Skin Care

It’s important that you know more about the skin when caring for someone with incontinence. The more information you have the better it is to prevent problems and detect them early on so you know the difference between a rash and a more serious problem.

The skin is made up of three layers and is our bodies largest organ and first line of defense:

  • Epidermis consists of the outside layer that you see
  • Dermis is the middle layer where the oil (sebum) is produced
  • Subcutaneous tissue (fat) is the deepest layer

A protective film of sebum and other substances called the acid mantle secretes from our skin. The acid mantle is a naturally acidic (pH of 4 - 6.8) and acts as a protective shield against the environment and germs. Harsh cleansers, sweat, urine and stool can quickly damage this natural shield. Bacteria and fungus can easily thrive when the shield is damaged. You are at a higher risk of infections and IAD (Incontinence Associated Dermatitis) the more acid mantle is damaged.

Skin problems effect more than 70% of older people as skin ages it becomes drier, thinner and slower to heal. The protective barrier (acid mantle) breaks down and weakens with moisture created from urine, sweat and stool, which raise the risk of infection.

Urine or bowel incontinence can cause excess moisture to build up in and around the genitals, buttocks, hips and the area between the pelvis and rectum (perineum) making it more likely to have various skin problems such as redness, irritation, peeling and yeast infections.

  • Bacterial Infection:

    Incontinence allows the skins surface to come in contact with bacteria from waste products that make a person more at risk to have a bacterial growth or infection. Very dry skin leaves the surface with skin cracks and fissures create an opportune breeding ground for bacterial growth as micro-organisms can be absorbed through the skin. It is thought to be considerably dangerous for the elderly as their skin may be characteristically dry. Bacteria can literally double every 20 minutes in an unchecked conductive environment.

    Incontinence Dermatitis:

    Incontinence dermatitis is a common condition that affects all age groups from an infant child to an elderly adult. Perineal dermatitis or diaper rash are the common terms used for this condition. Over exposure of moisture and chemicals from urine and faeces cause irritation and breakdown of the skin, which is the main cause of perineal dermatitis.

    Maceration:

    Macerated or Waterlogged skin is the result of excess and over exposure to moisture making the skin very fragile and weak. Fragility of the skin creates a greater risk for damage to occur from the slightest friction or pressure. Once the skin is macerated gentle rubbing from diapers, bed linens or even towels can cause injury.

    Fungal Infection:

    Incontinence creates a damp and warm skin environment that is ideal for the proliferation of pathogenic fungi and requires treatment with an anti-fungal agent in order to heal the skin. The symptoms include a skin rash that is a fiery red, itchy or burnt that is typical of the fungal origin.

    Caustic Agents:

    Exposure to caustic agents like ammonia can increase the pH levels of the skin causing irritation. Ammonia is one of the caustic agents found in urine contributing to the reproduction of more micro-organisms that are used by bacteria as a source of nutrition. The cycle will continue to go on and on without the proper treatment. Faecal incontinence suffers are at a higher risk of bacterial colonisation of the skin.

  • Bedsores (pressure sores):

    Bedsores also known as pressure sores or pressure ulcers are injuries to the skin and underlying tissues resulting from prolonged pressure on the skin. Pressure to the skin reduces blood flow to the area and without enough blood circulation the skin can die and an ulcer may form.

    IAD (Incontinence Associated Dermatitis) Symptoms to look out for:

    Damage to the skin from frequent incontinence (especially bowel incontinence) can irritate the skins surface leading to IAD. Symptoms include:

    • Swollen skin with oozing, crusty or scaly rash
    • Shiny red skin or white, yellow, dark reddish purple skin tones
    • Burning, itching, tingling pain around the buttocks, rectum, labial folds, groin or between the legs

    An infection, pressure ulcer or bedsore could be forming if you have any of these symptoms listed above. IAD has been found to be mistaken for a pressure ulcer.

    IAD Explanation:

    Usually found over fatty or fleshy areas but may be found over bony areas and is associated with incontinence. There is no defined shape for IAD.

    Pressure Ulcer Explanation:

    Usually found over bony areas and is associated with short or long term immobility. The shape is usually circular and symmetrical (may be butterfly shaped) between the lower back and buttocks (sacrum).

    Common Risk Factors for IAD:

    pH Levels of the Skin –

    Sweat, urine, stool and some cleansers make the skin more alkaline creating an environment that is more susceptible to germs and infections.

    Bacterial Growth Infections –

    When skin levels are moist and alkaline it makes germs easier to grow especially when absorbent briefs and pads are used. When using Allusive’s unique designed pull up pants, slip brief or flexi pad in the correct size you will have a good air flow between the body and the pad which will help keep the skin free from these irritations and infections.

  • Skin and Moisture Irritations –

    Sweat, urine and stool irritate the skin. Digestive enzymes further irritate and break down the skin, especially after having diarrhea or a watery stool.

    Friction –

    Skin that becomes fragile and moist are more sensitive to friction of clothing, under garments, beds, chairs and cleaning.

    As we Age –

    Our skin becomes drier, thinner, less elastic and slower to heal.

    Health Conditions –

    Skin pH levels can rise and damage the protective acid mantle through having diabetes, kidney disease (chronic renal disease) and cardiovascular disease making IAD more common in these areas.

    Holistic and How We Can Help!

    Our products have been designed for maximum comfort and protection of your skin. We have created a unique designed range of options to keep the skin feeling fresh and dry. The more moisture build up on the skin means the more likely it is for an infection or irritation to occur. Our products keep you feeling drier for longer to minimise the risk of infections or irritations to occur. It’s important that you look at the sizing and get the right fit for you. Holistic has a range of wet wipes and alcohol free hand sanitisers to help protect the skin.