheets and clothes should be changed immediately after the become soiled, and pillows or foam padding should be used to decrease pressure. Wheelchair-bound patients should be able to avail themselves of a properly fitting chair, where they can shift their weight every 15-20 minutes, and also use products to decrease pressure.