Education Category: Skin Care

What does the skin do?

The skin protects the body’s organs, blood vessels and nerves. The skin between the legs (the perineum) and between the buttocks (the perianal area) is easily damaged.

What is a rash?

A rash is a change in the skin that affects its colour, how it looks and how it feels. A rash can be any size, with different colours. Some rashes have blisters, bruises or splits in the skin. Rashes can be itchy or painful.

Why does a rash matter?

• A rash can be uncomfortable for the person and this might affect regular activites such as going to the toilet.
• When the skin is damaged by a rash, the body can lose heat, water and nutrients that it needs.
• A rash can let bacteria (germs) or fungi enter the body and cause an infection.
• If the person gets a rash, it can get worse without the right care.

What causes a rash?

A lot of things can cause a rash. If you see a rash, it is important to take notice of:

• how big it is
• what it looks like
• whether it is causing problems for the person, for example itching or pain.

You need this information to pass on to your supervisor, care coordinator or a health care professional.

There are a lot of reasons why a skin rash can happen in the perineum or perianal areas.

• Some people have very sensitive skin and can have a reaction to products, for example soaps, washing powder, creams, lotions and powders.
• The skin might be irritated by urine or faeces that is not cleaned properly and has dried on the skin.
• The skin is not dried properly after washing the skin.
• The person may have a medical condition, for example an infection or a skin disease.
• The person has an allergic reaction to a medicine or food or something that has touched the skin.

How can you stop a skin rash developing?

To try to stop a skin rash from developing you need to provide good care when the person uses the toilet.

• Be careful when helping clean the person after they use the toilet. The skin between the legs and buttocks can easily be damaged.
• Dry the skin completely after bathing. Pat it gently, but don’t rub the skin.
• Take care when wiping the skin. Too much wiping can damage skin. If more cleaning is needed, you can use wet wipes (alcohol and fragrance-free) or wet toilet paper. For more information go to Cleaning after going to the toilet.
• Avoid using scented soaps, deoderants and talcum powder. These products can irritate the skin.
• Check the ingredients of the person’s skin care products. Stop using them if they contain alcohol, perfume or disinfectant. These products can dry out the skin too much and lead to broken areas of skin and allergic reactions.
• If barrier cream is needed to protect the skin for someone who uses continence pads, choose a product that can be used with continence pads. A continence nurse advisor, the National Continence Helpline or manufacturer’s website can give you this information.
• Check if the person has any allergies (or sensitivity) to a product or ingredient. Always read the ingredients list on the packet or bottle before using any product.

Ask for help from your supervisor, care coordinor or a health care professional if the person you support has a rash.

Don’t put anything on a skin rash unless it is recommended for that person by their GP, or another health care professional.

Need more help? Call the National Continence Helpline on 18OO 33 OO 66 and talk to a continence nurse advisor.

Extra Resources

• Skin care and incontinence

Skin care products

When using skin care products, it’s important to only use products that are included in the care plan for the person you support. Do not use other people’s skin care products. Make sure you follow the instructions on the care plan carefully (if available). Always read the labels of products and look at manufacturer’s websites for more information about what’s in the product and how to use it.

If you don’t understand how to use a product, ask your supervisor, the person’s general practitioner (GP), a continence nurse advisor or another health care professional. If you notice the person’s skin appears red or broken, stop using the product and get advice from your supervisor. For more information about rashes go to Skin has a rash.

Skin care products:

• are designed to keep the skin healthy and clean
• protect the skin from moisture and other things that can irritate the skin
• reduce skin irritation and breakdown
• should be applied gently
• should be applied to clean skin.

