Skin Care Problems Faced by the Obese and Incontinent Patient


Obesity rate continues to rise in the US. According to recent reports by two public health groups, 16 states had an increase in adult obesity over the past year. Skin cleanliness is important for anyone who has loss of bladder or bowel control. A person who has these issues and is also obese needs to take extra care of their skin.

It is extremely important for the caregivers, of those who are incontinent and obese, to know how to care for the skin of those people. The high amount of sweat and perspiration in an obese person contributes to problems with the skin. It is likely for an obese patient to experience moisture-associated skin damage. Commonly diagnosed as interiginous dermatitis (intertrigo). Also known as fold dermatitis. This is when the skin in the folds of the body is irritated because of the moisture and friction in the folds. As moisture gathers and becomes trapped in the skin folds, bacteria, fungus and viruses can grow and lead to skin breakdown. The incontinent, obese patient is more likely to have such skin problems because of the likelihood of urine and perspiration trapped in skin folds. The heath care provider of an incontinent, obese person should be sure to check the folds of that patient’s skin regularly.

Recognizing the warning signs of skin problems is a necessity.  Itching, burning, pain, odor and redness are the first signs of a problem with the skin. If not treated the patient could experience swelling, erosion and crusting. Common areas of problem are the armpit, just below the breast, the back of the knee, the groin, the buttock folds and the upper thighs.

There are many skin care products available to help manage and treat skin problems. A promising medical product to help with skin damage is the InterDry® Ag Textile (Coloplast, Minneapolis, MN). This is a knitted polyester textile infused with an antimicrobial silver complex (a substance that kills the growth of bacteria and fungi). This product helps keep skin dry by removing excess moisture and reduces skin rubbing with its soft, knitted texture. One sheet of this can be used for up to five days and usually replacement is not needed after those days. Be aware that this is not designed to be a wound dressing. It is only to be used to manage problems associated with fold dermatitis. Visit NAFC’s website for a listing of other skin care products available.

Stay away from old wives tale products that are assumed to remedy skin problems. Many think that talcum powder will solve all skin problems. What some do not realize is that talcum powder does not combat against fungus or bacteria, the common microorganisms causing the skin problems in incontinent patients.