Skin Care

STRUCTURE:

FEATURES

The skin is the largest organ of the body.

The skin protects us from the elements, helps regulate body temperature, and assists with the sensations of touch, heat, and cold.

The skin has three layers:

• The epidermis, the outermost layer of skin, provides a waterproof barrier
• The dermis, beneath the epidermis, contains tough connective tissue, hair follicles, and sweat glands.
• The hypodermis, the deeper layer (subcutaneous tissue) is made of fat and connective tissue.

THE EFFECTS OF INCONTINENCE ON THE SKIN:

Urine and faeces can change the pH of the skin as soon as there is any contact.  This affects the overall protection of the skin making it more vulnerable to pressure ulcers and incontinence dermatitis.

INCONTINENCE DERMATITIS (IAD):

Is very common, especially in the elderly, amongst individuals who experience incontinence

Symptoms of IAD include:

• redness, ranging from light pink to dark red, depending on skin tone
• patches of inflammation or a large, continuous area of inflammation
• lesions
• pain or tenderness in the localised area
• burning
• itching

IAD can affect a small or large area as shown below:

IAD can affect skin on many parts of your body, including the:

• perineum
• groin
• buttocks
• upper thighs
• lower abdomen

 HOW TO CARE FOR THE SKIN

• Ensure a toileting regime is in place for an individual identified to have incontinence
• Routine observation of the skin condition at every intervention ie toileting, change of pad, attending to hygiene
• Use disposable skin friendly wipes to clean the area following an incontinence episode
• Wash the area with a cleanser, ideally combined with a moisturiser, that balances the skin’s pH level.
• Use a water based barrier cream as advised or prescribed – use sparingly – refer to local formulary
• Do not use talcum powder

• Provide the appropriate incontinence pads and ensure they are fitted as per manufacturers recommendations, with appropriate underwear

• Always change faeces soiled pads as soon as possible

Ref:

Healthline – What is Incontinence – Associated Dermatitis and How is it treated?  Silver, N (2017)