Tips on how to clean individuals with incontinence
How to clean individuals with incontinence and maintain skin health
For individuals with incontinence, there are many factors that can cause skin damage and discomfort. To avoid this, skin health should be an integral part of daily continence care. Here, you’ll find best practice tips for cleaning individuals with incontinence.
Cleaning tips and skin health questions answered
As well as hands-on care tips on cleaning individuals with incontinence, you can also find answers to frequently asked questions such as:
How does poor continence care cause skin health issues?
Which personal hygiene supplies do I need?
What is the proper way to wipe an individual with incontinence?
Should I use soap and water to clean the perineal area?
Do you clean males and females with incontinence differently?
How poor continence care causes skin problems
Poor continence care can expose sensitive skin to irritants such as urine and faeces, compromising the skin’s protective barrier. This can lead to painful skin conditions such as incontinence-associated dermatitis (IAD) and significantly increase the risk of infection.
Today, IAD is highly prevalent in nursing homes with up to 30% of residents with urinary incontinence (1) and up to 50% with faecal incontinence experiencing the condition.(1) These figures prove the importance of proper personal hygiene and maintaining skin health.
To maintain skin health, all cleansing and treatment of skin in intimate areas must be done in the right way, with appropriate products and according to individual needs.
How to prepare when cleaning an individual with incontinence
Before you begin cleaning, it is important to be prepared. This not only means having the right hygiene products to hand, it also means ensuring the right conditions regarding comfort and dignity.
To create a comfortable environment for cleaning, ensure that the room is warm enough. If using wet wash gloves, these can be gently heated in a microwave before use for added comfort (refer to instructions for use for full details). Then, make sure you have everything you need including gloves, apron, wet wash gloves, wash cloth, no-rinse wash cream, barrier cream, a towel and a clean absorbent product that suits the individual’s needs.
Use no-rinse cleaners, not soap and water
When cleaning an individual with incontinence, avoid using soap and water. Most soaps contain surfactants, which dissolve dirt but can also remove the skin’s natural oils and cause dryness. Surfactants can also cause irritation if they remain on the skin. Several clinical guidelines and health care professionals recommend no-rinse cleansers for perineal care.(2) No-rinse cleansers are more effective than soap and water, kinder to skin and don’t need to be rinsed with water, which is more convenient if cleaning an individual in bed.
Firstly, apply a small amount of no-rinse cream to a clean washcloth or wash glove. Always start by gently wiping the cleanest areas first and then move towards the dirtiest areas (front to back), only wiping once with each side of the cloth – this helps prevent the spread of bacteria.
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Use no-rinse cleaners, not soap and water
When cleaning an individual with incontinence, avoid using soap and water. Most soaps contain surfactants, which dissolve dirt but can also remove the skin’s natural oils and cause dryness. Surfactants can also cause irritation if they remain on the skin. Several clinical guidelines and health care professionals recommend no-rinse cleansers for perineal care.(2) No-rinse cleansers are more effective than soap and water, kinder to skin and don’t need to be rinsed with water, which is more convenient if cleaning an individual in bed.
Firstly, apply a small amount of no-rinse cream to a clean washcloth or wash glove. Always start by gently wiping the cleanest areas first and then move towards the dirtiest areas (front to back), only wiping once with each side of the cloth – this helps prevent the spread of bacteria.
The different ways to clean males and females
How to assist males with perineal hygiene
Always start with the cleanest area first. The anal opening is considered the dirty area and should be saved for last. Therefore, begin by gently retracting the foreskin (if uncircumcised) and clean the tip of the penis, moving from the urethral opening outward. Clean each side of the scrotum and groin folds separately using a clean part of the cloth for each wipe – clean from front to back. After washing, pat the area dry and pull the foreskin back over the glans.
How to assist females with perineal hygiene
Gently separate the labia and wipe from front to back to avoid transferring bacteria to the urethra. Clean each side of the labia and the vaginal area, then wash the groin and pat dry.
Assisting with hygiene in the perineal area
When cleaning the anal area for males and females, ask or assist the individual to lie on their side. Start by washing the back, then buttocks. Wipe the anal area last. Again, wipe from front to back to prevent spreading bacteria and then pat dry. Don’t forget to clean within any skin folds or around a stoma or wound.
Perineal hygiene for incontinent individuals
After each product change, it is essential to gently cleanse the perineal and anal area to remove any residual urine and faecal matter. This helps maintain skin integrity, prevents irritation and reduces the risk of infection.
Protecting and inspecting the skin
As well as cleaning, the individual’s skin should also be checked every day for signs of redness or damage. Ensure the skin in warm, moist areas of the body such as the groin, between folds of skin on the abdomen, under the breasts, etc. is dry and healthy. If you see signs of skin irritation, assess the cause and adjust the care plan accordingly.
If the skin appears red or irritated, or if it is part of the care plan, apply a thin layer of barrier cream to the clean, dry skin. This provides an extra layer on top of the skin to protect it from excess moisture and irritants like urine and faeces. It can also help reduce skin-to-skin friction that causes skin breakdown.
Avoid using excessive amounts in the perineal area as this may interfere with the absorption capacity of the incontinence product. A light application of barrier cream ensures effective skin protection and optimal product performance.
Once the individual is clean and a new product has been applied, dispose of the gloves, washcloth and any soiled products responsibly. After assisting with perineal hygiene, wash your hands thoroughly and support the individual in washing theirs as well to help prevent the spread of infection.
Skin health, dignity and satisfaction
When delivered properly, and according to individual needs, continence care can improve wellbeing by maintaining skin health and retaining dignity. Proper perineal hygiene, especially for individuals living with incontinence, helps prevent skin irritation and infection. It also supports comfort and contributes to emotional and physical wellbeing.
When carried out gently and with respect, hygiene practices build trust, reduce distress, and enhance the overall quality of care by reinforcing the individual's dignity and sense of safety — key elements of person-centred care.
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