OSTOMATES GUIDE TO BETTER SKIN CARE
I think we can all say that we take our bodily functions for granted, especially where our skin integrity is concerned. Our skin is a very important part of our bodies and I thought that it might be appropriate to talk about some of the things in relation to this part of our make-up
DEFINITION OF SKIN
Our skin is the largest organ of our bodies and reflects multiple systems of health. It makes up to 15% of our body weight and receives 33% of our circulating blood.
Our skin has a ph balance of 4.5-5.5
Our skin is colonised by yeast, fungi and bacteria.
FUNCTIONS OF THE SKIN
1. It regulates our body temperature
2. It controls our sensitivity to touch, heat, cold, pain and pressure
3. It protects our underlying tissues
4. It takes care of the excretion of water and waste product
This is made up from the layers of cells with a base layer and is always forming new cells through cell division. As new cells grow, they become flattened and move up developing Keratin; the outermost layer is then worn away friction. The Epidermis layer also has the job of making the skin waterproof.
The following tissues and structures are all found in the dermis or inner layer. Connective tissues, elastic fibres, capillaries, muscle fibres, sensory cell, nerve fibres, pigment cell that produces melanin, sweat glands, hair follicles and sebaceous glands.
The Hypodermis or Subcutaneous Tissue consists of adipose and connective tissues, stores lipids and has a major function with thermo-regulation. It connects the dermis to the underlying bone and muscle.
EFFECTS OF AGEING ON YOUR SKIN
In order for our skin to function in a normal way, it needs a constant supply of blood. In the case of a child's skin, which is actively growing, the vascular network is extensive. As we get older, this network grows smaller. When this happens, the following takes place:-
- The turnover of our cells slows down from 14 days to 40 days
- Vitamin D function is reduced
- Collagen fibres fracture readily and combine into clumps that form wrinkles
- The risk of trauma is increased and the skin tears easily
- Barrier functions are reduced and so skin irritation risk increases
THE RISK FACTORS
One or more of these factors may put your skin integrity at risk :-
- Obesity, Age, Smoking or Diabetes
- Poor nutritional status
- Impaired sensory perception
- Immunosuppression often caused by Steroid Therapy
- Chemotherapy and Radiation Treatment
- Urine or Faeces that remains sitting on the skin
HERE ARE SOME GUIDELINES FOR BASIC SKIN CARE;-
- Do not use antiseptics, disinfectants, dettols or spirits to clean skin.
- Do not use lanolin based creams, as these are too oily for the appliance to stick onto. However, water based creams are recommeded.
- Avoid perfumed soaps as these can induce an allergic reaction over a prolonged period of usage time.
- If the abdominal area is hairy, it is recommended to shave the surrounding skin where the appliance sticks, using a disposable shaver. You can achieve better hygiene and the appliance is more comfortable to wear
- If there is a build up of adhesive material on the skin,then adhesive wipes can be used to remove this
- You can even use diluted Eucalyptus soap solution, this has the twofold effect of removing the sticky residue and moisturising your skin at the same time.
- On use cortisone creams for short periods only and always under the supervision of a Doctor. Prolonged use of cortisone creams can reduce the ability of the skin to heal.
Today' appliances are designed to provide a leak proof, secure seal to he skin and in so doing this, it causes body waste to be contained,
Allergies to appliances or listed pharmaceutical products is an uncommon cause of skin problems.
A generalised erythema or pink tinge on the skin when the appliance is removed is normal, if observed for a long enough period you may see th colour sart to fade.
The most common cause of stomal skin problems is irritant reactions, which often results - often resulting from too large aperature on the appliance base or urine or faeces soiling on the skin.
Problems under the Base Plate
It is a very common problem to experience itchy skin under the sticky portion of an ostomy appliance.
This complaint of itchy skin is usually associated with dry skin.
The skin is either peeling or flaky; feels like sandpaper to touch and has lost its smooth elastic feel or may be rough and uneven.
The use of adhesive wipe removers can create itchy skin.
Dehydration, particularly with ileostomates, can lead to dry and itchy skin.
As the skin becomes more fragile with ageing, it can become dry and itchy.
IMPORTANTANCE OF MOISTURISING OUR SKIN
1. Keeping moisture in skin forms the basis for all good skin care.
2. Water alone will not successfully rehydrate damaged skin
3. Moisturisers are required for restoring the intracellular lipids, providing waterproofing between the cells.
Ways To Moisturise your Skin
- Use either Dove or a medicated moisturising soap
- Shower using a Sorbolene wash solution instead of using soap
- Consider moisture based, soap free wash solutions
- If skin is very dry and peeling then either a pinetarsol wash or Q.V. wash solution is recommended (Found in either chemists or large supermarkets).
- If using a mositurising cream underneath your appliance then use water based cream not lanolin based ones,
DO YOU WANT TO IMPROVE YOUR QUALITY OF LIFE
When you have an ileostomy or colostomy bag, there are always problems looming. One of these which is a big one the trouble of leakage, which can lead to very sore skin around your stoma. If this is the case with you, then you should ask yourself these three very important questions:-
1. Does your current pouch feel rigid and uncomfortable?
2. Do you suffer from leakage problems?
3. Do you have trouble applying your pouch correctly?
If you answered yes, to one or all or these questions, then there are appliances available to help with these problems, one in particular is called "HydroFrame, which is a thin, flexible hydrocolloid extension, similar to your existing skin barrier. If you have had to use tapes in the past to secure your pouch, then you need this product HydroFrame, which is a much gentler alternative. This product has a proven track record because it:-
- Can improve your pouch wear time and security.
- Helps to minimise the risk of leakage.
- Is kinder to your skin and won't cause irritation.
- Has a unique skin circular design that fits any 1 or 2 piece skin barrier or flange.
- Has bevelled edges to stop rolling and lifting.
- Provides a longer wear time than alternative tapes does.
I have endeavoured to show to you, the ostomate, the importance of looking after your skin. I do hope that any ostomates reading this have been able to understand now just why it is very important to look after the skin surrounding and inside your ileostomy or colostomy. Please, if you are having problems, see your Stomal Therapist as they are the experts in this field, and can assist you with any problems that may arise with your Ilesotomy or Colostomy use, especially where your skin is concerned.
AFTERALL, YOU ONLY HAVE ONE SKIN, SO YOU HAVE TO LOVE IT AND LOOK AFTER IT, BECAUSE ONLY YOU CAN KEEP IT IN THE BEST CONDITION