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Skin Conditions and How To Prevent Them

The most common questions I get from patients with limb loss are, "what is this rash, and how quickly can I get rid of it!" Below is a list of the most common skin rashes that I have seen on residual limbs and my recommendations to treat and avoid them.

Allergic contact dermatitis - Itchy red spots when new products are introduced to the limb to include new lotions, detergents, liners, etc. Treat by determining the irritant and removing it. Also, using a topical steroid may assist with decreasing the pain and/or any itchiness present. Avoid this by testing new products on small areas of the skin or by wearing new products for short periods of time before checking the skin for a reaction.

Irritant contact dermatitis - Small red spots on the skin that could be itchy and are often related to increased levels of sweat, increased time in a socket, and/or increased friction in the socket. The area of this type of irritation will not extend past the area of contact. Treat this by removing the irritant and

washing the skin with high quality antibacterial soap, such as Hibiclens. Avoid this by keeping the skin clean, the liner clean, and using a barrier cream such as zinc on the residual limb.

Pressure sores - Increased redness around boney parts of the residual limb. Treat this by scheduling an appointment with the prosthetist as it is most likely due to an ill fitting socket or improper sock management. Prevent this by frequently inspecting the skin for any spots of redness that last more than 30 minutes after the socket has been removed.

Negative pressure hyperemia - Just the opposite of a pressure sore, this "hickey" results from decreased contact with the socket. The decreased contact could result from limb size changes for a variety of reasons. Treat this by taking some time out of the socket and scheduling an appointment with the prosthetist to determine the reason for the poor fit. Avoid this by understanding proper sock management and maintaining a healthy body weight.

Folliculitis - Red bumps or pustules around hair cells due to increased friction and/or ingrown hairs. Treat this by washing the skin and taking some time out of the socket. Avoid this by refraining from shaving the residual limb. Laser hair removal is a good substitute for shaving if this is important to the individual. Never shave the residual limb as it increases the risk of folliculitis.

Xerosis- Dry, flaky skin over the residual limb that can be treated with moisturizers.

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