Skin Care 101

Created 03/2022

Proper skin care is essential to the health and mobility of those living with limb loss or limb difference. Whether you have an upper limb or lower limb loss or difference, the residual skin must maintain its integrity for the proper and comfortable fit and wear of a prosthesis. Prosthetic sockets trap sweat and prevent air from circulating around your residual limb, which can create a virtual paradise for bacteria. Bacterial and fungal infections can lead to skin irritation, abrasions and eventually skin breakdown. Left unchecked, this could lead to infection and ulcerations, leaving you unable to use your prosthesis for an extended length of time.

While every amputation is different and everyone’s skin has unique needs, there are fundamental skin care elements that should be addressed daily. You should check with your healthcare team before starting a new routine.

• Clean and Dry

Cleansing and drying the residual’s skin is one of the best things you can do for your skin health. Wash the skin with a non-soap cleanser, and completely dry it with a soft towel. Most people do better if they wash/shower at night because that gives the skin time to dry completely before donning the prosthesis the next morning. You don’t want any water to remain on the skin or trapped in a skin fold because it can contribute to bacterial or fungal infections.

There are times of the year when you may need to wash the skin more often. For example, you may need to shower or cleanse your residual skin two or three times a day in the summer due to excess perspiration. If you naturally perspire more, multiple showers or cleanings may have to be part of your normal routine.

You’ll also need to cleanse (often with the same product you cleansed the skin) and dry your socket, liner, and/or sock daily. Make sure they’re completely dry before using them again.

• Moisturize

After you’ve washed and dried your residual, apply a nighttime moisturizer to nourish the skin, promote healing, and prevent breakdown. Well-moisturized skin stays flexible and soft, which helps it resist cracking, chaffing, and the development of callouses. Rub the moisturizer into the skin until it’s no longer visible.

• Special and/or Spot Treatments

Some people need a daytime moisturizer with antibacterial and antifungal ingredients to fight infection and prevent cracked skin and inflammation. Like the nighttime moisturizer, rub the daytime product into the skin, and let it completely soak in before you put on your prosthesis.
If you have pressure spots, you may need to apply a spot treatment or use a liquid-to-powder product that creates a protective barrier between the skin and the liner.

• Daily Skin Inspections

If the skin starts to break down or gets infected, the quickest solution is often to stay off the prosthesis. Daily skin inspections are your first line of defense against immobilizing skin issues.
Every morning and night before putting on and after taking off your prosthesis, use a hand mirror to check all sides and angles of your residual. You’re looking for signs of irritation like red marks that don’t disappear after 10 to 15 minutes, hardened skin, cracks, rashes, and anything else that looks out of the ordinary.

If you have discomfort during the day, take off your prosthesis, and do another skin inspection. You may be able to make a correction on your own by washing and re-moisturizing the skin or changing your sock or liner. However, contact your primary care provider, dermatologist, or prosthetist to discuss your options. Even minor skin problems can be potentially problematic, especially if you have another complicating condition like diabetes.

• Do not use talcum powder on your limb, as it can ball up and create an abrasion. If you must use a powder, cornstarch is better.
• Do not use alcohol or unknown chemicals/ creams on your limb.
• Remember – your limb is covered all the time, so be very careful if you expose it to the sun. Use sunscreen SPF 30 or better.
• Do not shave your limb; the resulting short hairs get pushed back into your skin, becoming ingrown hairs that can become infected.
• If the skin of your limb opens, go straight to your doctor and prosthetist.
• If you are having a fit problem with your socket, causing skin breakdown, go to your prosthetist for an adjustment. If the breakdown is infected, you will need to go to your physician as well. Stop using the prosthesis; have crutches and a wheelchair for backup.
• If you have a skin breakdown, don’t use a prosthesis. Put a clean dressing/band-aid on the area daily and see your doctor or prosthetist. Don’t “pad” a pressure area, as that creates additional pressure and will make it worse.
• A red spot that turns into an ulcer can mean weeks without being able to use your prosthesis. Stop using the prosthesis and call your prosthetist/doctor.
• If you have reduced or no sensation in your residual limb, check your limb more frequently during the day and don’t put it in hot water or expose it to the sun – it will burn and blister.

A regular skincare routine and daily skin inspections put you a step ahead of potential skin problems. However, the truth is that skin changes over time. You may not struggle with skin integrity now, but that can change with the season or as you age. Healthy skincare habits arm you with the ability to navigate skin-related obstacles before they develop into full-blown hurdles. Always check with your healthcare team if issues arise or before changing your routine. Be consistent and proactive, and you’ll have the best chance at maintaining a full, active lifestyle.

This fact sheet was produced in conjunction with VitalFitSR https://vitalfitsr.com/blogs/news/amputee-skin-care-101-how-to-care-for-residual-skin-and-stop-skin-problems-before-they-start .

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Amputee Coalition
601 Pennsylvania Ave, Suite 600, Washington, DC 20004
888/267-5669
amputee-coalition.org.

Authors and Contributors

The Amputee Coalition is grateful to the many organizational members and individuals that have contributed to this work. The Amputee Coalition Scientific and Medical Advisory Committee (SciMAC) conducts expert peer view for the Amputee Coalition-commissioned patient education materials. SciMAC contributes clinical and scientific expertise in developing, implementing, and evaluating the Amputee Coalition program and policy initiatives.

Suggested AMA format citation for this material:

Amputee Coalition. Skin Care 101. https://www.amputee-coalition.org. Published March 2022. Accessed [date].

It is not the intention of the Amputee Coalition to provide specific medical or legal advice but rather to provide consumers with information to better understand their health and healthcare issues. The Amputee Coalition does not endorse any specific treatment, technology, company, service or device. Consumers are urged to consult with their healthcare providers for specific medical advice or before making any purchasing decisions involving their care.

© Amputee Coalition. Local reproduction for use by Amputee Coalition constituents is permitted as long as this copyright information is included. Organizations or individuals wishing to reprint this article in other publications, including other websites must contact the Amputee Coalition for permission to do so, by emailing a request to rc@amputee-coalition.org.