Sebrena Sodalay, brand consultant for TENA, shares some insights into why it is important for wheelchair users to ensure that their skin remains dry.
To grasp the issues surrounding this fully, we need to have an understanding of how our skin works. The most important of its functions include preventing infection, protecting us from the elements (mainly the sun) and maintaining the delicate balance by managing body heat and water loss. In a nutshell, it provides a barrier function.
The skin or epidermis is the outermost layer that can be thought of as a brick-and-mortar wall, where cells are the bricks and naturally occurring fatty cells act as the mortar. The whole structure is important in regulating water movement, and ensuring sufficient hydration for effective skin function while also preventing overhydration (when the skin becomes soggy and more likely to break down).
Keeping the skin in balance is very important, as too much or too little water can quickly lead to skin problems such as inflammation or dermatitis. Where overhydration occurs, the skin allows irritants through the barrier, causing inflammation and increasing the risk of damage from friction. Overhydrating the skin can also occur due to incorrect skin-cleansing methods and excessive washing.
Prolonged exposure to high levels of moisture (sweat, urine or faeces) on the skin will cause it to break down, which is why it is so important to keep skin dry. Add to these challenges a lack of sensation or movement, and physical pressure is placed onto already compromised skin. Wheelchair users are therefore at far higher risk of skin damage and need to be vigilant at all times.
Products to help keep the skin dry
Choices will depend on the person’s individual needs. In general, wheelchair users make use of collection aids such as sheaths and leg bags, or they perform intermittent self-catheterisation. However, if they do suffer frequent urinary leakage, they need to consider using a product that will prevent this, such as an absorbent pad that will keep their skin dry.
It is crucial to use non-aggressive washing products and cleansing techniques, and to choose the right barrier cream. Thick, occlusive skin-protectant products that are used overgenerously so that they sit on the surface of skin can often cause more issues than it prevents.
The skin is home to billions of friendly bacteria that work to protect us. They help to prevent harmful bacteria from infecting the skin. Normal skin pH levels are vital to protect these friendly helpers. Beneficial bacteria can live in a lower pH (pH 4 to 6), whereas harmful bacteria prefer a higher pH.
It is important that the products and care procedures we use do not disturb this natural low pH. Soap is a high-pH product. It works by dissolving any dirt on the skin and can irritate the skin if it’s not rinsed off properly. TENA Non-rinse Wash Cream and Wet Wipes work by removing dirt gently from the skin, without the need for rinsing.
Healthcare professionals agree that consistent personal skincare is essential to control odour, maintain skin integrity and the wellbeing of incontinent individuals.
Other ways of staying dry
Probably the most important aspect of keeping cool is your choice of clothing. Some factors to consider:
- Wear loose-fitting clothing if you have a skin condition;
- Avoid creases and folds in fabric, as these can increase the risk of skin breakdown;
- In warmer weather, loose-fitting clothing allows air to circulate near the skin and reduce moisture and heat;
- Washing labels can be cut out of clothing if they cause irritation;
- Look for trousers with a longer leg length and looser fit around the bottom and tops of thighs;
- Tops with a loose fit across the shoulders and upper arms will be more comfortable if you self-propel;
- Clothes with slippery linings will generally be easier to put on and take off;
- Soft, flat seams will be more comfortable and are less likely to contribute to pressure ulcers;
- Stretchy fabrics are generally more comfortable to sit in and often make it easier to get dressed;
- Natural fibres are often most comfortable, are breathable and are best for maintaining body temperature; and
- Tops that open at the back tend to be easier to put on in a seated position if you are assisted by a carer for dressing.
For more information on the ideal clothing for wheelchair users, click here to read an article published at Livingmadeeasy.org.uk, an online resource run by the Disabled Living Foundation, a charity in the United Kingdom.