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kdcm1011 Asked October 2017

Raw skin on FIL's bottom. Any suggestions?

My FIL has raw skin on his bottom and he won't tell his doctor.  I believe it is due to incontinence that he denies and not showing.  Any suggestions?

disgustedtoo Nov 2017
Who did he tell that you were made aware of it? You or hubby? That would be the person he most trusts to "care" for it. Incontinence would likely be noticeable, between stains and smell. Does he live alone? Who, if anyone, provides care for him?

I do agree with others that despite not wanting to tell his doctor, it SHOULD be looked at by an experienced medical provider. Our mother was living alone and somehow injured her leg and by the time we knew about it, it had progressed to cellulitis, a serious skin infection. On his butt, covered for the most part all the time, it could fester even worse than her "sore" did. It took antibiotics, several rounds, and a long time to fully heal.

mickimcmurray Nov 2017
If he is refusing care, that it appears he needs, contact Protective Services to report self-neglect. They may be able to encourage him to accept help if not from you from an agency that will provide Personal Care or a Home Health Aide a few times a week. They can help with bathing and the application of the cream.

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Hugemom Nov 2017
Not to be negative, it I just wanted to add that this is a constant, ongoing battle. A lot of these what I call “pee rashes” spread. Everywhere there are skin folds all over the body can become irritated. I bathe my husband sometimes twice a day to keep these irritations at bay. I agree that cleanliness is your #1 defense against these things.

kdcm1011 Nov 2017
Thank you all for the suggestions and concern. Very good advice here and will discuss with husband which ones will help get FIL fastest on the path to treatment.

Again, thank you.

staceyb Nov 2017
He needs to be seen by his Dr,not rule out any fungal or bacterial infection and he may well need continuous multi weekly Dr's visits, if the skin break down is really bad, or deep. Skin infections on the buttocks can become extremely serious, really fast, and if bad enough, the patient can become Septic! Don't wait, get him into see his Dr, then go with what He recommends should be used on the skin irritation, or whatever it might be.

careisgiving Nov 2017
Do you have access to an herbal store? If so, ask for St. John's Wort-infused olive oil and for sweet almond oil (it's not edible!) and mix these with a barrier cream and apply this mix all over the skin. Sometimes my mother's buttocks turn a light shade of red/pink from the chronic urinary incontinence due to a medical condition and applying the cream mix clears up the redness right away. St. John's Wort is typically used for burns and bedsores and actually plumps up the skin. Sweet almond oil is very nourishing to dry skin and is often used on baby's buttocks for chafing. However, you or whoever is POA should consider notifying the FIL's doctor of the butt issue in case it progresses into something worse.

SueC1957 Oct 2017
Seewell,
I know tumeric is good for the body but warn anyone using it that it will stain anything it touches. It will leave a dark yellow stain.
How about mixing the tumeric with honey? But then cover the area with a diaper or waterproof pad in case the color bleeds. Very holistic approach.

Shane1124 Oct 2017
Kudos to Ray Lynn! You have it down, nice job!
Medihoney very good suggestion as well.
Also it’s important to clean the area gently and let it dry to air before applying anything. Use a mild soap and warm water, like Ivory or such without any perfume and no alcohol. That will burn like the devil.
Good luck!

moecam Oct 2017
If you say the treatment is free that helps - I said to mom 'you've paid enough taxes so start collecting what you have paid for' - it started a change in her mind set to start getting help

mlface Oct 2017
Make sure what you use doesn't burn. Try it on yourself first. There skin is so tender.

Seewell Oct 2017
Would it be possible to bring in a nurse to clean and dress it up. Sometimes, they listen better to a professional or a stranger!  I saw someone mentioning honey.  You could also try Kasthuri turmeric paste on the skin.  Kasthuri Turmeric  may be available in Indian grocery stores.  Buy the root and grind a bit into paste with little bit of water on a rough stone and apply on the affected area.

patooski Oct 2017
If it is happening in an area that is getting pressure when he sleeps, you might also try an inflatable mattress with a pump that keeps kind of rolling air gently through it. It just keeps the continuous pressure off. It's easy to assemble. I think it did help. I think we rented the pump from a medical supply store and had to buy the mattress. Not sure if say Medicaid would cover it. I think Medicare/United Health Care did not. (This was a couple of yrs ago.)

CaredForParents Oct 2017
Great answers on treatment. Also, keep in mind that HIPAA may be a one-way street, but anyone can inform his doctor of anything. Reco a hand-delivered letter or email.

Llamalover47 Oct 2017
An elder's skin thins as they age. I don't advise a cream because it will be more inclined to wipe right off. I recommend an ointment as it's more inclined to stay on the skin. It's critical that the skin, which is the largest organ on the body, remain infection free.

