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Skin Incontinence


The topic to be covered is on skin incontinence and on the factors that surround it. Additionally, its implications will be taken into perspective with thorough backing from external sources. The whole issue of skin incontinence is very important since it affects most elderly individuals (Gray, 2005). For those who are sick and have to sleep for days on end, the conditions become way prevalent ad gets to extreme levels (Wesnes and Lose, 2013). As a result, studying the whole condition, factors that surround it and its eventual implications is an important aspect that will have a huge contributing factor to how it is treated and effectively controlled for that matter.

Literature Review

The most efficient database used in this study was mostly scientific journals spanning from content in JSTOR to several other medical educative journals.  A note of the most recent journals on the particular subject of study was kept to ensure efficient up to date information was obtained. The other no- journal sourced info was basically pulled off medical websites and from the school library. Keywords include: Skincare, Preventive, adult, skin, and incontinence, sore.


According to Markland, (2008), typically, a patient who is incontinent cannot control the flow of stool or urine in his or her body incontinence can either mean only a little stool or urine leaking out or may be used to mean a total lack of control for the reflexes that influence bladder and bowel control. Stool and urine serve irritants to the skin. On the same note Gray, (2005) proceeds further to attest that skin that has been continuously exposed to stool or urine can quickly become inflamed, painful or red.  If the condition continues over a long period to the extent that it reaches heightened levels, the patient develops some levels of redness, open areas, sores, and severe sores on the skin (Hess, 2008). In certain occurrence, the skin can start to peel off(Newman, Cardozo and Sievert, 2013).

How Incontinence affects the Skin

Incontinence, especially urinary incontinence leaves the aging population at risk of impaired skin(NICE endorses darifenacin for urinary incontinence, 2013). Although the skin is faced with several factor that degrades it, exposure to feces and urine act as some of the major reasons that lead to its breakdown and leads to several injuries(Markland, 2008). The injuries in question vary in a wide scope and affect the adults in a variety of ways(Wesnes and Lose, 2013).

Types of Injuries that affects the skin subjected to incontinence


When the skin becomes overly exposed to moisture, it becomes macerated(Physiotherapy helps postpartum incontinence, 2002). Maceration is the waterlogging of the skin that eventually makes it fragile and vulnerable.(Schaum, 2014) The fragility puts the skin at and a greater risk of damage brought about by friction, pressure, and shear. On the occurrence that the skin is macerated, even simple rubbing by bed covers, diapers, or clothes can lead to injurious effects(Hess, 2008).

Inconsistence Dermatitis

According to Consultations: Urinary incontinence, (2013), a rather common condition brought about by incontinence is incontinence Dermatitis, which is also known as diaper rash. Markland, (2008) second this notion outlining that the condition is prevalent in all age groups spanning from children wearing diapers to adultsPerineal dermatitis s involves the irritation and subsequent breakdown of the skin due to over exposure to moisturized conditions and chemicals found in urine and feces(PERINEAL SKIN CARE, 2002).


Bacterial Infection

Bacterial growth and infection happen because incontinence makes the skin come into contact with bacteria and waste products and bacteria of all kinds(Reddy, 2008). The effect is alarmingly bad especially for old individuals who have skin that is continuously dry in most instances. The dry skin provides a conducive atmosphere for bacteria to breed(Cooper, 2000). The effect is possible because the microorganisms can get absorbed in the fissures and cracks found in the skin(Markland, 2008). To this extent, when eliminated, controlled or left unchecked, bacteria can double their number for every 20 minutes!

Exposure to causative agents

Urine brings with it different causative agents. For example, ammonia. Ammonia increases the pH of the skin leading to irritation(Brunk, 2007). Additionally, ammonia is also used by bacteria as a source of food, leading to a high reproduction of more micro- organisms. Without the proper form of treatment, the cycle continues and on(Cooper, 2000). Individuals who have fecal inconsistency are at an even higher level of risk for the colonization of the skin by bacteria(Worcester, 2012).

Tips for preventing skin breakdown

There are various ways that an individual can use to reverse of totally prevent the degrading effects of incontinence products(Beeckman et al., 2011). For one, an individual or those around them, should change incontinence products now and then especially immediately after the occurrence of soiling to avoid excessive skin wetness that may harm the skin. Soiling products, although effective at treating incontinence can have negative effects, especially on the patient(Fritel et al., 2015). Therefore, changing them on a regular basis and giving the skin adequate time to try is really important.

Secondly, the patient or those who take care of them should make sure that the skin is maintained at natural pH levels probably between 4 and 7 through the use of skin care products specifically made for the situation(Reddy, 2008). Low pH is what favors bacterial activity, and it also has an effect on the eventual way the skin degrades(Gray, 2005). Clearly picking and continually using the products in the most rightful of was helps a great deal in eliminating or reducing the degrading effects of the said condition(Salcido, 2010).

Occasional and continual cleaning should be one to help in reducing the bumps on the skin(Beeckman et al., 2011). These can effectively lead to incontinence since it is those barriers that potentially lead to sores. Therefore, a continuous cleaning process should be sought for the individuals with the condition. In the end, its detrimental effects will be reduced enabling the individual suffering from incontinence to be at least well again(Fritel et al., 2015).

