Your Skin's Barrier: Why it's such a big deal!

Written by Bryan Potok, CPO on June 14, 2018
Last updated on October 23, 2018

Skincare basics for amputees

The largest organ in the body, the skin is the number one shield against harmful elements found in the outside world. Made up of cells, binding lipids and moisturizing agents, the outermost layer of your skin is called the skin barrier and has a number of important functions to protect your body. The elastin and collagen found in it ensure that your skin remains elastic and strong. It keeps the water from our organs from evaporating. It helps wounds heal and defends you from harmful bacteria.

As an amputee, one thing you need to know but may not always come first on your list of priorities is caring for the skin of your residual limb. The skin barrier of an amputee’s residual limb is prone to damage especially when you wear your prosthesis. The shape of your limb changes depending on the weather, your level of activity, your diet and even your daily routine, so the way it fits into your prosthesis also changes, which cause your limb’s skin barrier to eventually break down.

The healthy skin on your limb feels smooth, soft and plump. It should have a good complexion and should not feel not itchy or irritated. Signs of damage include premature aging, dryness and roughness. Unhealthy skin barriers are prone to rashes, redness and irritation because the skin is unable to retain substances that are vital in allowing it to repair itself. The skin of your limb may even develop tender spots, blisters, bad odor and pus or discharge. When your limb’s skin barrier is broken, wearing your prosthesis may become uncomfortable or even painful.

The good news is there are ways to prevent damaging your skin barrier. Following are some of the most basic tips towards keeping it healthy.

Your skin's barrier is important and a big deal. Use a salve and moisturizer to protect it.

Cleaning your residual limb regularly is the first step towards keeping it healthy.

When you bathe or wash your limb, use a ph balanced antibacterial cleanser, and avoid harsh products that remove the essential oils from your skin. Use lukewarm water, as water that’s too hot can irritate your residual limb.

Moisturize.

After taking a bath, use a prosthetic salve or moisturizer that’s high in antioxidants. Avoid products with alcohol that dries the skin. Refrain from overdoing the use of various products. Combining too many active ingredients can irritate your skin. If you use several products, try to use them at different times during the day.

Don’t shave the hair off your limb.

Shaving can cause ingrown hair to develop, and ingrown hair can lead to an infection. Waxing might irritate your limb’s sensitive skin too. If you wish to prevent hair growth, consult with your doctor about other options such as laser hair removal.

Make sure you get the right prosthesis that fits your level of activity, diet and the weather in your area.

Open communication with your doctor and prosthetist helps them understand your needs so they can prescribe and create the best prosthesis for you.

Keep your weight stable.

When your weight fluctuates, your body shape is altered, including your limb, which can affect how it fits into your prosthesis. Keep active and maintain a healthy diet.

Make sure your prosthesis is well-fitted to protect your limb from friction.

Friction is a common cause of skin barrier breakdown among amputees even when the skin is otherwise healthy. Using a good-quality sleeve may help. Consult with your prosthetist if the fit of your prosthesis is uncomfortable.

Dry your prosthetic sleeves and liners completely before putting them on.

Make sure to follow your prosthetist’s cleaning instructions. Most advise that you wash them regularly with soap and hot water.

Eat omega-rich foods helps maintain healthy skin.

Examples of food rich in omega 3 are cold water fishes like mackerel and Alaskan salmon, walnuts, cod liver oil, chia seeds, and flaxseeds.

Treatment

If your skin barrier becomes damaged, your doctor may prescribe topical or oral medication, depending on the type and severity. There are various ointments and creams that are effective in treating breakouts, rashes and fungal infections. Inform your doctor immediately if you notice a foul odor, discharge or blisters on your residual limb. Avoid using your prosthesis if you develop these symptoms. It is always better to consult your doctor immediately at the first sign of damage, to prevent it from getting worse.

Having healthy skin on your limb ensures that you are able to stay mobile, and maintaining the health of your residual limb's skin barrier is not an impossible task. You just need to pay it some proper attention and understand how the skin barrier works, so you can make the right decisions in caring for it and keeping it healthy.