Skin care product selection. The PH of the skin is 5.5 Urine and faeces are alkaline which cause a...
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Transcript of Skin care product selection. The PH of the skin is 5.5 Urine and faeces are alkaline which cause a...
Skin care product selection
The PH of the skin is 5.5Urine and faeces are alkaline which
cause a chemical reaction when a patient is incontinent
Identify some common skin conditions
Common skin problems• Maceration• Excoriation• Dryness• Fragility• Blistering• Skin stripping• Scarring
Maceration
•Softening and breaking down of the skin from prolonged exposure to moisture.•Proteases found in chronic wound exudate actively damage healthy tissue.•Maceration is more common in chronic wounds
Maceration may delay healingenlarge woundsIncrease pain
Treatment• Manage exudate appropriately.• Use of barrier film such as cavilon.
Excoriation
excoriation
•Identify and resolve incontinence •Use of barrier creamsUrine collection devices
ECZEMA
Signs and symptomsItching/ puritisRednessVesicles / blisters
Contact sensitivityDressingsBandagesLotions / creamsTopical antibioticsConsider patch testing /
dermatology referral
Skin dryness/ dehydration
Hydration normally maintained by sebum
secreation and intact stratum corneum
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Causes of dryness
Systematic dehydrationDermatological conditionsInappropriate dressingsAgeing – hormonal changesEnviromental – soapMedications – steroids interfere with
epidermal regeneration and collagen synthesis.
Emollients
Regular use of emollients or mosturisers will prevent dry skin and acute flares thereby improving skin health
(British dermatology nursing group 2010)
Dry skin is usually itchy and leads to inflammation this is usually the first in the development of atopic eczema.
These skin changes lead to a decrease in natural moisturising factors.
Washing with alkaline soap reduces the thickness and number of layers within the skin.
Excess use of soaps / detergents can interfere with the water holding capacity of the skin and alter PH
Emollients are available in many formulations and patients should be encouraged to replace soaps with emmollient washes.
Which product to use?• Patient preference• Consistency required• Ingredients• Cost
Patient preference
May not like the thick ointments that stain clothes – lighter creams are more easliy absorbed.
May not like odour.• Bath additives• Soap substitutes• Leave on emmollients
Consistency
Creams•Lighter in consistency •Spreads easily but absorbed quicker
Ointments•Thicker and are more greasy.•Have occlusive effect and retain water in the skin•Better when high exudate.
Humectants
Humectant moisturisers replace the skins natural moisturising factors (e.g Urea and glycerol) therby attracting and retaining water in the skin cells.
eg hydromol
Aqueous cream
Recent research ahs found that if aqeous cream may cause irritation due to sodium lauryl sulphate which damages the skins barrier properties ( Cork et al 2003)
Ingredients
May include known sensitisers such as lanolin preservatives and fragrance (eg E45).
Nut derivatives ( eg arachais oil)
Emollient guidelines(PCDS/BAD atopic
eczema 2006)Apply liberally and frequently – every four
hours (qds)Patients underestimate quantity needed and
application frequency – large quantities should be prescribed – 600g/week
Quantity and frequency should be far greater than steroid therapy.
Education on how to use emollients is important