Skin care ranks high on the list of things individuals with limb loss need to stay active and mobile. As Greg Mannino, a prosthetist and 22x Paralympic champion, says, “The worst thing is . . . when your prosthesis feels good, the liner feels good, and you’re doing well. Then you get some kind of skin issue like breakdown or a hot spot.” Those small issues can keep you out of your prosthesis and quickly limit your mobility.
“As a physical therapist, one of the first things I look at when someone comes into my clinic is their skin. That’s where it all begins,” says Cosi Belloso, a physical therapist who specializes in limb loss and host of Cosi Talks.
The day-to-day process of keeping your skin healthy takes effort and consistency when you have limb loss. We took a few tips from Mannino and Belloso from VitalFit’s July 30, 2020 episode Liners and Hygiene.
Shower with your liner
The dark, humid, enclosed environment inside a liner is the perfect place for bacteria and fungus to start growing. “Once every 24 hours, the limb needs to be bathed, showered, and the liner needs to be cleaned,” says Belloso. She recommends taking the liner into the shower with you and “cleaning it with the same cleanser you use on your body.”
A gentle cleanser like VitalFit’s Daily Cleanser that’s appropriate for the skin is just as appropriate for your liner and does an excellent job of removing potentially harmful microbes. As Belloso puts it, “Anything that you can use on your skin, you can use on your liner and know it won’t cause a reaction.”
Rinse the liner (then rinse it again)
Soap or cleanser residue left on the liner can cause skin irritation. “I tell my patients to rinse, rinse, rinse. Then when they think they’re done, they have to rinse some more to make sure there’s absolutely zero residue in that liner,” says Belloso. Mannino adds that rinsing your sock, if you’re using one, is important, too. Place the liner on a stand outside the shower after you’ve washed it, and make sure it is completely dry before redonning.
Suspension wearers—wash your pull sock!
“If you’re a suction wearer like myself, even your pull sock needs to be cleansed occasionally,” says Mannino. Mannino warns that you can introduce bacteria when you pull in so clean that pull sock on a regular basis to keep unwanted microbes from affecting the skin.
Target bacteria and harmful microbes
Everything you use on your skin, from the cleanser to the moisturizer, should be focused on preventing infection from bacteria, fungus, and other harmful microbes. VitalFit’s entire line, including the Daily Cleanser, Day Moisturizer, Night Moisturizer, and Liquid-to-Powder Plus is made with antibacterial, antifungal ingredients. Mannino uses the products himself, alternating between the Day Moisturizer and Liquid-to-Powder Plus based on his planned activities. The products pull double duty by strengthening the skin while protecting it from infection.
Residual skin needs TLC (every day)
Skin care isn’t something you can do once a week. Your skin undergoes intense pressure, sheering, and tension while in a prosthesis. It needs maintenance and healing help every day. That includes:
- Daily moisturizing: Dry skin easily becomes cracked, creating a place for bacteria to enter the skin. Moisturize your skin before donning your prosthesis in the morning. Anytime you wash your skin, you should moisturize afterward. With time, it will become a habit that keeps your skin flexible but strong.
- Chafe prevention: “You put a little perspiration, a bit of heat, a little bit of activity, and it can translate into skin breakdown,” says Mannino. Friction easily builds with a poor prosthesis fit, gait alterations, or even an increase in your activity levels. VitalFit’s Liquid-to-Powder Plus is an excellent option on hot or active days. It goes on after moisturizing, applies like a lotion, and creates a powder-like barrier against the friction and rotational forces.
- Repeated cleansing: Most of the time, you only need to clean your residual and liner once a day. However, hot weather or intense activities may necessitate more frequent cleansing. Try to clean your skin as soon as you can after a hard workout or intense perspiration. In high temperatures, that could mean washing twice a day.
See a clinician to treat skin infections
The reality is that infections may still happen even if you take excellent care of your liner and skin. If you get an infection, see a clinician to get appropriate treatment. A clinician can determine not only the infection type (bacterial, fungal, or something else) but can also determine the type of infection and provide an appropriate treatment option for faster healing.
Final Thoughts
Check VitalFit’s full Liners and Hygiene webinar for information on liner types and more hygiene tips. Take care of your skin, so it can take care of you. Healthy skin gives you independence and freedom of movement to live life on your terms.