How Incontinence Affects the Skin

Urinary incontinence leaves the aging population at risk for impaired skin integrity. Exposure to urine and feces is one of the most common causes of skin breakdown and makes the skin more susceptible to the following types of injuries:

• Maceration
• Over-exposure to moisture can cause the skin to become macerated (waterlogged) which, in turn, makes the skin very fragile. This added fragility puts the skin at greater risk for damage caused by friction, shear, and pressure. Once skin is macerated, even gentle rubbing by bed linens, diapers, and wash cloths can cause injury.
• Incontinence Dermatitis
• A common condition related to incontinence is incontinence dermatitis. Otherwise known as perineal dermatitis or diaper rash, this condition affects all age groups from infancy to old age. Perineal dermatitis involves the irritation and breakdown of the skin as a result of over-exposure to moisture and chemicals in urine and feces.
• Bacterial Infection
• Another risk associated with incontinence is bacterial growth and infection. Incontinence allows the skin's surface to come in contact with bacteria from waste products. This is particularly dangerous for the elderly whose skin may be characteristically dry. Dry skin provides an opportune breeding ground for bacterial growth since micro-organisms can be absorbed through skin cracks and fissures. When left unchecked, in a conducive environment, bacteria can literally double in number every twenty minutes!
• Exposure To Caustic Agents
• One of the caustic agents contained in urine is ammonia. Ammonia increases the pH of the skin causing irritation. Ammonia is also used by bacteria as a source of nutrition, contributing to the reproduction of more micro-organisms. Without proper treatment, the cycle goes on and on. Patients with fecal incontinence are at an even higher level of risk for bacterial colonization of the skin.
• Fungal Infection
• The damp, warm skin environment generally associated with incontinence is ideal for the proliferation of pathogenic fungi. A skin rash that is fiery red, itches, and burns is usually of fungal origin, and requires treatment with an anti-fungal agent in order to heal.

To prevent skin breakdown due to incontinence:

• Prevent excessive skin wetness
• Maintain the skin at its natural pH range (between 4 and 7)
• Minimize direct contact with urine and feces
• Cleanse gently to avoid friction

Specialized products that gently cleanse and protect the skin are generally superior to soap and water. Maintaining healthy skin in spite of incontinence is a goal that can be achieved!

For more information, please see Skin Protection For Those Dealing With Incontinence.