The Rollin' RN's

Loving your Summertime Skin


Summer signifies vacations, a break from school or work, and time for fun in the sun. Protecting your skin during this time of the year is important for everyone but living with a spinal cord injury (SCI) can make it more challenging. We are here to break down some issues your skin could encounter as the temperatures rise and to provide methods to protect, treat, and keep it healthy.


It’s important to know that the skin is the body’s largest organ and it serves an important protective role in sensation and both fluid and temperature regulation. But with an SCI you may have decreased or no sensation and sweat more or less in various areas of your body. Throw in some summertime ingredients and you’ve got a mixture for concerns if you’re not mindful.


We created a list of some common issues that may affect your skin during the summer months:


Body Temperature Regulation

Most individuals with an SCI will have difficulty regulating body temperature below their injury level because the brain is no longer communicating with the part of the spinal cord that corresponds with the sweat glands of the skin. Their function is to release sweat to cool the skin as it evaporates and prevent overheating from the summertime temperatures. However, you don’t have to miss out on the summer fun. With a little bit of preplanning, you can stay comfortable and soak up some Vitamin D.


  • Drink. Staying hydrated is one of the best things you can do to stay cool in the heat. Cold water is best. According to livestrong.com cool fluids leave the stomach faster than warmer ones, which allows for faster rehydration. Be mindful to limit drinks with sugar, caffeine, or alcohol because they act as diuretics which can lead to dehydration.

  • Carry a mister or spray bottle of water. This is a great way to stay comfortable because it mimics sweat to cool down the skin. Some misters have battery-powered fans that can speed up cooling.

  • Keep a cool wet towel placed on the nape of the neck. This is an easy and fast way to cool down. Keep a small cooler with ice water close by to refresh the towel as needed.



Summertime Rashes

A common summertime rash is known as heat rash. “When heat rash develops, your skin is giving you a warning that if this continues, you could really have some severe symptoms, from heat exhaustion to heatstroke,” said Dr. Rajani Katta, dermatologist and clinical assistant professor at Baylor College of Medicine. Heat rash develops when blocked sweat glands trap perspiration under your skin. Symptoms range from surface blisters on the skin to deep red bumps and can be itchy or prickly. For this reason, you may hear the term “prickly heat”. These types of rashes tend to occur in hot, humid climates and are more common in individuals who are overweight or with extra skin folds that can trap sweat. A heat rash can also develop if clothing is too tight, preventing sweat from evaporating. Heat rash usually clears on its own after you get out of the heat. Applying a cool compress to the area can also be helpful and soothing.


The second type of rash that can affect the skin can be caused by fungus or yeast. This type of rash is usually found in warm and moist environments with little or no air circulation such as under the breasts, underarms, feet, groin, or anywhere there are skin folds. Symptoms may include skin redness, blisters, itching, peeling, or cracking skin. Over-the-counter antifungal topical creams can remedy many of these rashes but if the rash persists, contact your healthcare provider.

Strategies to reduce skin rashes:

  • Focus on areas of the body that are prone to excessive moisture and may consequently lead to heat rash or fungal/yeast infections. Wash these areas with soap and water, towel dry, and keep the area moisture-free, avoiding ointments and creams.

  • Wear loose-fitting, soft, lightweight, cotton clothing to keep skin cool and dry.

Sun Exposure

Summer and sun go hand in hand but spending time outside may be more challenging with an SCI for some of these reasons:

  • Decreased or no skin sensation.

  • Taking medications that can make the skin more sensitive to sunlight. Consult with a pharmacist.

  • An inability to change body positions may increase the risk of sunburn.

  • Because of reduced circulation and blood flow, a sunburn that results in blisters can quickly progress into an open wound.


Steps you can take to prevent sunburn:

  • Avoid the sun between 10 am and 4 pm when the sun is most intense.

  • Block harmful rays by wearing at least a 30 SPF sunscreen and reapply frequently.

  • Cover exposed areas with clothing, towels, and a hat. Don’t forget your sunglasses.

  • Find a shady area to relax.



Insects

Be conscious of your outdoor surroundings when it comes to bugs. Having decreased sensation or no sensation because of an SCI may prevent us from feeling bites or stings until they’ve already occurred. Mosquitos can carry disease so be sure to apply bug spray, wear clothing to cover up bare skin, and avoid the hours around dusk and dawn when mosquitos are more common. In many warm-weather areas, fire ants live and can be very aggressive. Their bites are numerous, painful, and could be serious or deadly if you are allergic to them. It just takes rolling your wheelchair over an active, unnoticed mound to be a target of these superfast ants. Bees, wasps, and hornets pose the same threat as fire ants. So stay alert to your surroundings.




Summertime feet

It’s the dog days of summer and who doesn’t want to go barefoot or wear some cool sandals? However, extra caution needs to be given to your feet when you have an SCI. If you have decreased or no sensation in your feet, it’s important to wear footwear to protect them from bumps or sunburn when outside in your wheelchair. And consider water shoes when swimming to protect feet from getting scraped on the bottom of the pool or by sand or rocks in open water. In warm and humid conditions take care to keep feet clean and dry especially around the toes to prevent fungal infections. Warm weather can also cause an increase in swelling (edema) in the legs and feet so consider buying footwear in a size or two larger to accommodate. Your feet will thank you for the special summertime attention.




Extreme temperatures

Lastly, extremes of summer temperatures call for extra caution in protecting your skin. When outside, park your wheelchair in a shady area when you’re not sitting in it or cover it with a towel or blanket. Keep in mind that objects with black, metallic, leather, and vinyl surfaces absorb heat making them HOT! Check the temperature of a surface before transferring and this includes car transfers.


Now you're ready! So, grab a drink, slather on the sunscreen, find an umbrella for shade, and enjoy your summer!




It’s all good, so keep on rollin’.

Roberta, RN and Patty, BSN, RNC

The Rollin’ RNs ™


References:

https://www.bcm.edu/news/dont-sweat-the-heat-rash

https://www.livestrong.com/article/533835-which-is-better-drinking-ice-water-or-warm-water/

http://www.shieldhealthcare.com/community/spinal-cord-injury/2018/03/09/temperature-roller-coaster-ups-downs-thermoregulation/

https://www.webmd.com/skin-problems-and-treatments/features/ringworm-or-candida#1

https://www.webmd.com/skin-problems-and-treatments/understanding-heat-rash-basics


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