How can I avoid irritated or sensitive skin caused by the sensor adhesive?

If you have irritated or sensitive skin please work with your healthcare professional (HCP).

You and your HCP may find the information below useful. This is a summary of clinical articles published by clinicians independent from Dexcom based on their knowledge and experience. Information has also been gained from patient experience.

These are not Dexcom products and Dexcom has not tested these approaches, nor do we endorse these specific approaches. For detailed step-by- step instructions on how to use your Dexcom Continuous Glucose Monitoring (CGM) System, please refer to the User guide for your Dexcom product.

Do you have irritation at the sensor site or sensitive skin? These considerations, skin barriers, and professional tips may help. Remember what works best for one person may not work best for everyone. You and your HCP may need to try several different products or methods to figure out whether these options work for you.

All products listed may not be available in all areas of the UK and Ireland.

General consideration¹

Clean skin with oil-free, antimicrobial soap and dry thoroughly¹,

If currently using alcohol wipes, try without as these can sometimes increase irritation

• Gentle exfoliation of the skin area for application is recommended³

• Trim hair with dry razor if needed ³

• Do not use any lotion or oil containing moisturizer where you insert the sensor

• Do not insert sensor immediately after a shower/bath or in a steamy bathroom—minimize humidity with hairdryer or application in a dry environment³

• Roll-on or spray antiperspirant (unscented) may help with skin prone to sweating. Create an empty oval on the skin with the antiperspirant, wait 10–15 min. Insert sensor on clean skin in center of oval.^2,3

• If using an over patch for G6/Dexcom ONE, do not apply the overpatch until 12 -24 hours after insertion. For G7 / Dexcom ONE+ apply included over patch immediately.

When does the irritation occur?

If the irritation is only occurring after the removal of the device, then a medical adhesive remover can be used. This makes the removal of the device easier and less likely to irritate the skin.

If the irritation is happening whilst wearing the device then a barrier product may be needed.

Medical Adhesive removers

Medical adhesive removers can be applied to the adhesive prior to peeling from the skin. They can be used to effortlessly remove the CGM from the skin avoiding trauma and pain. Most dry quickly and no residue on the skin.

Availability key ( OTC – Over the counter / P – Prescription / O – Online / NA – Not available )

Product	Advantages	Professional Tips	Availability
Opus Lift Plus 360	Spray can be sprayed at any angle More environmentally friendly aerosol No cold sensation	Available in spray or wipes	UK – O / P Ireland - NA
Clinipeel Medical Adhesive remover	No sting formula Non fragranced Spray can be used at any angle No cold sensation Not manufactured with natural rubber latex	Available in wipes and spray	UK – O / P Ireland - O
Appeal	Can be used on intact or broken skin Alcohol free Not manufactured with natural rubber latex	Available in spray or wipes	UK – O / P Ireland - O
Brava Adhesive remover spray	Spray can be used at any angle Alcohol free No sting formulation Quick drying	Available in spray only Available in XL bottle making it more cost effective	UK – O / P Ireland - O
Peeleasy	Can be sprayed at any angle Not cold on skin	Available in spray or wipes	UK - O / P Ireland - O

Barrier Films¹

• Barrier films are creams, wipes or sprays that leave a tacky film on your skin

• Barrier films may help prevent mild skin irritation from adhesives⁴

• Create an empty oval on the skin with the barrier film and insert sensor on clean skin in center of oval

• Let barrier film dry completely before placing sensor^1,4

• May apply 1 layer or a second after first layer has dried*

• Barrier films may be an irritant itself and may not prevent allergens from skin penetration

