The amputation of a limb brings monumental changes, but there’s one that catches some amputees by surprise—excess perspiration (aka, too much sweat). Amputees often report that they perspire more than usual, especially in the first few months after amputation. For a person with limb loss, perspiration management is an essential part of successfully using a prosthesis.
Sweat/Perspiration: Why and What Is It?
The body perspires to cool itself. However, there are different kinds of perspiration. Apocrine glands in the armpits and groin release thicker, muskier perspiration that causes body odor. The over 2.5 million eccrine glands throughout the rest of the body release a thinner, clearer perspiration. As the liquid portion evaporates, it cools the body, leaving behind a somewhat sticky film on the skin.
The body can put out a lot of perspiration during hot weather or high activity levels. However, perspiration, whether from the apocrine or eccrine glands, is more than liquid. Perspiration contains salt and minerals, too. The composition of the perspiration from the two gland types differs. The thicker secretions of the apocrine glands are more prone to bacterial and fungal infections. However, excess perspiration from either gland type can create an environment inside the prosthesis socket that promotes infection.
For amputees, excess perspiration creates a humid environment inside the prosthesis socket. The extra heat and humidity make it necessary to keep the residual’s skin and prosthesis socket as clean and dry as possible to prevent fungal and bacterial infections. Infections and rashes may sound like a small problem, but for amputees, those issues can sideline an otherwise active person from daily activities like walking.
A Change in Cooling Surface Area
Perspiration may be a natural and necessary part of life, but it causes unique challenges for amputees. Amputation reduces the body’s total cooling surface area in two ways:
First, the amputated limb contained some of the body’s cooling system. That part is gone, and the body needs time to adjust. However, the body is a pretty amazing machine. Typically, it adjusts and normalizes general perspiration levels over time.
The second surface area issue comes from using a prosthesis. The prosthesis and all its extra gear cover part of the body, trapping heat in the prosthesis socket and liner. All that perspiring taking place inside the socket doesn’t cool the body because there’s no air to evaporate it.
More Work, More Perspiration
While prosthetic technology has come leaps and bounds, it’s still more work to use a prosthetic when compared to a natural limb. Lower body amputees, in particular, work harder to do everyday activities like standing and walking. It takes extra work to balance, lift, and move the body in ways that don’t come naturally.
This is another issue that may, over time, resolve itself as muscles get stronger and adapt to new movement patterns. However, you may always burn more calories doing your regular activities than you once did. Consequently, the body has to work harder to keep you at a comfortable temperature.
How to Reduce and Control Amputee Sweating
Pre-Donning Skin Care
Whether you’re planning a hike or the weather report shows soaring temperatures, perspiration management starts before you’ve left the house. Start the day with clean, dry skin on your residual. Wash with a gentle cleanser that’s free of irritating chemicals and fragrances. Make sure to completely dry the skin. Moisturize the residual skin using a day moisturizer with anti-fungal ingredients as an extra layer of protection against infection.
Finally, if you struggle with perspiration or you know it’s coming, use a liquid-to-powder product on the residual skin before donning your prosthesis. These products apply like a lotion but create a friction barrier between the skin and prosthesis that helps manage perspiration and irritation.
Sweat Control Textiles and Cooling Liners
Sweat-control textiles absorb heat and moisture, pulling them away from the body. Sheaths and prosthetics socks made of these materials can help keep you cool, especially when you’re participating in athletics, outdoor activities, and other high-energy adventures. Perforated liners, cooling gels, and other technologies can also help keep you cooler when wearing and using your prosthesis.
Socket Adjustment and Fit
Keep an eye on your socket fit. An ill-fitting prosthesis may have you working harder than is necessary. Subtle changes in fit can make a big difference in the work it takes to walk, climb stairs, or even stand. Talk to your prosthetist if you notice a difference in the fit.
Frequent Cleaning When It Gets Hot
Summer sun not only leads to hotter temperatures but also hiking, biking, and more physical activities. Take special care of your liner and residual skin when you’re in the heat or pushing your physical limits. You may need to shower twice a day, followed by reapplying moisturizers and liquid-to-powder products to stay on top of the extra perspiration.
On all-day activities, take along everything you need to clean your residual and liner throughout the day. Extra hygiene measures protect the skin and prevent you from feeling swamped in perspiration.
Extra perspiration might be part of your daily life, but it doesn’t need to stop you from being active. Start your day with a plan. Keep that skin clean, apply a liquid-to-powder product, and factor in extra time to wash your residual and liner mid-day. The effort it takes to manage perspiration and keep your skin clean will pay off by letting you maintain an active lifestyle.