The Big Picture
Perineal care, also called pericare, means cleaning the genital and anal areas. These areas stay warm, moist, and dark, which supports the growth of microbes. Proper cleaning helps prevent infection, odours, and skin breakdown while promoting comfort.
Safe care depends on cleaning in the correct direction, protecting privacy, using warm water, following infection-prevention practices, and noticing changes that need reporting. Clients should do as much of their own care as they are able to do.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Perineal care (pericare) means cleansing the genital and anal areas.
- Clean from the cleanest area toward the dirtiest area, usually from front to back.
- The urethral area is the cleanest. The anal area is the dirtiest.
- Protect the client’s privacy by exposing only the area being cleaned.
- Use warm water, follow employer policy for temperature testing, and wear gloves.
- Report and record important observations, including redness, swelling, discharge, irritation, pain, burning, odours, incontinence, hemorrhoids, or a foreskin that does not retract.
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Course Notes: Key Ideas You Need to Know
What Perineal Care Means
Perineal care (pericare) means cleansing the genital and anal areas.
Routine cleaning helps:
- prevent infection
- prevent odours
- prevent skin breakdown
- promote comfort
Perineal care takes place at least once each day during the bath. It is also needed whenever urine or stool soils the area. Some disorders require more frequent care. Follow the care plan and your supervisor’s directions for the individual client.
Support the Client’s Independence and Dignity
Clients should perform their own perineal care when they are able. Some clients need assistance.
Use words the client understands when talking about the genital or anal area. Keep your language professional and respectful. Avoid slang and swear words.
During care, support:
- dignity
- independence
- individualized care
- preferences
- privacy
- safety
Smegma
Smegma is a white or yellow substance made up of dead skin cells and oily secretions. It occurs around the foreskin or clitoris.
Smegma acts as a lubricant during sexual intercourse. Production begins after birth and becomes most prominent during adolescence, from age 14 onward. Production begins to decrease in middle age and continues to decline with aging.
If smegma accumulates, it can lead to:
- foul odour
- burning
- itching
- irritation
Routine, thorough perineal care controls the buildup of smegma.
Infection Prevention and Cleaning Products
Follow Standard Practices and medical asepsis during perineal care.
Wear gloves. Use the cleaning product required by employer policy . Products listed for perineal care include:
- peri-wipes
- specially coloured cloths
- washcloths
- towel wipes
- swabs
Rinse the area thoroughly when required. Peri-wash does not need rinsing unless visible soiling is present.
The Four Main Cleaning Directions
Keep these four directions straight:
- Clean from the cleanest area to the dirtiest area.
- Clean from the front toward the back, or anal area.
- Clean from the top toward the bottom.
- Clean from the area farthest from you toward the area closest to you.
The urethral area is the cleanest. The anal area is the dirtiest. Cleaning in the correct direction reduces contamination of areas you already cleaned.
Protect the Skin, Privacy, and Comfort
The perineal area is delicate and easily injured.
Use warm water rather than hot water. Test the water temperature according to employer policy.
Expose only the client’s perineal area. This protects privacy and reduces chilling.
After rinsing, pat the area dry instead of rubbing it.
When the Client Has Soiled Themself
When a client has soiled themself, wash the buttocks first and then clean the anal area.
A client living with dementia might place their hands inside their briefs or into the area you are cleaning. Wash the client’s hands first. Give the client an item such as a washcloth or towel to hold during care.
What to Report and Record
Report and record these observations when they occur during perineal care:
- odours
- redness
- swelling
- discharge
- irritation
- pain, burning, or other discomfort
- signs of urinary or fecal incontinence
- hemorrhoids
- a foreskin that does not retract
Follow employer policy when reporting and recording your actions and observations.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition uses the broad phrase “basic assessments” when describing what should be reported and recorded after care. Current Nova Scotia standards define the CCA role more specifically.
In Nova Scotia, a CCA performs an observational point-of-care assessment. This means observing the person and care environment for changes, including skin integrity or changes in the person’s condition, and escalating changes to a supervisor. It does not permit the CCA to perform the comprehensive assessment used for nursing decision-making and care planning. (novascotiacca.ca)
Personal care, including changing and cleaning for incontinence-related needs, is included in the current CCA occupational standards. The employer sets the CCA’s scope of employment, which defines what the CCA is permitted to do in that workplace. Employer policies and procedures then direct how that care is provided and documented. (novascotiacca.ca)
Why this matters in Nova Scotia: For CCA education and workplace practice, separate observation and reporting from a comprehensive clinical assessment, and follow the employer’s scope of employment and documentation requirements.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: September 11, 2026
Perineal Care for Children
Children of all ages need perineal care.
