Cleaning too much?

[Ski]

(Note: This will be in detail! i.e Graphic)

I've been incontinent for almost 3 years now, and I think I've noticed a trend with myself now.

I used to get BAD, and I mean BAD diaper rashes. At first, my scrotum would get oozy. At the same time, it would get itchy.

It would get progressively worse and so unbelievably itchy that I couldn't stop itching it if I was able to get my hand down there. I wear "onsies" which helped me resist the urge to itch. After wearing a diaper for an hour or so, the itching would go away enough to where I was not pre-occupied with the discomfort.

After I would change, the itching would come back with a vengeance, and stay for an hour. It was so bad I accidentally cut my scrotum with my fingernails just trying to get relief. I would even hyperventilate some of the time if I couldn't itch, because it was so persistent. After a couple weeks, it would then progress to the next stage, which was pain along with the itchiness.

I tried to air it out, and pull the ooziness away by wearing a penis clamp and regular underwear. The oozing was so bad that my underwear was soaked from that, not urine.

I swore I'd never let that happen again, so the next time I could feel it coming on, I started showering, a lot. Like 3 to 4 times a day. I purchased that dial antibacterial soap, and used that on a loofa (that poofy thing you put body wash on), and would clean that region with water that was painfully hot for a good 2-3 minutes. And the absence of discomfort I felt almost made me want to drop my knees in relief. As soon as I got out of the shower though, the itchiness would return.

Well after doing this for a few weeks (yes, WEEKS), I noticed it wasn't getting any better. I tried baby power but I feel like this made it worse. In fact, EVERYTHING made it worse. I got a prescription of Nystatin, and over the course of a few more weeks, it slowly went away while I performed my painful cleaning process.

A couple months ago, I felt the rash coming back, and I cleaned that area with REGULAR (non-antibacterial) soap, no loofa, normal water temperature, and whatever I had went away in a week or so with minimal, and tolerable, levels of itchiness.

So my questions:

Could the abrasive surface of the loofa been damaging the skin?
Along with the hot water?
And the anti-bacterial shampoo?

My girlfriend thought that maybe I had a fungal infection, and by cleaning too much I was ridding my body of good bacteria that could have been fighting it. Maybe this is why it took weeks for this "rash" to go away the first few times?
Does this sound like a fungal infection? I think it was since the Nystatin helped quite a bit.

Any ideas why the itchiness would go away after having a diaper on for an hour? And why it would itch so bad after a change?

Any had a rash (or whatever it was) this bad before? I seem to get these episodes twice a year.

[johnstone]

You might want to try using some different diaper rash creams/pastes until you find the one that works best for you. Any time I feel any skin discomfort I use a really good product called "Remedy". It is a Medline product and be purchased online. It's NOT a cream, this is a paste and works better than GREAT.

Hope this helps.

[greenbank]

Hi Ski

I have found the The New Diaper Primer Chapter 6: Hygiene And Diaper Rash (link below) absolutely fantastic. I was lucky enough to come across this chapter at the start of wearing diapers and so far (that has tempted fate) no rash itch etc. Sadly the author is no longer with us however the legacy left behind has helped me no end I hope it will help you as well.

http://www.incontinentsupport.org/chap6.php

All the best and hope you have a light at the end of your tunnel of discomfort soon.

Greenbank

[Patrick]

If this happens again, you might consult a dermatologist. Mine recommended a jock itch preparation, which worked so well that I haven't had another instance of diaper rash, and that was years ago.

[JDinVirginia]

Ski,

Washing multiple times a day is a good thing, but too much washing with soap can actually contribute to diaper rash or make it worse as it washes off natural protective layers. Try skipping the soap except, perhaps, for once a day.

Skip the loofa. You can even skip using a wash cloth. This is doubly so when washing multiple times a day, as you are.

Temperature of the water should not make a difference.

Absolutely try using an adult diaper rash cream. I have had very good results from the Equate Diaper Rash Relief which contains 40% zinc oxide. It Walmart's generic brand but despite costing less, seems to work better for me.

