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Changes in skin

Whereas most of the body’s organs are hidden inside and we can’t see what’s happening to them, the skin is very visible and shows signs of the dying process.

Pressure Sores

The reduced blood supply to your skin makes it very vulnerable to damage even with minimum pressure and very gentle handling. It’s common to get bruising on the skin that can sometimes look quite alarming. Skin that is in contact with surfaces can develop pressure sores despite excellent skin care from carers and professional staff.

As you spend more time in bed you will find a position to lie in that is the most comfortable for you. The skin over the parts of your body that are in contact with the bed is squashed and the blood supply that is already reduced is cut off even more.

When this happens the skin dies and breaks down leaving a sore. Your carers will try to prevent this happening by encouraging you to move and helping you to turn over every couple of hours. They may notice if areas of your skin are looking more discoloured and pay particular attention to reducing the pressure on those parts.

You may have a special mattress for your bed to help reduce the pressure.

There are some things that make you even more vulnerable to developing sores on your skin. These include if you have been taking steroids or chemotherapy, incontinence, friction and infection.

Skin sores can be very painful as the nerve endings in the skin are damaged.

If you develop sores on your skin there are various ways of dealing with them so that you feel comfortable. If you are at home your GP and district nursing team will help your carers and advise on treatment. If you are in a hospital, nursing home or hospice, the staff there will look after your skin.

Colour and temperature

As you get weaker, your circulation starts to shut down so less blood gets through to your skin. This means that your skin may look pale and will probably feel cool. It’s likely to be most noticeable on your hands, feet, fingers, toes, nose and ears.

Your skin may also look mottled with a bluish/purplish discolouration.

Swelling

You may notice swelling of all of your body or just parts of it. Gravity helps to pull the fluid to the lowest position so if you spend a lot of time lying down you may notice that your face becomes puffy and your eyelids swell. If you spend a lot of time sitting, you may notice the most swelling is in your legs. Sometimes the swelling can be huge making your legs more than double in size and making them feel very heavy.

Sometimes some of the excess fluid trapped under the skin can start to ooze out from the skin leaving it feeling damp and clammy and contributing to the risk of developing pressure sores.

Pain, tenderness and other sensations

The nerve endings in the skin are damaged by the reduced blood supply and so they do not work properly. These damaged nerve endings send confused messages to your brain which tries to make sense of them. The result can be a range of sensations: