How should skin be cared for in a patient with ongoing urinary incontinence to prevent moisture-associated dermatitis, and when are barrier creams indicated?

• A. Regular cleansing and patting dry; barrier creams or films applied after cleaning; use absorbent products that wick moisture.
• B. Apply barrier creams before cleaning and after; do not use absorbent products.
• C. Barrier creams are indicated for skin irritation but not under active infection.
• D. Avoid using barrier creams in any case.

Answer: (C)

Barrier creams serve as a protective layer to shield skin from moisture and irritants when the skin around the perineal area becomes irritated from ongoing incontinence. They are most appropriate when there is skin irritation or early dermatitis, helping to restore and maintain skin integrity by reducing contact with urine. The important caveat is that barrier creams are not indicated during an active infection: occlusive products can trap moisture and bacteria, potentially worsening infection and masking signs that need treatment. In practice, once infection is resolved, barrier protection can be reintroduced to prevent recurrence, while continuing gentle cleansing, patting dry, and using moisture-wicking absorbent products to manage incontinence-related moisture.