What are Barrier Creams? The Best Options and How to Use Correctly
Incontinence and Skin Damage
Our skin not only serves multiple functions that are vital to our body, it is also our first line of contact with the outer world, meaning it is often taking the most damage. Our skin protects our bodies from outside threats, from minor traumas to chemical and microbial assaults. Incontinence, on the other hand, is a painful and often humiliating problem where one experiences involuntary leakage of urine or stool. More than 50% of older Americans struggle with incontinence according to a government report, but it can also affect people of all ages.
Unfortunately, incontinence is known to cause significant damage to the skin, often resulting in incontinence associated dermatitis (IAD). This means that the skin that comes in contact with the involuntary leak of urine of stool will become inflamed and eroded, what is medically termed ‘contact dermatitis’. The skin is then even more vulnerable to harm from other sources such as friction, and the damaged area could potentially allow more bacteria in, increasing the risk of infection. Although both urine and feces can do their own individual harm to the skin, the worst damage ensues when they’re mixed, as an increase in pH occurs that aggravates the fecal irritant effect.
Preventing IAD is generally a priority for any patient suffering from incontinence, and one of the ways to do so is by using barrier creams.
What are Barrier Creams?
Barrier creams are creams, gels and ointments that were designed to protect the skin from contact with outside hazardous substances, and are often recommended as a way to reduce the damage caused by contact dermatitis or for sensitive skin. Barrier creams restore skin hydration of the damaged area while also acting as a repellent and protecting it from skin irritations, as well as softening the skin. Barrier creams differ from moisturizers in that they do not moisturize or protect against pressure damage, and moisturizers do not form a protective layer between skin and irritants.
How to Use and Apply Barrier Creams
Firstly, the area must be cleaned with a mild soap (many are available for IAD specifically), and then patted dry. The barrier cream should then be applied in a thin layer on the damaged skin, and then left to dry out before recovering the area. The drying is critical so the product isn’t lost getting stuck to the clothes or cover. The cream should also be removed whenever a routine of skin care is repeated to avoid having a build-up of the product. Multiple layers or over application is problematic and should be avoided, as it will not only cause you discomfort, but cracking of the product could happen allowing moisture to penetrate and rendering the prevention useless.
In more severe cases of incontinence where there is constant leakage, the cream is likely to be washed off often and so should be reapplied more frequently.
What is the Best Barrier Cream for Incontinence? Features to Look Out For
Skin barrier creams widely range in formulations in the market, and there are many brands offering them in a variety of gels, pastes, and ointments that typically depend on skin types. What one should expect from a proper barrier cream is for it to be occlusive and insoluble, ensure it works as a protective barrier to reduce skin breakdown and don’t easily rub off or get washed away.
Often these products are water-based, and one should lookout for the ones that contain zinc oxide, petrolatum, dimethicone, lanolin or other skin sealants (Lichterfeld, et al, 2015). The role of these chemicals is often misunderstood, with patients heavily focusing on a single available ingredient. However, it is their cumulative effect that succeeds in providing a skin barrier. It is recommended, however, to find the product that achieves its goal with the fewest ingredients possible, as the more ingredients the more likely some extras will cause more issues rather than solving them.
Products containing chlorhexidine gluconate, alcohol or fragrance should definitely be avoided, because these ingredients often cause more painful and “burning” sensations when applying them.
Finally, it is essential to keep in mind the incontinence products one is using (if any), such as pads and underpants, when selecting a skin barrier cream. The product has to refrain from coating a pad’s surface, for example, getting in the way of the leakage being absorbed by the pad, which stands against the prevention we are working to achieve in the first place. Dimethicone is often recommended as a chemical that does not get in the way of absorption processes.