Skin complaints in incontinence is not uncommon. Read here why skin incontinence is harmful and how skin irritation develops.
Incontinence patients need very good skincare. Urine and stool on the skin attack this very strongly. In addition, the skin is already weakened by age-related changes already. With the right care products and diaper briefs can be prevented secondary diseases.
How skin irritations arise
Urea and ammonia are the main components of urine, they are alkaline. Thus they attack the natural acid mantle of the skin considerably. This weakens the diminished resistance of the skin, which can not regenerate properly.
The acid mantle (Hydrolipidmantel) is defined by the pH of about 5.5 (slightly acidic, pH 7.0 is neutral). The epidermis and sweat are slightly acidic, the light acid stops pathogens. Urine may also be slightly acidic, but sometimes it is neutral to slightly basic, values around pH 7.5 – 8.0 are not uncommon.
This neutralises the acid mantle of the skin, creating a moist, warm, neutral and therefore ideal environment for fungi and bacteria. Most often, Candida albicans, which causes candidosis (“diaper fungus”), settles on this skin. This can also affect babies, but this takes care of the mom in the space of a few hours. In older people who lack this very frequent and regular care, sometimes also sprouts and filamentous fungi occur.
Staphylococci and the Corynebacterium are most frequently observed in the rarer bacterial infections. The latter populates the skin even in healthy people, but does not damage any intact acid mantle. Superficial infections (erythrasma) are the result.
In addition, in fecal incontinence, digestive enzymes significantly irritate the skin surface. In the rump area diaper dermatitis inevitably leads to decubitus, because older skin is thinner and drier than in younger people. Actually, those affected would need very regular care (at least as with a baby).
Maintain the skin properly
Special attention should be given to patients with obesity or diabetes and bedridden people. This group has an increased risk of skin damage caused by incontinence. In their skin folds, a painful Intertrigo (Wolf) can develop.
For care, the diaper area after each change of the briefs gently clean, this is enough lukewarm water. The residues of care creams must be well removed. Cleaning wipes should not contain alcohol or perfume, both of which may increase irritation. Doctors advise cleaning products that match the natural pH of healthy skin. It may be slightly acidic or skin neutral washing lotions and syndets with moisturizing substances that are more suitable than soap.
With fecal incontinence, special cleansing foams have a moisturizing effect and at the same time absorb the odor. The subsequent skin protection is carried out with water-in-oil emulsions. Baby oil is not suitable. Briefs should be hypoallergenic and have a fast wicking speed; superabsorbents are best suited.
Find out more about how you should skincare on incontinence and get valuable tips and tricks.
Why especially older people are affected
Probably a third of people over the age of 80 involuntarily lose urine, in some cases even stool. Exact numbers do not exist because many sufferers from shame conceal the problem until the last. Even more precarious is the problem of direct nursing care. For example, in old people’s homes only about 20% of all residents have complete control over their sphincters.
A not to be underestimated consequence are the considerable exertions, which the skin is exposed thereby. It inevitably comes into contact with the urine and the stool, because in high life years only insoles or incontinence briefs come into question.
The other anti-wetting aids – such as pessaries for women – only help with mild incontinence. For very old people, they are completely unsuitable, especially as there are quite a few dementia patients in this age group who can not handle it. Incontinence briefs are used, but they always carry the risk of diaper dermatitis. At least 40% of those affected suffer from this. They even develop various skin complaints, because the dermatitis very often joins allergic reactions.
For proper skin care you should use quality products. Take a look at our Skin Care Products category and get an overview! Also recommended are the products under skin cleansing, as they are particularly mild to the skin.