Skin Care of the Head
Paralysis can lead to issues with skin integrity due to pressure issues. These are wounds that begin inside the body, usually over a bony prominence pushing against the inside of the skin. The pressure causes capillaries to collapse which interrupts the blood supply. The cells in the body cannot receive oxygen or nutrients needed to keep them healthy, so they are starved and eventually die. Once this process has started, a change in pigment on the outside of the skin appears in a range of colors such as a purplish spot in darkly pigmented individuals or as a pinkish spot in lightly pigmented individuals.
There are many locations on the body that are common areas for pressure injury, however, since most individuals have sensation on their heads, the thought of pressure areas here are often overlooked. However, some individuals do have interrupted head sensation, have challenges in moving their head position, develop pressure injury from equipment, lie too long on one side especially while asleep, or are unable to tell a caregiver that something on their head is hurting.
Here are some common areas where pressure can occur on the head:
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To avoid pressure injury to your head:
- Turn frequently and perform pressure releases even to your head to reduce the risk of developing a pressure injury on the head.
- Check every inch of skin, including the head, for pressure injury especially if the individual has issues in moving their head.
- You may need a pressure dispersing cushion under your head as when in your wheelchair or bed. Medical equipment for reducing pressure on the head can be ordered by your healthcare professional if you require it.
- Utilize equipment such as oxygen tubing carefully. Any equipment adding pressure to delicate areas of the head may require padding to protect against rubbing and pressure on the skin.
- If a pressure injury develops, stay off or keep equipment off of the area to avoid the progression of the wound.
- Seek healthcare for appropriate treatment of your pressure injury.
Pediatric Consideration:
Often parents or caregivers look at infant, child, or teen skin and see resilient tissue. However, remember pressure injury begins within the body where you cannot see. All ages of individuals are susceptible to pressure injury. Performs skin checks frequently all over the body including the head.
Smaller children have heads that are proportionately larger than adults. Therefore, their heads are heavier and can be at more risk than adults for pressure injury. They also, may not be able to tell you that they need a change in position. This creates the responsibility to check their skin, including heads, to prevent pressure injury.