Introduction

Service providers play an important role in supporting the health and wellness of consumers. Prevention and early detection of any health problem is the first step of effective health care. A consumer's skin condition can tells us important things about his or her overall health. Sometimes changes in skin condition may be overlooked because the significance of the change is not recognized. A minor problem can quickly develop into a more serious one without proper intervention and treatment.

Listed below are basic strategies concerning monitoring and identifying changes in skin condition.

Strategies

Know what is "usual" for the person. Each of us has a unique skin appearance - the color, the way it feels, whether it is moist or dry, cool or warm, etc. Overall skin appearance can vary from person to person and from body part to body part. The important thing is to be familiar with each consumer's skin appearance. That way, even subtle changes can be easily identified.

Routinely monitor skin appearance and condition. If a consumer needs assistance and support for routine daily care activities such as bathing and dressing, staff can use that opportunity to observe for any skin changes. It is important to notice any changes from the usual skin condition:

• Skin color: Look for any changes in the general coloring of the skin, including the lips, nail beds, hands and feet. Particularly note if the skin appears flushed or pale. A health care professional should be notified immediately any time a blue ashen color is observed to the skin or lips.
• Skin temperature: Note any changes in the overall temperature, if the skin feels too warm or cold. Sometimes a person's hands and feet may feel cooler than the rest of the body. Any specific area of the skin that is warmer or cooler than usual should be noted.
• Skin moisture: Normally the skin is dry and may be moist where there are skin folds. It is important to note if the skin appears sweaty or clammy without any apparent reason. Any dry patches of skin with flaking or scaling should be noted.
• Reddened areas: Any reddened areas of the skin must be closely watched. This may be the beginning sign of skin breakdown from too much pressure or friction to the area. This can occur with skin covering bony parts of the body like an elbow or hip. People who need assistance to shift or change their body position may be especially prone. Any reddened area that does not quickly fade when the source of pressure is removed should be noted.
• Breaks in the skin: Common breaks in the skin include such things as cuts, scratches, scrapes, cracks, lacerations, wounds, and sores. Any break in the skin should be properly treated when first detected to prevent infection. Then it is important to look for any swelling, tenderness, redness, or oozing of fluids from any sores or wounds. These changes should be noted as well as any sores or wounds that are slow to heal.
• Rashes: Rashes usually appear as small reddened areas of the skin that may or may not be raised or have small bumps. Rashes that do not improve after a few days of treatment, rashes that continue to spread, and rashes involving severe itching must be noted.
• Moles: Moles are usually harmless skin growths that vary in color from pink flesh tones to dark brown or black. Most people have moles, some more than others. It is important to check moles on a regular basis to note any changes in size, color, and shape. Also, moles that bleed or look sore should be noted.

Report changes in skin condition to a health care professional. It is important that service providers report changes in a consumer's skin condition (as described above) to a health care professional. This should include anything that does not look normal or seems unusual. As the saying goes, "err on the side of caution". The health care professional can then determine what actions should be taken. Prompt identification of changes in skin condition helps ensure the person receives any needed care or treatment. It also can lead to the detection of other underlying problems or conditions.

Tips for Maintaining Healthy Skin

Listed below are suggestions for ways service providers can promote healthy skin and help prevent some skin problems from developing.

• Encourage a healthy diet and proper fluid intake according to each consumer's needs.
• Maintain clean and dry skin; if a person is incontinent, check frequently and thoroughly clean the skin of any waste as soon as noted.
• Be aware of products and substances that may irritate the skin; some consumers may have skin allergies to ingredients in common products like scented soaps or detergents.
• Make sure shoes and clothing fit properly, are clean and dry, and aren't rubbing against the skin.
• Encourage physical activity appropriate to each person's abilities and interests.
• Assist a consumer in shifting body positions as may be indicated by a physical management plan; as a general rule, most people need to change positions at least every two hours.
• Frequently check the fit of any assistive, supportive or prosthetic devices; make sure the device is not rubbing or scratching the skin, or pressing against the skin too much.
• Use proper lifting and transferring techniques as may be needed; minimize sliding or friction and never pull a person across any surface.
• Make sure that bed linens and other resting surfaces are clean, dry, and free of wrinkles.
• When recommended by a health care professional, lubricate the skin with lotions or other products; never rub lotions into an open cut or wound.
• Encourage use of sun-screen products and protective clothing while outdoors.
• Always practice good hand washing techniques to reduce the transfer of bacteria.
• Routinely monitor skin appearance and condition; promptly report changes to a health care professional.