I am a carer for a male tetraplegic as a result of a severe ABI. He wears pads diapers/nappies day and night. There are quite a few carers who like to slather on the sudocrem. He is extremely sensitive to touch. Cleaning in the groin becomes a nightmare for all involved. He does have excoriated areas from the pads. The sudocrem builds and builds unless i take action to clean it. (This is quite a process as this is extremely uncomfortable for him) i generally wipe in the groin with a warm washer but have began using cotton tips to remove the build up gunky sudocrem. I have later found out that another carer has used shaving cream in the area to remove sudocrem in an area already broken down and sensitive and i have noticed the area reddening and skin breaking away! Can anyone recommend a safe and less painful way to remove the cream, to allow healing of the skin, or any advice you could give would be great for this lovely man who already is in agony.
Hello and welcome sasscw, firstly, I think it is great that you have come to ask for advice, it is very considerate.
Regarding the issue, I think that you need a written action plan and guidance that can be followed by other carers too. This is just a thought but if I were you, this is what I would do.
I would make some observations in a journal of the affected areas, describing the degree of skin breakdown etc and date it. Advise that a medical practitioner takes a look as it is possible that prescribed cream may be needed to help treat the area.
If a doctor is not organised to take a look then I would cleab away the sudocream with cotton wool soaked in warm water then padd the area dry with cotton wool. I would leave the diaper off to let some air get to the groin area and maybe put some pure aloe vera gel on it.
Ask other carers to do the same, ensuring that there is time allowed for the diaper not be fastened up so air can get to the groin area. Warm, dark creases on the body that sweat with non breathable material are a breathing ground for bacteria. If this person does not have an infection then I will be amazed.
The ideal is to treat the core issue rather than trying to improve ways of cleaning of sudo cream. The plan needs to be consistently followed through by other staff, in fact I would ask them to sign and date what they have done and how the groin area is improving.
Eventually Sudocream can probably be applied once any infection is cleared up and after a daily clean and airing.
Sasscw, please see about using something different from the sudocream entirely. Even when a chemical is “legal”, it can still be harmful. Sudocream has several ingredients that I distrust. Here are two examples:
benzyl benzoate “Topical Anti-scabies and Lice Medications Benzyl benzoate (Category C, not available in the USA) Benzyl benzoate was banned in the United States because its metabolite, benzyl alcohol was associated with neonatal fatal intoxication (“gasping syndrome,” with encephalopathy, metabolic acidosis, bone marrow suppression, and multiple organ failure). However, intoxication only occurred when benzyl alcohol itself was used to rinse central vein catheters. Products containing benzyl alcohol are still available in over the counter products in the USA. Except for local skin irritation, no reports of toxicity in animals or humans have been reported after topical application of benzyl benzoate. A Thai study examined 444 pregnant women in their second and third trimester who utilized 25% benzyl benzoate preparation topically. No increased risk for birth defects was reported. The use of topical benzyl benzoate is likely safe.[9,10]” www.ncbi.nlm.nih.gov/pmc/articles/PMC5122270/
Propylene Glycol “Propylene Glycol is the active ingredient in antifreeze. It is also used in makeup, toothpaste and deodorant. Stick deodorants have a higher concentration of PG than is allowed for most industrial use! Direct contact can cause brain, liver and kidney abnormalities. The EPA requires workers to wear protective gloves, clothing and goggles when working with it. And yet, the FDA says we can put it in our mouths!!” www.bewell.com/blog/what-chemicals-should-you-look-out-for-in-your-personal-care-products/
The ingredients in Sudocrem are: Zinc oxide Benzyl alcohol Benzyl benzoate Benzyl cinnamate Lanolin (hypoallergenic) Purified water Sodium benzoate Paraffin wax Microcrystalline wax Heavy liquid paraffin Synthetic beeswax Sorbitan sesquioleate Propylene glycol Antracine 54 Linalyl acetate Lavender