Perineal care, often called “peri care,” is the routine cleaning of the genital and anal region. This specific care maintains the health of the skin between the anus and the genitals, known as the perineum. Performing this hygiene correctly prevents skin breakdown, reduces odor, and lowers the risk of infections, such as urinary tract infections (UTIs). Regular and gentle peri care is particularly important for individuals with limited mobility or those recovering from medical procedures.
Defining Perineal Care and Necessary Supplies
The perineal area includes the external genitalia (vulva or penis and scrotum), the anus, and the adjacent upper inner thighs. This region is vulnerable to moisture and bacterial accumulation from urine and feces, which can quickly lead to irritation or skin maceration. Peri care is designed to cleanse this sensitive area while protecting skin integrity.
Gathering the correct supplies ensures a smooth and sanitary process. You will need disposable protective gloves to prevent the transfer of microorganisms. Cleansing agents should include warm water and a mild, non-irritating, pH-neutral soap or specialized no-rinse perineal cleanser. Harsh soaps should be avoided as they can disrupt the skin’s natural barrier.
You will also need several clean washcloths or disposable wipes, a basin for the warm water, and a waterproof pad or towel to protect the underlying surface. For the final step, a clean, soft towel is necessary for thorough drying. Having a skin barrier cream or ointment on hand is advisable for individuals prone to incontinence or skin breakdown, to apply a protective layer after cleaning.
Essential Step-by-Step Technique
Before beginning, ensure the individual is positioned comfortably, typically lying on their back with knees flexed, while maintaining privacy. After donning gloves, gently clean the upper inner thighs, working from the cleanest area outward to remove surface soil. The focus then shifts to the genitalia, using a fresh section of the washcloth or a new wipe for each cleaning stroke to avoid cross-contamination.
For individuals with female anatomy, the cleaning motion must always be directed from the front (urethral opening) toward the back (anus). This front-to-back rule is a fundamental principle for preventing UTIs, which are often caused by the transfer of E. coli from the rectum. The labia majora are cleaned first, followed by separating the labia to clean the folds of the labia minora and the area around the urethra.
For individuals with male anatomy, cleaning begins at the tip of the penis, specifically the urethral meatus, using a circular motion and working outward down the shaft. If the person is uncircumcised, gently retract the foreskin before cleaning the head of the penis to remove accumulated smegma. Return the foreskin immediately to its natural position after cleaning to prevent paraphimosis.
The scrotum is cleaned next, paying close attention to the skin folds beneath the testicles, which can harbor moisture. After the genital area is cleansed and rinsed, turn the individual onto their side to access and clean the anal area, using a separate, clean cloth or wipe. All areas must then be thoroughly patted dry with a clean, soft towel to eliminate moisture, preventing skin maceration and fungal growth.
Variations for Specific Care Needs
The standard cleaning technique is adapted for specific circumstances, such as medical devices or post-surgical recovery.
Catheter Care
When caring for a person with an indwelling urinary catheter, the focus shifts to the insertion site to prevent catheter-associated urinary tract infections (CAUTIs). The area around the meatus is cleaned first, followed by the catheter tubing itself, wiping gently away from the body for about four inches to reduce biofilm formation. The tubing should be secured to the leg to prevent unnecessary movement and traction.
Postpartum Care
Postpartum care requires a gentle, non-abrasive approach, especially when stitches or swelling are present. Instead of traditional wiping, a peri bottle filled with warm water is commonly used. The bottle is gently squeezed to direct a soothing stream of water over the perineum while the person is sitting on the toilet. This rinsing action cleanses the area and helps dilute urine, which can sting open skin, before gently patting the area dry.
Immobile Individuals
For individuals who are immobile or require full assistance, maintaining proper positioning and dignity is paramount. The initial cleaning of the front perineum is performed with the individual on their back. To access and clean the anal area thoroughly, the person must be gently rolled into a side-lying position. This positioning allows for complete cleaning of the buttocks and anus while maintaining privacy.