Types of skin care products:

• Cleansers: can be used instead of soap and water and are designed to keep the normal moisture level of the skin. They are available in pump sprays, foams and pre-moistened wipes. Some products need to be rinsed off, but others can stay on the skin. They need to be applied gently to clean skin. Using soft disposable wipes to apply the cleanser is better than using towelling face washers. Pat the skin dry after cleaning. Do not rub the skin as it can be easily damaged. For more information, go to Cleaning after going to the toilet.
• Moisturisers: help stop the skin drying out by sealing in or adding more moisture. If used to protect the skin of the perineum, they should be perfume and alcohol free and made for sensitve skin.
• Barrier creams: protective creams or films made to seal the skin off from contact with sweat, urine or faeces. They also help protect the skin from rubbing on bed linen or continence products. Barrier creams can sooth irritated and sensitve skin and can help to kill germs. Some barrier creams can stop continence products from absorbing urine properly. They can also mix with faeces and make cleaning the skin after passing a bowel motion more difficult. If using a barrier cream, make sure it is recommended for use with continence products.

Further help

A continence nurse advisor can help by conducting a continence assessment for the person you support if they don’t have a continence care plan. They will develop a continence care plan which will include information about continence products, skin care products and other aids suitable for the person’s incontinence and their living situation.

Need more help? Call the National Continence Helpline in 18OO 33 OO 66 and talk to a continence nurse advisor.

Extra Resources

• Skin care and incontinence

What does skin do?

• The skin protects organs, blood vessels and nerves.
• The skin stops the body losing heat, water and electrolytes.
• The skin prevents infection entering the body so if skin is damaged, the body will be at risk of infection. This is because bacteria (germs) can enter the body through broken areas of skin.

Why is it important to clean skin after using the toilet?

• Cleaning the skin between the legs and buttocks after using the toilet is important to keep these areas clean, dry and healthy.
• Wet or dirty skin can lead to fungal infection, scalding and damage.
• It is important to use good hygiene in cleaning tasks to stop spreading bacteria to other people, or to yourself.
• You should wear disposable non-latex gloves when helping someone clean after going to the toilet. It is important to wash your hands with soap and water before putting on gloves and wash your hands again after removing the gloves.

Cultural needs

• People from different cultures can have different needs for cleaning the skin after using the toilet.
  • People in Western society usually wipe with toilet paper or cleansing wipes.
  • People in some cultures usually wash with water using a bidet or container of water.
• You might need to change how you help a person based on their cultural needs.
• You can find this out by asking the person or their family.

Tips for helping someone after they use the toilet

• Do not rub the skin because this can cause irritation and small breaks in the skin. Instead, gently pat or dab the skin.
• Take care when wiping the skin. Too much wiping can damage the skin. If more cleaning is needed, you can use cleansing wipes (alcohol and fragrance-free) or wet toilet paper.
• After bowel motions, wipe from the front to the back to stop spreading faeces into the folds of the skin (especially for women) where it is harder to clean thoroughly.
• If the person has a lot of faeces on them, you may need to shower them to completely clean their skin.
• Some people with disability might need to use wet wipes instead of toilet paper to stop skin breakdown.

Tips for healthy skin

• Make sure the skin is completely clean and dry after the person uses the toilet.
• Protect the skin by washing thoroughly between the person’s legs and buttocks after each bowel motion. This might be with a wet wipe or in the shower.
• Soft toilet paper is gentler on the skin than thin or harsh paper. Some people are allergic to chemicals in toilet paper. If so, stop using the paper and ask a continence nurse advisor or health care professional to find a better option.
• Avoid using scented soaps, deoderants, or talcum powder. These products can irritate the skin.
• Check the ingredients of the person’s skin care products. Stop using them if they contain alcohol, perfume or disinfectant. These products can dry out the skin too much and lead to broken areas of skin or allergic reactions.
• If a barrier cream is needed to protect the skin for someone who uses continence aids, choose a product that can be used with continence pads. A continence nurse advisor, the National Continence Helpline 18OO 33 OO 66, or manufacturer’s website can give you this information.
• Check if the person has any allergies (or sensitivity) to a product or ingredient.
• Always read the ingredient list on the packet or bottle before using any product.

For more information on skin care watch the video below.

 

Need more help? Call the National Continence Helpline on 18OO 33 OO 66 and talk to a continence nurse advisor.

Extra Resources

• Skin care and incontinence