Dad_Was_Robbed Oct 2017
This problem really needs addressed before it becomes infected and the doctors really need to become involved when he lands in the ER if it gets that bad, which can easily happen. He might also land under guardianship if he can't take care of himself. Just warn him about the freedom he'll lose if he falls under guardianship

anonymous581090 Oct 2017
He needs a barrier cream. Dietary needs for healing is increasing the protein in his diet plus keep his fluids up.

Tothill Oct 2017
Why don’t you tell his doctor? Even if you do not have medical poa, you can let the doctor know your concerns.

Hugemom Oct 2017
Hubby is incontinent both ways and also on diuretics, so it seems like he’s constantly wet. He’s also bedbound and can get to the toilet. I’ve tried many barrier creams, most of the ones mentioned here. He has an open sore rash on his back that looks like blisters from urine. What I found works the best is plain old cornstarch. Used with diaper rash cream. It’s kind of messy to wash off, and I don’t scrub the irritated skin, but it works.

anonymous739426 Oct 2017
Sounds like a pressure sore. This needs it to be properly dressed by a nurse. Maybe a visiting nurse from an agency can come take a look at it, at home. Also he should sit on a roho cushion (pressure cushion balloon) rather than hard surface. Also you could look into a pressure care mattress to avoid any many more sores or this sore getting worse.

Freakedout Oct 2017
Home health stores sell many types of special gel cushions that help prevent skin breakdown. They can be put on wheelchairs or regular chairs and there are some for beds. I know the VA provided a wonderful gel cushion for my father-in-law. I don’t don’t know if insurance or Medicare will pay for these if a doctor prescribes them.

Lymie61 Oct 2017
Sounds like a 2 fold problem. The first being getting him to accept help (and that there might be a problem). I't is so tough as the caregiver to see them deteriorate but it's even harder on them, especially someone proud, used to being strong and in charge the way it sounds like your FIL is. My FIL was the same way and just didn't share things like this with his children either. Anyway as others have mentioned, often it's easier for them to hear it and share or participate in care plans with someone outside of family. Both the immediate treatment of the developing sores as well as the underlying cause (likely incontinence as you mentioned) need to be addressed of course and both are going to be touchy, embarrassing subjects for him so if he has a long time primary practitioner that he has a good relationship and trust with they might be the better ones to start the conversation/treatment plan and if that isn't going to work (you and his family have a better feel for who and what is most likely to get the best reception) that person can initiate a home evaluation for your in-laws by VNA. I say in-laws because it might be an easier sell, easier for him to swallow if it's about your MIL or the two of them rather than all about the sores on his bottom. We have had to "sell" this to my mom now a couple of times and it was a bit easier because she had made a trip to the ER this last time and these evaluations are often triggered when elderly make a visit to the ER. But the basics are I believe that a primary and maybe any medical provider (so if he has another doctor he trusts more) can order this pretty much anytime they see a possible need, getting sores like that healed and preventing them from happening again would qualify as would just assessing the house and their routine for any services or equipment, ideas that would make life and in particular their health (so ordering, taking and storing medications, bathing, eating) easier. Your in-laws may not need any services but maybe the "experts" have new ways of accessing free services or can spot medications issues. For instance maybe incontinence is a side affect of some med he's on, sometimes those things develop later and just changing the med will take care of the problem. My mom had been on a medication for quite a while with no problems and it wasn't until one of these nurses did her evaluation that a new symptom she was having, shin pain, was connected to this med she had been taking for a while. No ones fault just one of those things that took new eyes and a new full picture evaluation. Sorry I got off course selling the idea the way I had to with my mom. Point is it could be introduced in a non threatening way, just as a normal smart thing people take advantage of and having them come might enable someone unrelated but with medical credentials (so maybe trusted) to address the sensitive issues like sores and incontinence and if he or they do need help caring for the sores, making sure they are bathing (I think that was someone who responded not your FIL), eating properly and it takes some of the pressure on how to start the dialogue or assess things off of you and their children. Long and short, let a trusted doctor address it and the treatment and or let a doctor set it up to have home nursing services address and asses it. This way it's covered by Medicare and not out of pocket too.