Product	Advantages	Professional Tips	Availability
Cavilon ™ No sting barrier	Waterproof, breathable barrier film Contains alcohol for antiseptic properties	Available in wipes Let dry completely on skin Not marketed as having tackifying properties but may see mild enhancement to adhesion*	UK – OTC / O / P Ireland – OTC / O
Opus Skin Safe	Protects against body fluids and adhesives	Available in wipes or spray	UK – OTC / O/ P Ireland – NA
Smith and Nephew - Skin Prep	Waterproof breathable barrier film Popular choice due to moderate protection and moderate adhesive properties combined*	Available in wipes or spray Skin prep indicated for intact skin Does not include antiseptic	UK – OTC / O/ P Ireland – OTC /O
Smith and Nephew – No Sting Skin Prep	Waterproof breathable barrier film Popular choice due to moderate protection and moderate adhesive properties combined *	Available in wipes or spray No Sting Skin Prep indicated for damaged skin Does not include antiseptic	UK – OTC Ireland – NA
SurePrep TM	Vapor permeable barrier film Includes antiseptic	Available in wipes Can be used on damaged skin as protection	UK – OTC / O / P Ireland – NA
Medi Derma-S ®	Waterproof Alcohol, Fragrance, Latex, Parabens and Phthalates Free	Available as wipes cream or film applicator Can be applied to both damaged and intact skin	UK – OTC / O / P Ireland – OTC

Barrier films with extra adhesive

Product	Advantages	Professional Tips	Availability
Skin Tac (Torbut)	Used as adhesive enhancer as well as a barrier	Has a removal product as well Wipes can also be used to stick down edges	UK – OTC / O Ireland – OTC / O
Skin Glu	Used as adhesive enhancer as well as a barrier	Wipes can also be used to stick down edges	UK – OTC / O Ireland – OTC / O

Barrier Patches and Bandages¹

• Use barrier patches and bandages only if barrier film did not work for you

• Dexcom has not tested the use of barrier patches and bandages. Talk to your HCP about the use of barrier patches and bandages.

• When used as a barrier, patches/bandages must be placed between the sensor adhesive patch and the skin^2,5

• These are extra dressings that could be made of different materials such as transparent films, hydrocolloids or flexible fabrics

• Third party companies also make underpatches specifically for the different CGM products available. Dexcom have not tested these products with Dexcom CGM

• A reusable non adhesive product is also available for some CGM products

Transparent Film Dressings

• Cut an empty oval in the patch/bandage and insert sensor on clean skin in center of oval.

• Place on skin before sensor adhesive and aim for the hole you have cut.

• Dexcom has not tested any of its products being inserted through another dressing

Product	Advantages	Professional Tips	Availability
IV3000 (Smith&Nephew)	Transparent, thin film, precut Many patients report less skin reaction with IV3000 compared with Tegaderm*	More prone to peel with water, sweating, humidity* May also be used as an adhesive enhancer when placed oversensor tape	UK – OTC / O / P Ireland – O
Tegaderm	Transparent, thin film, precut	More prone to peel with water, sweating, humidity* May also be used as an adhesive enhancer when placed over sensor tape	UK – OTC / O / P Ireland - O
Opsite (Smith&Nephew)	Roll of thin transparent film can be cut to size	More prone to peel with water, sweating, humidity* May also be used as an adhesive enhancer when placed over sensor tape	UK – OTC / O / P Ireland - O

Hydrocolloid Dressings

• For G7 / Dexcom ONE+ you will need to cut a hole for the sensor filament to go through and apply dressing to the skin, before inserting the Dexcom.

• For G6 / Dexcom ONE it may be easier to apply the hydrocolloid to the sensor before adhering to the skin

• Cut dressing to size and then fold the dressing in half and cut a triangle. When you unfold you will have a diamond shaped hole.

• Remove the adhesive papers from the Dexcom G6 / Dexcom ONE and stick the non-adhesive side of the hydrocolloid dressing to the Dexcom adhesive, ensuring the hole you have cut goes around where the sensor filament will insert from.

