General skincare measures in palliative care
Good skincare is essential to improve skin condition and manage skin problems, particularly itch and sweating. Regular skincare may avoid the need for systemic drug therapy, particularly when dryness causes or exacerbates the skin condition.
General skincare measures are shown in General skincare measures in palliative care. Tailor the skincare regimen to the patient, balancing the frequency of skincare measures against the burden and benefits of the treatment for the patient.
Many patients with palliative care needs develop fragile, thin skin, with increased risk of bruises, tears and ulcers; take care when handling patients.
Apply a generous amount of emollient [NB1] (eg aqueous cream, glycerine 10% in sorbolene cream, liquid paraffin 50% mixed with white soft paraffin 50%) twice a day, particularly after bathing.
Try not to use skincare products that contain lanolin or fragrance.
Wash in warm (not hot) water and pat skin dry gently. Use sponge baths or towel washes if confined to bed. Avoid showering every day if fatigue is a problem.
Use a soap substitute (eg aqueous cream, soap-free bars or wash) or use dispersible oils if the skin is very dry (added to bathwater or sprayed onto wet skin immediately after showering); try not to use soap and shampoo.
Keep a cool environment; if required, use skin cooling measures such as regular sponging with cool water.
Wear light and loose-fitting cotton clothes.
Be aware that some foods (eg coffee, alcohol, spices) may cause blood vessels to widen, leading to flushing and warmth.
For itch, keep fingernails and toenails cut short, wear cotton gloves and socks at night, try not to scratch, and gently rub instead.