Incontinence - skin care; Incontinence - pressure sore; Incontinence - pressure ulcer; Incontinence - bed sore
A person with incontinence is not able to prevent urine and stool from leaking. This can lead to skin problems near the buttocks, hips, genitals, and between the pelvis and rectum (perineum).
People who have problems controlling their urine or bowels (called incontinence) are at risk for skin problems. The skin areas most affected are near the buttocks, hips, genitals, and between the pelvis and rectum (perineum).
Excess moisture in these areas makes skin problems such as redness, peeling, irritation, and yeast infections likely.
Bedsores (pressure sores) may also develop if a person:
TAKING CARE OF THE SKIN
Using diapers and other products can make skin problems worse. Although they may keep bedding and clothing cleaner, these products allow urine or stool to be in constant contact with the skin. Over time, the skin breaks down. Special care must be taken to keep the skin clean and dry. This can be done by:
Use soap-free skin cleansers that do not cause dryness or irritation. Follow the product's instructions. Some products do not require rinsing.
Moisturizing creams can help keep the skin moist. Avoid products that contain alcohol, which may irritate the skin. If you are receiving radiation therapy, ask your health care provider if it is OK to use any creams or lotions.
Consider using a skin sealant or moisture barrier. Creams or ointments that contain zinc oxide, lanolin, or petrolatum form a protective barrier on the skin. Some skin care products, often in the form of a spray or a towelette, create a clear, protective film over the skin. A provider can recommend barrier creams to help protect the skin.
Even if these products are used, the skin must still be cleaned each time after passing urine or stool. Reapply the cream or ointment after cleaning and drying the skin.
Incontinence problems can cause a yeast infection on the skin. This is an itchy, red, pimple-like rash. The skin may feel raw. Products are available to treat a yeast infection:
The National Association for Continence (NAFC) has helpful information at www.nafc.org.
IF YOU ARE BEDRIDDEN OR USING A WHEELCHAIR
Check the skin for pressure sores every day. Look for reddened areas that do not turn white when pressed. Also look for blisters, sores, or open ulcers. Tell the provider if there is any foul-smelling drainage.
A healthy, well-balanced diet that contains enough calories and protein helps keep you and your skin healthy.
For people who must stay in bed:
For people in a wheelchair:
Smoking affects healing of the skin, so stopping smoking is important.
Bliss DZ, Mathiason MA, Gurvich O, et al. Incidence and predictors of incontinence associated skin damage in nursing home residents with new onset incontinence. J Wound Ostomy Continence nurs. 2017;44(2):165-171. PMID: 28267124 pubmed.ncbi.nlm.nih.gov/28267124/.
Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Advances in Wound Care (New Rochelle). 2018;7(2):57-67. PMID: 29392094 pubmed.ncbi.nlm.nih.gov/29392094/.
Harper A, Wilkinson I, Preston Jo. Geriatric medicine, frailty and multimorbidity. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clark's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 15.
James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Dermatoses resulting from physical factors. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 3.
Kwon R, Rendon JL, Janis JE. Pressure sores. In: Song DH, Neligan PC, eds. Plastic Surgery: Volume 4: Lower Extremity, Trunk, and Burns. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 16.BACK TO TOP
Review Date: 2/18/2022
Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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