• Remove adhesive papers from hydrocolloid and stick to skin

Product	Advantages	Professional Tips	Availability
Compeed Blister Plaster	Widely available in chemists and supermarkets	Compeed is slightly smaller than the Dexcom adhesive	UK – OTC / O Ireland – OTC / O
Duoderm	Has ultrathin option Latex free	Offers stronger barrier protection than an adhesive patch such as IV 3000 or Tegaderm 2 or 3 plasters overlapping may be needed sometimes	UK – OTC / O / P Ireland – OTC / O
Comfeel	Has a transparent Option	Offers stronger barrier protection than an adhesive patch such as IV 3000 or Tegaderm 2 or 3 plasters overlapping may be needed sometimes	UK – OTC / O / P Ireland – OTC / O
Replicare	Has thin option	Offers stronger barrier protection than an adhesive patch such as IV 3000 or Tegaderm 2 or 3 plasters overlapping may be needed sometimes	UK – OTC / O Ireland – OTC /O
Granuflex	Latex free	Offers stronger barrier protection than an adhesive patch such as IV 3000 or Tegaderm 2 or 3 plasters overlapping may be needed sometimes	UK – OTC / O / P
Supermarket / Pharmacy own brands	Widely available Come in different sizes	Offers stronger barrier protection than an adhesive patch such as IV 3000 or Tegaderm 2 or 3 plasters overlapping may be needed sometimes	UK – OTC / O Ireland – OTC / O

Flexible fabric dressings

For G7 / Dexcom ONE+ you will need to cut a hole for the sensor filament to go through and apply the dressing to the skin, before lining up and inserting the Dexcom.

For G6 / Dexcom ONE You will need to cut a hole for the sensor filament to go through. Some people find it easier to stickto the skin first whilst others choose to stick to the Dexcom first.

Product	Advantages	Professional Tips	Availability
Mefix (Molnlycke)	Porous flexible fabric	Can easily be cut to desired shape and size	UK -OTC /O / P Ireland OTC / O
Hypafix	Porous flexible fabric	Can easily be cut to desired shape and size	UK -OTC / O / P Ireland - OTC / O
Expression Med Underpatch	Breathable, non woven hypoallergenic	Come precut to size	UK – O Ireland - O
D Patch	Hypoallergenic, water resistant patches made from Cotton and spandex mix	Comes in different bright colours and can be used as underpatch or overpatch	UK – O Ireland - O
Type one style Underpatch	Precut hole for sensor insertion	Available precut with precut hole for all different devices. Has a template printed on top for precise insertion	UK – O Ireland - O

Reusable Non adhesive underpatches

Flexiarmour underpatches are a reusable non adhesive patch, designed to be used with an additional medical adhesive. These are precut to size and have a precut hole for the sensor to insert through. The underpatch is stuck to the Dexcom adhesive, creating a non-adhesive barrier. A layer of medical adhesive of choice is put onto the skin. The Dexcom is then inserted. The use of an overpatch is recommended.

References:
1. Messer LH, et al. Preserving Skin Integrity with Chronic Device Use in Diabetes. Diabetes Technol Ther. 2018;20(S2):S254-S264.
2. Ives B, et al. Practical aspects of real-time continuous glucose monitors: the experience of the Yale Children’s Diabetes Program. Diabetes Educ. 2010;36(1):53-62
3. Chase HP, Messer L. Skin Care and Sensor Sticking. In: Understanding Insulin Pumps, Continuous Glucose Monitors and the Artificial Pancreas. 3rd Edition. Children’s Diabetes Research Foundation; 2016:122-123.
4. McNichol L, et al. Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. Orthop Nurs. 2013;32(5):267-81
5. Englert K, et al. Diabetes Research in Children (DirecNet) Study Group. Skin and adhesive issues with continuous glucose monitors: a sticky situation. J Diabetes Sci Technol. 2014;8(4):745-51.
* Used within institution or support in public commentary, online articles, diabetes blogs, social media.Dexcom, Dexcom Clarity, Dexcom Follow, Dexcom One, Dexcom Share, Stelo, and any related logos and design marks are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries.

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