8 Summer Skin and Prosthetic Problems

Written by Bryan Potok, CPO on September 12, 2018
Last updated on August 4, 2019

Summer months are getting hotter each year. And if you're thinking of spending a day at the beach or lounging by the swimming pool, you are not exempt from some skin and prosthesis-related problems that are commonly prevalent during the hot and humid season. So, we'd like to help you keep your vacations fun by exercising a bit of caution to prevent discomfort and even jeopardizing your mobility.

In this article, we’ll help you prepare to make the most out of the remaining hot season while also staying clear of season-related skin and prosthetic problems.

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Image by Stuart Boreham

1. Heat-related illnesses

Before we delve deeper into the most common skin and prosthetic problems you may encounter this summer, we feel that we must talk about season-related illness such as heat stroke (a.k.a. sunstroke), heat cramps, and heat exhaustion. Taking care of your body works best when it’s done from the inside out.

The body is designed to cool itself down under extreme or prolonged heat by sweating; however, it also has its limits. When you wear a prosthesis, part of your "radiator" or ability to cool yourself through your skin is covered by the socket. When the body is no longer capable of cooling itself, it raises the body temperature to dangerously high levels and leads to heat stroke.

Meanwhile, heat exhaustion happens when the body’s temperature rises and starts to lose water or salt. Some of the symptoms you have to watch out for include muscle cramps, fatigue, feeling faint, intense thirst, and heavy sweating, among others.

However, if you lead an active lifestyle, you may be susceptible to heat cramps, a condition that is believed to be caused by excessive activity, causing muscles to lose the ability to regulate its contractions.

While it may seem that one cannot escape from these heat-related illnesses especially this summer, the good news is that you can avoid it. Do your best to keep out of the sun between 11 am and 3 pm. Within this time window, the sun is at its hottest and, therefore, at its most dangerous. But if you have to go out in the heat, make sure to apply sunscreen with at least SPF 30 to 50. You may also want to bring an umbrella or wear a hat and a light scarf. And, most of all, keep yourself well hydrated.

2. Sweating

Excessive sweating, especially when you’re just going about your day, can be a hassle. But aside from being generally uncomfortable, sweating can cause additional movements within the socket that can lead to painful blisters.

Also, heavy perspiration can sometimes lead to loss of suspension in your prosthesis. When you’re drenched in sweat, it’s not uncommon to feel your liner slowly moving downward.

Sweating per se cannot be avoided, but you can make your prosthesis fit more reliably by using an antiperspirant like Alps Prosthetic Anti-Perspirant. To make your prosthesis fit snugly, use prosthetic socks that are designed to wick away moisture from your skin such as Knit-Rite Liner-Liner Prosthetic Socks. It’s also best to carry a small supply of socks with you so you can quickly change into fresh socks any time you feel the need to freshen up.

3. Dry, irritated skin

Dryness and irritation can afflict your skin whether in the middle of winter or on the hottest summer day. The latter’s hot and humid air can strip away essential oils that keep skin moisturized. However, the summer air is not solely responsible for drying and irritating the skin around your residual limb. Using prosthetic liners and piling on the socks can aggravate the heat and humidity inside your socket so you might want to lay low on these products for a while.

If it’s already too late for your dry and irritated skin, you may want to try these tips:

Take showers and baths in warm water. Compared to hot water, warm water can be soothing for your irritated skin.
Wash your residual limb using a mild cleanser, and watch out for products that are labeled “antibacterial” or contain too much fragrance. These products can quickly dry your skin.
Make moisturizing a habit. Even during hot summer days, it’s important to slather on fragrance-free prosthetic moisturizer after every shower and bath. Moisturizer combats the drying effect of summer air by trapping water effectively in your skin. To ensure the effectivity of your moisturizer, apply it within 5 minutes of taking a shower or bath.
Moisturize on-the-go. Bringing a small bottle of moisturizer with you allows you to re-apply after washing your hands or anytime your skin starts to feel parched during the day. Trust us. Your skin will thank you.

4. Using excessive socks

“Volume loss” either through water loss or actual weight loss is typical during the summer, which means your prosthesis may feel a tad looser. While using layers of socks may seem like the best option, it can also open a whole host of friction-related problems. Furthermore, the extra layers can reduce your range of motion and cause uneven pressure within your socket.