Urine and stool often contact the perineal area of children who wear diapers. Younger children sometimes wipe inadequately after urinating or having a bowel movement.
Remind children with female genitalia to wipe from front to back. Older children sometimes hesitate to clean their genital and anal areas and need reminders.
Giving Perineal Care to a Client With Female Genitalia
The procedure has three parts:
- preparation
- cleaning
- post-procedure care
Keep the steps in order.
Pre-Procedure
- Identify the client according to employer policy.
- Explain the procedure.
- Perform hand hygiene.
- Gather:
- wash basin
- soap or peri-wash
- at least four washcloths
- bath towel
- flat sheet
- bath thermometer
- waterproof pad
- gloves
- paper towels
- Place paper towels on the overbed table in a facility, or on a nearby work area. Arrange the supplies on them. The paper towels absorb water that splashes from the basin.
- Provide privacy.
- Raise the bed to a comfortable working height.
Position and Prepare the Client
- Lower the bed rail nearest you if it is raised.
- Cover the client with a bath blanket. Fan-fold the top linen to the foot of the bed. Use the top sheet if a bath blanket is unavailable.
- Position the client on their back. Remove clothing from the waist down.
- Put the waterproof pad under the client’s buttocks to keep the bottom sheet dry.
- Drape the client so only the perineal area remains exposed.
- Raise the bed rail if it is used.
- Fill the basin with water at 40.5°C to 42.7°C (105°F to 109°F). Measure the temperature according to employer policy. Water that is too hot can scald the client.
- Place the basin on the overbed table or work area. This reduces worker back strain.
- Lower the bed rail if it is raised.
- Help the client bend their knees and spread their legs. If the client cannot bend their knees, help them spread their straight legs as much as possible. Another option is side-lying care when that position fits the client’s needs.
- Put on gloves.
- Fold the corner of the bath blanket between the client’s legs and onto the abdomen.
- Wet the washcloths and squeeze out excess water.
- Apply soap to a washcloth when soap is used. Peri-wash does not require rinsing unless visible soiling is present.
Clean the Perineal Area
- With your nondominant hand, separate the client’s labia as far as possible. Keep that hand in the same position between wipes. This exposes the area and reduces recontamination.
- Clean in three strokes:
- First stroke: Clean the labia farthest from you. Wipe downward from top to bottom in one stroke.
- Second stroke: Clean the labia closest to you. Use a separate section of the cloth and wipe from top to bottom.
- Third stroke: Use a clean section of cloth to wipe down the centre of the perineum. Clean from the pubic area toward the rectal area in one stroke. Clean thoroughly around the clitoris and vaginal opening.
Use a different wipe or clean part of the washcloth for every stroke. This reduces contamination of areas already cleaned.
- Keep the client minimally exposed, warm, and comfortable throughout the procedure.
- If the area remains heavily soiled, repeat the strokes until clean. Use a clean section of the washcloth for each stroke. Use additional washcloths when needed.
- To rinse the perineal area, repeat the same cleaning sequence from steps 21 through 24 using a clean, moist washcloth. Repeat as needed. Use more than one washcloth when needed.
This cleaning direction helps prevent pathogens from being introduced into the client’s urethra or vagina.
- Pat the area dry with the towel. Do not rub delicate skin.
- Fold the bath blanket back down between the client’s legs.
- Help the client lower their legs and turn onto their side away from you.
Clean the Rectal Area
- Apply soap to a washcloth.
- Separate the buttocks. Clean from the vagina toward the anus in one stroke.
- Repeat steps 29 through 31 until the rectal area is clean. Use a clean section of the washcloth for each stroke. Use more than one washcloth if needed.
- Rinse the rectal area. Stroke from the vagina toward the anus. Repeat as needed with a clean section of cloth each time.
- Pat the area dry.
- Remove the waterproof pad.
- Remove the gloves and wash your hands.
Cleaning from the vagina toward the anus helps prevent transferring pathogens from the anus toward the vagina. Removing soap helps prevent skin breakdown.
Post-Procedure
- Provide for safety and comfort.
- Cover the client.
- Remove the bath blanket if one was used.
- Place the call bell within reach when this step applies.