You did not mention what kind of diaper you are wearing. Although I much prefer a plastic-backed diaper, once I began having irritation I began rotating in a breathable diaper once or twice a day.

I will echo Greenbanks recommendations to check out the New Diaper Primer as it is extremely helpful.

Regarding your severe diaper rash lasting for weeks, my dermatologist told me that if a rash did not begin to clear up within a week, as I implemented increasingly strong measures, I should make an appointment to check for a fungal infection.

Good luck!

--John

[Ski]

Good info JD. I usually wear a Molicare Super+ around the house, and a Dry 24/7 if I'm leaving the house or overnight. I wear the 4Care "onesie" as well, which is good for limiting sagging, but thinking it could actually make a rash take longer to heal since it keeps the diaper next to the skin.

I did go to the Dr. the first time it came up, I'm thinking all the extreme measures I was taking is actually what prolonged the healing process.

I should add too, when I was having the rash I would try to wear a Molicare Super, which is semi-breathable.

[JDinVirginia]

Ski,

A "semi-breathable" diaper with breathable sides (what I call a "hybrid), should be almost as good as a fully breathable diaper as most of the ventilation comes from the sides anyway. If the rash persists, the ultimate in breathability is sitting without a diaper on an absorbent pad for an hour per day to allow the skin to dry and "air out." Of course, this is easier to do if you are retired or working out of your home.

A lesser contributing factor may be how snugly we tape our diapers. It may help to leave very little space between the top of the inside diaper leg elastic and the crotch to allow some air flow. As I am bowel incontinent I was taping my diapers very snugly - perhaps too snugly - to contain odor. There appears to be a fine line between too tight and too loose.

--John

[msshendo]

I honestly don't think that the rough cleaning with the loofa was helping much. I honestly think it might have been hurting some. I think you were getting relief from the scratching of the loofa more than any medical benefit. Just my opinion.

[wheels5894]

There's the other thing, too. All the washing is taking oils out of the skin and dry skin is itchy. (I know, I have had eczema since I was baby .) The thing is, that once the skin is itchy, and one starts to damage it with scratching, infections get in and it oozes nasty stuff and looks dreadful. The way I have solved it is to use emollients - actually a shower gel that is emollient rather than soap and it does the trick.

Maybe you have more a rash from dry skin rather than nappy rash. Try something in the nature of an emollient for a few days and see if it helps. It's worth seeing if you can find a way to 'air' the skin too, for at least a part of a day.

[Ender]

I just wanted to chime in quick. I should really properly introduce myself to the forum and stop 'lurking.' Hard to figure out what to say; easier to share what I've learned from a similar experience.

The water temperature, as long as it's not scalding, shouldn't be an issue. An abrasive loofah probably wasn't helping. I think the biggest problem may be the antibacterial soap.

While I was healing from a surgery in 'that area,' I was very concerned about the incisions getting infected. So I rubbed in an antibacterial ointment whenever I changed the dressings--over the incisions and over the whole area for good measure. I wound up with a red, oozing scrotum. I asked the urologist about it during a follow up appointment; they had also noticed the excessive redness and irritation around the suprapubic catheter exit on my abdomen, where I also was applying the cream. They said that it looked like a yeast infection and that those can be caused by excessive use of the antibiotic cream I was putting on. I discontinued the antibiotic cream (everywhere) and the redness and oozing (and terrible itchiness) cleared up. I would imagine an antibiotic soap, used frequently, might have the same effect. The fact that it itches worse right after this cleaning treatment is a sign that your skin isn't liking something about it, either the soap is too harsh, the scrubbing too hard, or some combination thereof. A lot of this is trial and error and figuring out what works best for one's body.

I'm now long healed and the catheter is no longer installed. I've found that washing the entire area gently with a washcloth and mild moisturizing soap once daily, along with cleaning thoroughly with mild unscented wipes and applying a rash cream (even in absence of a rash) with cornstarch powder at each change does the trick for preventing rashes and itchiness altogether. So does staying hydrated to prevent the urine from becoming concentrated and harsh to the skin.