Skin problems that are caused by urinary and fecal incontinence are hard for both patients and their caregivers to deal with. The most common form is perineal dermatitis, which scientists say happens with a third of patients with fecal incontinence. You may have this condition if you have red, itchy or burning skin on the upper leg and buttocks.
If not taken care of, it can cause skin to flake and rub off. Because this area is hard to reach and comes in contact with urine and stool, wounds that form there have a better chance of getting germs in them. This makes it more likely you can get a UTI (urinary tract infection) and pressure ulcers. But the chance of getting perineal dermatitis can be greatly lowered by taking care of your skin.
You can do this with special cleaners that remove waste and put your skin back in its regular chemical balance, and creams or lotions that protect and heal the skin.
Here are three tips to help protect your skin:
Cleaning Regularly – One of the most important things you can do to take care of your skin is wash the area each time you have incontinence. You also should wash it after using a catheter insertion or fecal collection system, or if you use absorbent pads and briefs. While absorbent products may make you feel dry, they may leave behind waste that can press against the skin, making it red and itchy.
- Balancing Your Skin pH – When urine and waste rub against your skin, they can change the chemical balance, or pH level, of your skin. This wears down the skin’s thin, outside layer, known as the acid mantle, and can lead to dermatitis and other skin problems. Keeping a slightly acidic pH level helps keep germs from growing on your skin. Some soaps and cleaners can have a bad effect on your skin’s pH. Most bar soaps are highly alkaline (non-acidic), which can take away your natural oils and leave skin dry, red and itchy. But soap that is too acidic also can take away these oils and strip away your skin’s outside layer. So, choosing the right skin cleaner for the area where you have incontinence is very important.
- Moisturizing – Applying medicine that has chemicals such as zinc oxide to the upper legs and buttocks after you wash them can help keep skin soft, smooth and healthy. It also keeps it dry and will not wash away when urine or feces rub against the skin. Some products also have ingredients that help stop germs and fungus from growing. Some studies show that the use of skin lotions, creams and other medicine can lower the chance of getting skin problems and sores by 50% or more. Keep in mind, if you have red, sore skin, try using a no-rinse perineal cleaner. It goes on as a foam and does not require rinsing or rubbing, which can irritate sensitive skin. This may be covered by your insurance.
Protecting the skin from incontinence with Fecal Management Systems
There are incontinence products called fecal management systems that can help lower the skin’s exposure to watery waste. Like an indwelling catheter, these are made of a thin, bendable tube with a balloon at one end and a flange at the other that connects to a bag.
The balloon end is put into the sphincter and blown up with a small amount of water to keep it in place, and the tube is taped to the skin.
Fecal management systems can be left in place for several weeks before you have to use a new one. While more study is needed, one small study showed skin health stayed the same or got better in more than 92% of people who used a fecal management system for about four weeks.
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