. 2018 Jun 1;20(Suppl 2):S2-54–S2-64. doi: 10.1089/dia.2018.0080

Table 2.

Skin Protection and Barriers


General consideration
• Clean skin with oil-free, antimicrobial soap and dry thoroughly^18,31
• Gentle exfoliation recommended for oily skin³¹
• Trim hair with dry razor if needed³
• Alcohol may or may not be used, depending on how it is tolerated on skin. May be more important for infection prevention with infusion cannulas than with CGM sensors³
• Do not place immediately after a shower/bath or in a steamy bathroom—minimize humidity with hairdryer or application in a dry environment³¹
• Solid or spray antiperspirant (unscented) may help with skin prone to sweating. Apply thin layer, wait 10–15 min, wipe off excess and prepare site^18,31,38
• What works best for one patient may not work best for another. Patients may need to try several different products
Prophylaxis
• Topical prophylactic treatment of skin is generally off-label and has unknown risks associated with long-term use^a

Product	Advantages	Professional tips
Nasal steroid applied topically (fluticasone, etc.)	—Over the counter —May reduce hypersensitivity reaction^31,35	—Anecdotally, 1–2 puffs to the skin, let dry completely before inserting cannula/CGM^a —Unknown consequences with chronic use^b

Skin protection barrier films
• Barrier films may help prevent mild skin irritation from adhesives³³
• Glucose sensor manufacturers recommend not inserting a sensor through barrier films,³⁸ although anecdotal evidence suggests this is commonly done^a. Patient may leave a small circle on skin without film for CGM/IIS insertion³¹
• Wipe on skin and let dry completely before placing CGM/IIS.^31,33
• May apply 1 layer or a second later after first layer has dried^a

Product	Advantages	Professional tips
IV Prep (Smith&Nephew)	—Waterproof, breathable barrier film —Also contains alcohol for antiseptic properties	—Wipes —Let dry completely on skin —Although not marketed as having tackifying properties, may see mild enhancement to adhesion^a
Bard^® Protective Barrier Film (Bard Medical)	—Waterproof, breathable barrier film	—Wipes or spray —Does not include antiseptic
SurePrep™ (Medline)	—Vapor permeable barrier film —Includes antiseptic	—Wipes —Can be used on damaged skin as protection
Skin prep/no-sting skin prep (Smith&Nephew)	—Waterproof, breathable barrier film —Good for barrier and additionally has tackifying properties —Popular choice due to moderate protection and moderate adhesive properties combined^a	—Wipes or spray —Skin prep indicated for intact skin, no-sting skin prep indicated for intact or damaged skin⁴⁰ —does not include antiseptic
Cavilon™ No Sting Barrier (3M™)	—Waterproof, breathable polymer-based barrier film	—Wipes or spray —does not include antiseptic
AllKare^® Protective Barrier Wipe (ConvaTec, Inc.)	—Waterproof, breathable barrier film	—Wipes —does not include antiseptic

Barrier Patches and Bandages
• As a barrier, patches/bandages must be placed underneath the sensor/pump tape^16,18,31
• Good for placing on skin before sensor adhesive. Recommended to punch hole in it for sensor/cannula,³¹ however, many patients report inserting through without problems^a
• Offers more protection from allergy/irritation than liquid barrier wipes^a

Product	Advantages	Professional tips
IV3000 (Smith&Nephew)	—Transparent, thin film, precut patch —May be less irritating than sensor/cannula adhesives	—May also be used as an adhesive enhancer (see Table 3) when placed over sensor/infusion set tape —More prone to peel with water, sweating, humidity^a —Many patients report less skin reaction with IV3000 compared with Tegaderm^a
Tegaderm or Tegaderm HP	—Transparent, thin film, precut patch	—HP stands for “Holding Power” and may adhere more strongly than standard Tegaderm —May also be used as an adhesive enhancer (Table 3) when placed over sensor/infusion set tape —More prone to peel with water, sweating, humidity^a
Opsite/Flexifit (Smith&Nephew)	—Roll of thin transparent film can be cut to size	—May also be used as an adhesive enhancer (see Table 3) when placed under sensor/infusion set tape^a
Hydrocolloid dressings: —DuoDERM^® —Toughpads —(Dynarex) Dynaderm™	—Hydrocolloid provides thick protection —Waterproof —Some brands have “extra thin” version if desired less thickness —Some latex free	—More often used under sensors than IIS^a —Offers stronger barrier protection than an adhesive patch, such as IV 3000 or Tegaderm —Recommend cutting hole for sensor placement, although patients report inserting sensors through hydrocolloid dressing without problems^a
COMPEED^® Plasters	—Absorbs moisture on skin, possibly aiding adhesion	—Original intention as blister cushion —Anecdotally adheres better after warming to skin temperature in hands before application^a

Recommendations based on literature (cited), expert opinion, manufacturer's indication, or common clinical practice unless otherwise indicated.

^{^a}

Used within our institution or support in public commentary, online articles, diabetes blogs, social media.

^{^b}

Unclear support, requires additional studies.