This pamphlet is for you if you experience tenderness, itching, or rash from the patch from your insulin pump, your infusion set, or your sensor. The pamphlet describes how to treat both mild and severe skin reactions, and how to prevent them from occurring again. The acute treatment is to give the skin rest and good skincare.
In particularly severe cases with a rash, daily use of prescription steroid cream may be necessary. You should apply steroid cream until the rash is gone. However, for a maximum of 4 weeks to avoid damaging the skin's natural barrier.
3 steps: How to prevent skin reactions again
Step 1: Good skincare
Use generally perfume-free skincare products and soap. You can use a good moisturizer (with up to 70% fat) in the skin areas where you are not currently using equipment. These are named pause areas. Moisturizer strengthens the skin's natural barrier. However, it is important not to use moisturizer on the skin on the day you apply the equipment.
Step 2: Apply and remove your diabetes equipment gently
Always place your diabetes equipment on clean and dry skin where there are no adhesive residues, scar tissue, or wounds. Use as many different skin areas as possible to give the skin rest for as long as possible.
Avoid disinfection with alcohol: It dries out the skin and damages the skin's natural barrier.
When you need to change equipment: Loosen the patch gently, preferably using water, oil, or a plaster remover (e.g., Esenta) to remove the adhesive.
Step 3: The Sandwich Method
The sandwich method is a method where you place a barrier between your skin and your diabetes equipment. This way, you avoid the patch, which causes itching or rash, touching the skin.
Find the right barrier
You can find the right barrier by using groups A, B, and C in the table below:
- Start with the products in group A, then group B, and then group C.
- You should use one group for at least 2 weeks before moving on to the next one.
- You can try several types in the same group within the 2 weeks.
The type of adhesive in each barrier is in parentheses in the table. An adhesive is the glue that makes the patch stick. Most are made of acrylic, but silicone and hydrocolloid are more skin-friendly. However, most people can tolerate acrylic.
Group A:
Thin film/cream Try for at least 2 weeks. | Group B:
Thin patch Try for at least 2 weeks. | Group C:
Thicker patch Try for at least 2 weeks. |
| Brava Skin Barrier: Wipe or spray (silicone) | Hypafix Stretch (acrylic) | Hypafix Skin Sensitive (silicone) |
| Cavilon: Wipe or spray (silicone) | Hypafix Transparent (acrylic) | Duoderm (hydrocolloid) |
| Esenta Skin Barrier: Wipe, spray or foam (silicone) | IV-3000 (acrylic) | Compeed (hydrocolloid) |
| Welland WBF: Wipe (silicone) | Leukomed T (acrylic) | |
| | Tegaderm (acrylic) | |
| | Leukomed T Plus (silicone) | |
| | Mepitel One (silicone) | |
Use the photo guide in the pamphlet 'The Sandwich Method' when using group B or C.
If the rash is due to an over patch placed over the equipment itself, start by replacing the over patch with another one. You can try Mepore tape, kinesiology tape, or Co-Plus bandage (if the equipment is on your arm). If that doesn't solve the problem, you can try a patch from group B or C.