Now if getting to the needs isn't so much of a problem, treating the sores and preventing them from coming back or trying is the main focus of course and I have just wasted far too much of your time (sorry). First whether incontinence is a permanent problem or not while treating the sores something like Depends (I know that may be a tough sell) is really helpful both for keeping a person dry and while keeping a salve or cream of some sort on open sores to heal them and keeping the mess off clothes including underwear. It also of course keeps the area cleaner if that's an issue at all and forces a change to fresh underwear regularly. I have to say the ones they make these days and there are several options (we have found Depends to be the best for my mom and I buy them in bulk through Costco or Amazon, much more affordable than Walmart, grocery or pharmacy) and you really can't see them under clothes and they don't feel like diapers or a wad of something that reminds the wearer they have incontinence. They make them specifically for men and women too now so they are designed for the difference in anatomy. But sores seem like an easy introduction because they are being used more like bandages and part of that need, not directly because of incontinence if that is still a touch subject. If indeed he is having some incontinence issues maybe he will notice an advantage in wearing the Depends (or whatever) and continue on his own. As far as creams I'm sure any of the ones already mentioned will work, I might stay away from anything associated with diaper rash just because of the association which is probably why there are so many now with more mature names, even though they are all basically interchangeable (diaper cream/adult bottom sore cream). Personally I would have my mom using a salve with lavender, frankincense, tea tree essential oils (all or one of them) and probably mainly coconut oil with others as a carrier and beeswax to firm it up. I have a great rose oil healing salve I like to keep on hand too that would work as would one made with herb infused oils. I have never tried a silver ointment like the one mentioned by RayLinStephens but it sounds like a good one too. These salves aid in the healing and don't just make a barrier between the sore and moisture so the healing should go faster but the barrier is probably most important and easiest to find.

Good luck, I know how sensitive this can be and how hard it gets. I think we all do here, just the fact you care enough to seek out help and ideas is a good indication that your FIL is a lucky man to have family who care enough to stop and think about his overall well being not just take over. It is such a hard time but it can also be a wonderful time if you let it.

moecam Oct 2017
We have used an Rx ointment for hemorrhoids called 'proctosedyl' for about 40 years - but we use it for EVERYTHING but in eyes or mouth - good for burns, cuts, mosquito bits etc & for diaper rash but there we put it on then silicone barrier cream on top to protect skin more - ask his dr for something like that in case where you live they don't have it but should be able to find something similar - good luck

moecam Oct 2017
My dad had a similar issue - we changed to a thick foam pillow to sit on - bought through pharmacy - can get them with & without covers - egg crate top - because he may have the beginning of a bed sore because he is so thin & he sits a lot - lying on side in bed for spells can help as then different skin is taking his weight - he could watch t.v. like that if he doesn't want to sleep

EmandEm Oct 2017
True that you will get many answers to this problem but I have to tell you that the one suggestion that worked on my loved one was A&D ointment. I thought it was a miracle!

Snowcat60 Oct 2017
Get some good therapeutic grade lavender essential oil and add about 20 drops to a 2 oz spray bottle of either distilled water or colloidal silver and have them spray it on each time after using the bathroom.
Or add a few drops to a carrier oil like jojoba oil and apply several times a day. This oil is excellent for healing burns and many skin irritations. You could also try Triple Neem Care ointment which can be purchased at Amazon. As for the essential oils try Edens Garden which can also be purchased online.

Barb53 Oct 2017
Any cream with zinc oxide . Put it on thick and don’t scrub it off. Let it flake off on its own before reapplying.

BeBethany Oct 2017
Hello everyone, when my daddy started loosing 'shed loads' of weight he had sacral sores that were really deep and unpleasant.... he was convinced the community nurses had 'injured' him by pull the gown ties roughly through his bottom cheeks!! They hadn't of course.... however what I found the best ever treatment was... bathing with tepid salt water 4/5 times a day and ordinary starch powder!! Apparently it's an old remedy... but within 10 days the sores had gone and lovely pink shiny new skin was growing xx

RayLinStephens Oct 2017
As many people as you ask, that's how many things will be recommended.

I tried everything recommended for my DH but what works is Colloidal Silver Gel. AND get a good barrier cream - that didn't seem to matter which - anything for diaper rash is mainly a barrier cream. Right now, we're using PeriGuard but there are hundreds on the market. It's getting the wound to heal that was difficult. The only thing to work for us was the Colloidal Silver Gel, $15 jar at Amazon for "Silver Miracles Colloidal Silver Gel" and I go through about a jar a month for DH. But it's good for so many things, I bought enough to last out the rest of this year.

Some barrier creams recommended to me:
Selan Silver, Boudreaux Butt Cream, Aloe Vesta Protective, and I found Camloseptine at a medical supply site (has Calomine in it) - I see Desitin already mentioned above.

I also bought Tuck's Pads to clean the site (witch hazel pads) - I found a tremendous deal at Amazon but Walmart has their own generic too.

If you cannot get it under control, it will become increasingly worse. If he has HomeHealthCare, mention it to the nurse and she will keep an eye on it.

mlface Oct 2017
I use Desitin cream on my hubby when he gets red raw places. I used it on my babies years ago. It works wonders. Make sure it's the white cream.

luckylu Oct 2017
kdcm1011,
I'm sorry your'e Father in Law is having such a rough time.
What worked the best for my Mother on her raw hiney,was Medi honey put on the wound and then a Dermagram patch put on top that,covered by a piece of gauze with adhesive tape to hold it,kept on overnight each night until the wounds were healed. It took some time and efforts,but they finally healed on Mother.
Good luck finding something that works for you all.Take good care,Lu

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