When layering socks below-knee (BK) amputees can experience looseness along the bottom of the sock and excessive tightness along the knee. Meanwhile, above-knee (AK) amputees usually experience a feeling of “sloppiness” within their socket.

Despite these problems, the good news is that you don’t have to suffer from loose sockets due to volume loss. One solution is to use calibrate gel pads or a gel roll-on. These products can tighten your socket without increasing your sock ply count.

If you’re suffering from chafing in some regions of your residual limb, immediately treat the area with a prosthetic salve or an anti-chafe product. If you’d like to read up on how losing weight affects your prosthesis, click on the hyperlink.

5. Folliculitis

Folliculitis develops when hair follicles get infected. Infected hair follicles develop to look like pimples or rashes, which are often itchy and tender. While folliculitis can strike no matter what the season, the incidence rises during the hot summer months. The hot and humid weather combined with sloppy hygiene practices creates the perfect opportunity for infections.

To reduce your risk of getting folliculitis, you need to practice not only good hygiene but also be cautious about anything that comes in contact with your skin.

Beat those pesky bacteria by making sure to wipe your prosthetic liner and applying fresh socks right after working out. Forgetting to do these creates the perfect breeding ground for staph bacteria to do their job.
If you shave, you may want to avoid shaving your residual limb to reduce the chances of infecting any hair follicle.
Dipping into refreshing pools may seem irresistible during this season, but it’s best to stay out of hot tubs or whirlpools especially if you’re unsure if the chlorine levels are appropriately controlled. You may have come across a condition called “hot tub folliculitis” which is acquired from—you guessed it—unsanitary hot tubs.

6. Prickly heat (a.k.a. heat rash)

Prickly heat is an unpleasant skin condition that plagues those who sweat a lot. These prickly rashes (hence, the name) develop when sweat glands are blocked. As long as the trapped sweat cannot get out, it builds up under your skin, causing tiny, itchy bumps that release sweat when they burst.

You can reduce your risk of developing these troublesome bumps by doing everything you can to stay cool and fresh. But since we can’t avoid sweating this summer, most dermatologists recommend the following:

Use an antiperspirant. If you’re a prosthesis-wearer, use a prosthetic antiperspirant to keep your residual limb prickly heat-free.
If you exercise outdoors, do so during the coolest parts of the day, which means moving your workout schedule to early mornings, late afternoons, or early evenings. You can also choose to train indoors where there is air conditioning, such as most gyms and fitness studios.
Make sure to keep your residual limb clean and hydrated at all times. For a midday refresh, cleansing wipes and a small bottle of moisturizer can do the trick.

But if you are already suffering from prickly heat, wash the affected area in warm water and with a mild cleanser. Then treat the area by applying cortisone cream. Make sure to choose cream over ointment for its non-clogging formula.

7. Swimmer’s itch

Another skin problem you may encounter this summer is the swimmer’s itch, which can be acquired by swimming in water infested by the larvae of certain parasites. They thrive in freshwaters such as ponds and lakes. Telltale signs that you are infected is developing an itchy rash after being exposed to infested water.

The good news is that you can reduce the risk of developing swimmer’s itch by briskly rubbing your skin with a towel as soon as you get out of the water. Unlike other parasites which can begin the process of infection while the host is still in the water, the ones responsible for swimmer’s itch only start to work their way in when the water on your skin begins evaporating.

However, if you find that your skin stings when you rub it briskly, you may have something else.

8. Seabather’s eruption

Seabather’s eruption is a rash that affects areas of the skin that are covered by a bathing suit. These rashes are caused by the sting of a jellyfish, which can be impossible to avoid when you’re in the water. Symptoms of this skin problem can be immediately felt. If you’re infected, you’ll notice a tingling sensation in areas under your bathing suit, and it can last for several weeks.

Aside from avoiding seawater, there aren’t a lot of ways to prevent seabather’s eruption. If you think you have been infected, avoid rinsing with freshwater as this can only make the larvae cling to your skin. Immediately pat dry with a towel and change into clean clothes. To treat the area, apply hydrocortisone lotion or calamine lotion.

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