The skin is the largest organ of the body and acts as a barrier against microbial invasion and harmful chemicals. It also regulates heat and water loss and produces vitamin D.
Barrier creams, film sprays and wipes play an important role in preventing damage to the skin and maintaining the skin’s integrity. By protecting and moisturising the skin, they help to prevent and treat incontinence-associated dermatitis (IAD), excoriation from contact with wound fluid and around stoma sites, maceration to periwound areas, as well as conditions that arise from the skin becoming too dry and fragile.
How do skin care products work?
Barrier creams protect the skin from corrosive moisture such as wound fluid or urine. Traditional skin barriers will often contain a lipid and water emulsion with metal oxide or silicione that will block and repel moisture. They can be greasy and may interfere with dressing retention.
Newer products provide a quick-drying second skin with a thin layer of polymers. Barrier films provide a breathable protective layer that can be applied with a spray or a wipe, which can be used on periwound skin or to protect from urine. They are sometimes used as film dressings enabling the wound to be protected but easy to observe. They can last up to 72 hours before they need to be reapplied. As they are non-greasy, they should not interfere with dressings.
Other products are siloxane-based and they repel water. The skin needs to be dry before these products are applied. They sometimes contain acrylate terpolymer, which can build up if reapplications are made too frequently.
Stronger skin sealants will sometimes contain cyanocrylate, which is also used in sutures. It can be difficult to remove so care must be taken on fragile skin.
How do I choose the right product?
Check with the patient whether they are sensitive to any of the ingredients in any of the skin care products. Make sure that the product you choose will not interfere with the action of the dressings you are using.
Are there any precautions?
- Some barrier creams may interfere with the absorbency of dressings and therefore interrupt exudate management
- Emollients can sometimes cause sensitisation
- Cyanocrylate can feel hot when it is applied
- Make sure that barrier cream is used sparingly so as not to block the skin.
- Offers protective film
- Use on broken skin