Skin Care - Managing Fecal Incontinence: Bladder Conditions

Content provided by the Faculty of the Harvard Medical School

Skin care

Proper care of the skin in the anal area is critical to maintaining comfort and preventing skin irritation and breakdown. Skin irritation is more than a misery. It can invite infection and even compromise your treatment if the skin becomes too sore for your muscles to work well. If you have both urinary and fecal incontinence, bacteria in the feces can react with urine to produce ammonia, which lowers the skin pH and leaves it more vulnerable to infection. Yeast infections can also result, when yeast in the feces is nurtured by contact with urine.

Skin should be cleansed after each episode of incontinence. Choose an extremely mild, nonalkaline soap — such as Dove or Basis — or buy one of the special cleansers designed to gently dissolve and remove stool and urine. These are nonirritating, soap-free cleansing lotions; some are available in portable disposable wipes. They eliminate the need to scrub areas of tender skin, and some do not require that you rinse the skin after use. Look for nonalkaline, fragrance-free products.

In studies conducted in nursing homes, cleansers worked better than soap to prevent breakdown of sensitive perineal skin in patients with incontinence. After cleansing, allow the area to air-dry if possible (or blow dry with a hairdryer set on cool) or pat it dry (don't rub). Afterward, apply a protective moisturizer or moisture barrier to protect your skin from damage by urine or stool contact. Barrier products such as petroleum jelly, Aquaphor, or Desitin are readily available and inexpensive.

Film-forming skin protectants — applied by spray, applicator, or individual wipe — go on as a liquid but rapidly evaporate to leave behind a film of clear acrylate. This barrier allows airflow, but protects the skin from moisture. Film-forming skin protectants may help reduce the rubbing of pads or absorbent products or make it less irritating to use products applied with adhesive. Some films last as long as three days before reapplication is needed.

To treat or protect against fungal infection, you may be instructed to use an ointment or cream containing an antifungal agent, such as clotrimazole or miconazole. Ask whether you should apply another barrier product while using the antifungal.

A nurse who deals with incontinence or stoma care can offer advice on skin care issues.

Last updated:	September 05, 2008