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Skin care and incontinence

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People who have urinary or fecal (bowel) incontinence are at great risk for skin irritation, ulcers, and infection.

Others at risk for skin irritation include people who:

  • Are malnourished or dehydrated
  • Have poor circulation to the legs
  • Have received radiation therapy to the area between the pelvis and rectum (perineal area)
  • Have reduced mobility, can't move, or have impairment of the senses
  • Must stay in a wheelchair or bed

Use of diapers and other containment devices may prevent dirty bedding and clothing. However, these products tend to keep the urine or stool in constant contact with the skin. Over time, the skin can become damaged. Special care must be taken to keep the skin clean and dry.

Clean the skin and perineal area right after incontinence occurs. Cleanse the skin with a mild soap and water, rinse well, and gently pat dry. Cleaning the skin often may cause drying and irritation. Moisturizing creams may be used to keep the skin moist, however, avoid products that contain alcohol, because this may further irritate the skin. If you are receiving radiation therapy, ask your health care provider if it is okay to use any creams or lotions.

Several skin cleansers are specifically designed to cleanse and deodorize the skin without causing excessive dryness or irritation. These products include foams, non-aerosol sprays, and wet wipes (individual disposable towelettes). Be sure to follow the product's instructions. Some of the products do not require rinsing. Be aware that some people may have allergies to the fragrances used in these cleansers.

If there is constant exposure to urine or stool, consider using a skin sealant or moisture barrier. There are several creams or ointments that contain lanolin or petrolatum, which form a protective barrier on the skin. Some skin care products (often in the form of a spray or a towelette) actually create a clear, protective film over the skin.

Even if you use these products, you must still clean the skin after each incontinence occurrence. Reapply the cream or ointment after cleaning and drying the skin.

People who often have incontinence problems may develop a yeast infection on the skin. An itchy, red, pimple-like rash appears. Skin may feel raw.

There are several products (both over-the-counter and prescription) that can be used to treat the yeast infection. If the skin is constantly moist, a medicated antifungal powder (such as Mycostatin powder) may be used. A moisture barrier or skin sealant may be applied over the powder. An antifungal cream is also available for use in people who have a yeast infection on dry, cracked skin. If severe skin irritation develops, see your health care provider.

The National Association For Continence (NAFC) publishes a resource guide of continence products and services, which includes a listing of the manufacturers and distributors of specific products. To obtain this resource guide call 1-800-BLADDER or go to the website www.nafc.org.

OTHER IMPORTANT PREVENTIVE MEASURES

Those who must stay in bed should:

  • Change positions often
  • Have clean sheets and clothing
  • Turn constantly

Those who use a wheelchair should:

  • Have enough cushions
  • Make sure the chair fits properly
  • Shift their weight every 15 - 20 minutes

Review Date:1/30/2008
Reviewed By:Michael Langan, MD, Department of Geriatrics, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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