Skin decolonisation Purenga ihomatua ā-kiri
Skin decolonisation is a 5-day process to remove as much bacteria as possible from your body. This is done to reduce the number of skin infections you get.
About skin decolonisation
If you are having problems with repeat antibiotic‑resistant infections or staphylococcus aureus (staph) infections, your healthcare provider may recommend you undergo decolonisation. This process works to try to get rid of what is causing your infections.
You and everyone living in your house will need to follow this treatment for 5 days.
Other people in your house need to do it because they may carry antibiotic‑resistant or staph bacteria in their nose or on their skin, even if it does not cause them any problems. If you are decolonised and they are not, they will transfer the bacteria back to you.
Before you decolonise your skin
You cannot do this treatment if you or anyone else in the house has an active skin infection. You need to make sure you are all fully healed. Also, make sure you treat any other skin conditions. This includes any eczema, psoriasis and tinea (athlete's foot).
If you or anyone in your house gets a new skin infection, you will have to delay doing the decolonisation.
Steps to decolonisation
Getting ready
Make sure everyone in the house understands good personal hygiene and what they need to do to achieve it.
- Have a bath or shower once a day and more often if you do very sweaty activities. If you have dry skin and are not very active, a bath or shower every second day should be OK.
- Wash your hands properly with liquid soap and water or an alcohol-based hand gel. Take care to clean between your fingers and up to your wrists.
Hand hygiene - Keep your fingernails clean and short.
- Do not share razors, towels, facecloths or toothbrushes with anyone else in the house.
- Do not share creams, ointments, make-up or other personal items.
- Throw away any used razors, and skin creams or make-up that might have been contaminated.
- Use an electric razor rather than a blade shaver during decolonisation treatment. Do not have any hair removal treatment including waxing during decolonisation treatment.
- If you use creams or ointments from a container, use a new clean stick or spoon to remove the amount you need each time. This stops you contaminating the whole container.
Laundry
- Make sure everyone in the house has a bath or shower then puts on clean clothes.
- Put clean bedding on all beds and use clean towels and facecloths. To make sure your clothes, bedding and towels are clean, wash them in hot water with your usual laundry detergent. Or, if you wash them in cold water, either iron them with a steam iron, dry them in the sun or put them somewhere dry and uncontaminated for 10 to 14 days.
House cleaning
- Clean all hard surfaces including bathrooms and floors with detergent and water.
- Vacuum all carpets, rugs, mattresses and electric blankets.
- Take extra care vacuuming bathrooms and bedrooms. Make sure you vacuum around and under the bed.
- Wash any pet bedding, especially dog bedding. Dogs can carry antibiotic‑resistant or staph infections without showing any signs.
You can either:
- shower using an antiseptic skin cleanser every day for 5 days
- have a bleach bath twice in the 5 days.
Using an antiseptic cleanser in the shower
Types of antiseptic cleanser are:
- Octenisan 0.3% or Chlorhexidine Gluconate 4% hair and body wash solutions.
- Chlorhexidine Gluconate 1% lotion for pēpi, tamariki and elderly with sensitive skin. Use every day as a body wash for showering. Use twice a week as a shampoo for hair washing.
Follow these steps to make sure you wash properly.
Hair washing:
- Wet your hair and scalp.
- Apply a small amount of undiluted antiseptic cleanser and lather well.
- Leave on for one minute then rinse.
If you want to, you can use your usual shampoo and conditioner afterwards.
Body washing:
- Wet your whole face and body in the shower or bath.
- Turn off the shower or stand out of the bath.
- Apply the undiluted antiseptic cleanser to a damp clean flannel. Reapply as you go — you will need enough to cover your whole body.
- Start with your face, paying special attention to your nose area. Avoid contact with your eyes.
- Work down to your neck then arms including your fingers and underarms.
- Then wash your chest and back including your belly button and skin folds.
- Next clean down your thighs and legs including your toes.
- Lastly clean your genital areas, groin, bottom and anal area with the flannel or cloth.
- Leave the cleanser in contact with your body for one minute before rinsing it off in the shower or bath.
- Dry yourself with a freshly washed clean and dry towel.
Having a bleach bath
Instead of using an antiseptic cleanser, you can have a diluted bleach bath. This can be easier for tamariki than using an antiseptic cleanser.
Use a household bleach that has no added fragrance or detergent.Bleaches come in different strengths, usually 2 to 5% hypochlorite. The strength should be written on the label.
You can buy household bleach at a supermarket.
Calculating how much bleach to use
You will need to calculate how much bleach (hypochlorite) you need in your bath depending on the strength of the bleach you are using and the amount of water in the bath.
- For a 4.2% bleach product, add 1 ml for every litre of water.
- For a 3.1% bleach product, add 1.3 ml for every litre of water.
- For a 2.1% bleach product, add 2 ml for every litre of water.
The average bath filled to 10 cm deep will use about 80 litres of water. So if you use a 4.2% bleach you will need:
- 80 litres x 1 ml = 80 mls of bleach.
The average pēpi bath will use about 15 litres of water. So if you use a 2.1 % bleach you will need:
15 litres x 2 ml = 30 mls of bleach.
Taking your bath
Follow these steps to make sure you wash properly with a bleach bath:
- Run your bath with warm water. Add the correct amount of bleach and mix well.
- Soak in the bath for about 10 minutes before rinsing off.
- Do this on day 1 and on day 3 or 4.
If you do not have a bath, use the above calculation to mix the bleach in a bucket. Sponge it over yourself generously and leave it on for 10 minutes before showering it off.
Nose decontamination
Apply mupirocin or povidone-iodine ointment to both your nostrils twice a day for 5 days. Your healthcare provider will give you a prescription for this.
- Apply it with a cotton bud up to about 1cm into your nostril. This is just enough so the tip of the bud goes into your nose. Apply the ointment fully around the inside surface of each nostril.
- Use a new cotton bud for each nostril so you do not contaminate the tube.
- Take care around the entrance to your nostrils, as povidone-iodine ointment can stain your skin.
Laundry
- Wash all clothes, bedding, and towels that have been used during the week.
- Put clean bedding on all beds.
- Make sure clean underwear, clothes and towels are available for everyone for the next day. To make sure your clothes, bedding and towels are clean, wash them in hot water with your usual laundry detergent. Or, if you wash them in cold water, either iron them with a steam iron, dry them in the sun or put them somewhere dry and uncontaminated for 10 to 14 days.
House cleaning
- Clean all hard surfaces including bathrooms and floors with detergent and water.
- Vacuum all carpets, rugs, mattresses and electric blankets.
- Take extra care vacuuming bathrooms and bedrooms. Make sure you vacuum around and under the bed.
- Wash any pet bedding, especially dog bedding.
Once you have completed the decolonisation process, it is important you and your whānau maintain good personal hygiene and keep your home clean to prevent recolonisation.