This gives the client an easy, safe way to contact staff when needed.
- Return the bed to its lowest position. Follow the care plan for bed rail use when this step applies.
- Empty and clean the wash basin.
- Return the basin and supplies to their proper places.
- Wipe the overbed table or work area with paper towels. Discard the paper towels.
- Remove the privacy measures.
- Follow employer policy for dirty linen.
- Perform hand hygiene.
Report and record your actions and observations according to employer policy. Recording and reporting actions, observations, and basic assessments serves legal purposes and keeps the rest of the health care team informed.
The call-bell and bed-position steps marked with an asterisk may not apply in community settings.
Positioning and Comfort for Older Clients
Some clients with female genitalia cannot safely or comfortably separate their legs for care. Some feel more comfortable in a side-lying position.
Review the client’s care plan before providing care. Report and document discomfort that occurs during personal hygiene or perineal care.
For clients with male genitalia, know whether the client is circumcised or uncircumcised before starting. Care must remain safe and respectful.
Some clients with male genitalia experience an erection during perineal care.
Giving Perineal Care to a Client With Male Genitalia
The male-genitalia procedure begins with the same preparation used in steps 1 through 21 of the female-genitalia procedure.
Clean the Penis and Scrotum
- Complete female-genitalia procedure steps 1 through 21 for preparation.
- If the client is uncircumcised and the foreskin retracts, retract it. Microbes and discharge can build up under the foreskin.
- Grasp the penis.
- Clean the tip in a circular motion. Start at the urethral opening and work outward from cleanest to dirtiest. Repeat as needed and use a clean section of washcloth each time.
- Rinse with another washcloth.
Soap left on the skin can cause dryness and irritation.
- Return the foreskin to its natural position.
- Clean the shaft with firm downward strokes. Rinse.
- Help the client bend their knees and spread their legs. If the knees do not bend, help the client spread their straight legs as much as possible.
- Clean the scrotum and rinse well. Observe the skin folds for redness and irritation.
- Pat the penis and scrotum dry. Avoid vigorous rubbing because it irritates delicate tissue and might contribute to an erection that embarrasses the client.
- Fold the bath blanket back down between the client’s legs.
- Help the client lower their legs and turn onto their side away from you.
- Clean the rectal area using the same rectal-care sequence described for female genitalia. Rinse and dry well.
- Remove the waterproof pad.
- Remove and discard the gloves. Perform hand hygiene.
Post-Procedure
- Complete post-procedure steps 37 through 47 from the female-genitalia procedure.
Report and record your actions and observations according to employer policy. Recording and reporting actions, observations, and basic assessments serves legal purposes and keeps the health care team informed.
Exam Clue Words
- First: Cleaning direction matters. Start with the cleanest area and move toward the dirtiest area.
- Must: Water for the listed basin procedure must measure 40.5°C to 42.7°C (105°F to 109°F).
- Report: Report the listed changes and complaints observed during perineal care.
- Document: Record required actions and observations according to employer policy.
- Follow the care plan: Use the care plan for individual needs, positioning, bed rail directions, and the frequency of care.
Fast Review
Use this section to check the facts that carry the most weight before a quiz or exam.
- Perineal care (pericare) means cleaning the genital and anal areas.
- Give perineal care at least once daily during bathing, whenever urine or stool soils the area, and more often when the care plan or supervisor directs.
- Clean from cleanest to dirtiest, front to back, top to bottom, and farthest from you to closest to you.
- The urethral area is the cleanest. The anal area is the dirtiest.
- Protect privacy by exposing only the perineal area.
- The basin water temperature for the procedure is 40.5°C to 42.7°C (105°F to 109°F).
- For female genitalia, clean the far labia first, the near labia second, and the centre of the perineum third.
- Use a clean section of cloth for each stroke and keep cleaning strokes moving toward the anal area.
- For an uncircumcised client, retract the foreskin only if it retracts, clean underneath, and return it to its natural position.
- Pat delicate areas dry rather than rubbing them.
- Report and record listed observations, including odours, redness, swelling, discharge, irritation, discomfort, incontinence, hemorrhoids, and a foreskin that does not retract.
- Follow Standard Practices, including the required glove and hand-hygiene steps.
Final Pep Talk
This topic has a lot of steps, so focus on the pattern behind them: protect privacy, move from clean to dirty, use clean sections of cloth, and keep the procedure in order. Review the sequence in smaller groups until the order feels familiar.