Skin Incontinence in Relation to Infection Control

People living with the problem of skin incontinence are at a higher risk of multiple infections if their condition is not well handled (Ripley, 2007). People taking care of patients living with this condition should ensure that adequate measures and precautions are taken so as to prevent cases of secondary infections. Observing the highest level of hygiene is important to address this problem.

Policy and Ethical Issue in Caring for People Suffering from Skin Incontinence

       Skin incontinence is one of the medical conditions that subjects patients to stigmatization. The effect of this stigmatization is that the patients do not receive adequate care compared to other patients suffering from diseases that have no stigma (Cooper, 2000). Government should put in place policies to compel all the care providers to offer the highest possible level of care. Care providers should ensure that they are ethical when discharging their duties by ensuring that they do not discriminate against people suffering from this condition.

Public Education

There is need for the public to be well educated about this health condition. When people understand this problem, they will be in a position to assist these people in managing their problem. In addition, the kind of discrimination that exists will reduce.

Staff Education and Training

In order to improve the quality of care that is accorded to patients suffering from Skin Incontinence, medical personnel should be subjected to training and development programs for them to acquire the required skills. When employees are trained, they will be equipped with the relevant skills to enable then deal with the problem effectively. In the United States, the International Continence Society is mandated to create awareness to the public about this condition (Ripley, 2007). Training and development programs depend on the individual hospitals based on the needs assessment.


In essence, it is very important to stay clean and take care of our bodies. For infants or old individuals who cannot quite take ca e of themselves, those around them, either family or medical personnel should strive to take care of them. The continual exposure of the skin to fecal matter and urine serves as a detrimental factor that impact the patient in a bad way. If not well taken care of, a skin subjected to incontinence can lead to macerations, Inconsistence Dermatitis and subsequent exposure to causative agents. To prevent these detrimental effects, the following procedures should be perused. First, changing the skin care products and using the most relevant ones for the incontinence condition should be pursued. Additionally, the patient or those administering care to them should make sure a normal pH level ranging 4 to 7 is kept. The pH level should be kept to make it tolerable since low ph. allowance the prevalence of bacteria. Lastly, an occasional cleansing process should be established to make sure there are no bumps on the skin that will eventually make the skin be affected by incontinence. Therefore, the pillar mechanisms to take care of the skin are to keep it dry, condition and protect and to keep it clean.

























Beeckman, D., Woodward, S., Rajpaul, K. and Vanderwee, K. (2011). Clinical challenges of preventing incontinence-associated dermatitis. British Journal of Nursing, 20(13), pp.784-790.

Brunk, D. (2007). Anticancer Agents Causing Unbearable Skin Toxicity. Skin & Allergy News, 38(10), p.26.

Consultations: Urinary incontinence. (2013). The Pharmaceutical Journal.

Cooper, P. (2000). The use of Clinisan in the skin care of the incontinent patient. British Journal of Nursing, 9(7), pp.445-448.

Fritel, X., de Tayrac, R., Bader, G., Savary, D., Gueye, A., Deffieux, X., Fernandez, H., Richet, C., Guilhot, J. and Fauconnier, A. (2015). Preventing Urinary Incontinence With Supervised Prenatal Pelvic Floor Exercises. Obstetrics & Gynecology, 126(2), pp.370-377.

Gray, M. (2005). Skin Care of the Incontinent Patient. Advances in Skin & Wound Care, 18(3), pp.138-139.

Gray, M., Ratliff, C. and Donovan, A. (2002). Perineal Skin Care for the Incontinent Patient. Advances in Skin & Wound Care, 15(4), pp.170-175.

Hess, C. (2008). Clinician’s Documentation Checklist. Advances in Skin & Wound Care, 21(5), p.240.

Markland, A. (2008). Predictors of Fecal Incontinence in Women with Urge Urinary Incontinence: From the Urinary Incontinence Treatment Network’s BEDRI Study. UroToday International Journal.

Newman, D., Cardozo, L. and Sievert, K. (2013). Preventing urinary incontinence in women. Current Opinion in Obstetrics and Gynecology, 25(5), pp.388-394.

NICE endorses darifenacin for urinary incontinence. (2013). Clinical Pharmacist.

PERINEAL SKIN CARE. (2002). Advances in Skin & Wound Care, 15(4), pp.176-178.

Physiotherapy helps postpartum incontinence. (2002). BMJ, 324(7348), pp.0c-0.

Reddy, M. (2008). Skin and Wound Care. Advances in Skin & Wound Care, 21(9), pp.424-436.

Ripley, K. (2007). Skin care in patients with urinary or faecal incontinence. Primary Health Care, 17(4), pp.29-34.

Salcido, R. (2010). Patient-Centered Care in Wound Care. Advances in Skin & Wound Care, 23(2), p.54.

Schaum, K. (2014). Medicare Payment: Surgical Dressings and Topical Wound Care Products. Advances in Wound Care, 3(8), pp.553-560.

Serena, T. (2014). A Global Perspective on Wound Care. Advances in Wound Care, 3(8), pp.548-552.

Wesnes, S. and Lose, G. (2013). Preventing urinary incontinence during pregnancy and postpartum: a review. International Urogynecology Journal, 24(6), pp.889-899.

Worcester, S. (2012). Harnessing Technology Can Improve Patient Care. Skin & Allergy News, 43(9), pp.1-40.



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