The skin on our bodies is made up of two layers. The top layer is called the epidermis and the under layer is called the dermis.
The epidermis is also made up of two layers. The outer, or surface, layer is made up of dead skin cells and the inner layer is made up of living skin cells. The surface layer is continually being shed and replaced with newer cells from the inner layer. Shedding takes place as we shower or clean ourselves and even rubs off from the friction of our clothes.
The dermis layer is more complex. Made up of a fibrous tissue it provides the strength and elasticity. In this layer you will find the hair follicles, sweat glands, oil glands, blood vessels, and nerve endings (pretty crowded place).
Our skin acts as an environmental bubble for our bodies, providing protection, sensation, fluid regulation, and temperature control.
A major part of skin care is maintaining proper nutrition. Vitamins A, E and B6 are essential to maintaining nutritional levels. From the first day a dietary plan needs to be established so that a balanced diet is maintained. This does not mean a diet of hamburgers, french fries, milk shakes and a big slices of cherry pie to cover all four basic food groups.
Along with Nutrition For The Skin comes weight control. As a para or quadriplegic exercise is often difficult and may require assistance from a second person. Without exercise the body looses the primary means of burning off calories. With a balanced diet and adequate exercises, even if they are assisted, weight gain can be controlled and maintained.
Being confined to a wheelchair all day is the perfect breeding ground germs. Even with weight shifts adequate air circulation does not occur in the groin area. If you wear a urine collection device, such as a condom, foley or suprpubic Catheter or water proof padding or Leg Bag the possibility of infection is even higher.
Suggestions for maintaining proper hygiene are:
- Wash your groin area before going to bed each night.
- Air out the groin area at least once a day.
- Change or clean your urine collection device daily.
- You can use powder, not too much though because it will cause caking and result in chaffing, in the groin area.
- Take a shower or bath often.
- Always dry the groin area thoroughly after a bath or shower.
- If you have dry skin use lotion. Dry skin can quickly become open sores.
- Nail care is also important.
- Cleaning under the nails, and possibly keeping them short and cut straight across to avoid hang nails are some suggestions.
Your skin now has less circulation, a lack of feeling, and movement is greatly reduced. Because of these new problems your daily skin care is very important in order to avoid infections, sores, and irritations.
Inspecting the skin daily is extremely important. If you fail to inspect your skin daily pressure sores and infections could occur very quickly.
You, or someone who can help, should inspect your skin at least once a day. You will want to look for reddened areas, scrapes, cuts, bruises or any kind of discoloration out of the norm. Areas that need special attention are the groin area, behind knees, the areas around the ankles and elbows, and your Posterior (hips and tailbone areas should be checked carefully).
Clothing is one of the primary causes of skin irritation. Wearing tight pants will now cause skin irritation more quickly than ever before. Here are some suggestions when picking out your new wardrobe.
- Choose loose fitting clothes for day to day apparel.
- Cut a small line into the tops of tight socks.
- Buy jeans that have a low-profile look in the crotch area.
- Thick seams in the thigh or crotch areas can cause irritation.
You will also want to make sure that any urine collection systems that use straps or cover parts of the body, such as the condom Catheter, fit properly.
Working with Lisa while she was in the hospital I found that the most important part of skin care was providing regular massages. These massages, a very specific type, are necessary in order to avoid Edema.
Edema is when fluids collect in and around tissue. This is most often seen in the hands and feet. If the fluids start to collect the oxygen flow is greatly reduced and vital nutrients cannot flow into the affected area.
The massage technique the Physical Therapist taught me is similar to squeezing a tube of toothpaste. Starting with the hands, your must work the fluids out of the fingers. After a couple of minutes you will see the swelling begin to subside. You will want to perform this same technique with the feet.
Diabetes damages the blood vessels and nerves. Wounds and sores can become infected easier and heal at a much slower rate. If you have been diagnosed with diabetes follow your insulin routine carefully. You will also want to perform the skin inspections more closely, paying special attention to any reddening of the skin as they can become dangerous faster than those who do not have diabetes.
Are you feeling extremely down, have problems eating, don’t want to perform your daily routines? Depression can play a major role in causing pressure sores, infections, excessive weight loss or gain, and can be detremental to your health in general.
Stress can have the same results as depression, and often go hand in hand. With stress you will also have elevated blood pressure, muscle tension, and your body will burn up vital nutrients that are necessary for healthy skin.
With stress and depression alike you will tire easily, become more irritable, and feel fatigued. To help avoid both stress and depression you should take some time each day and relax. Read or listen to a good book, talk to that special friend, or meditate for an hour or so. For many years I lived close to where I worked. When I got to work I didn’t feel relaxed and when I got home I felt tired and irritable. A year ago we moved out of the city and it takes me an hour or more to drive to work. During this drive I listen to music or a good audio book, or I just think. I now feel awake when I get to work and am relaxed when I get home at night.
Hot/Cold Food and Drinks
With the loss of feeling in your legs and hip area it is easy to damage your skin. Use a tray, possibly insulated, when you want to place food items in your lap.
Heat in general is going to take some getting used to. That favorite heating pad or electric blanket can now become dangerous. Sitting in front of a fireplace, warming your feet next to a heater can cause serious damage without you evening knowing it.