Skin care

Feeling good in your own skin

The skin is our largest organ – it protects our bodies, helps us maintain just the right temperature, and gives us the sense of touch. When we feel comfortable with ourselves, we “feel good in our own skin”. If our skin is irritated or damaged, it can be very painful.

A surprisingly large number of chronic dialysis patients suffer from the tiresome problems of dry skin and itching. These skin complaints are not life-threatening, but they can be very uncomfortable and distressing, and as a result can affect your quality of life.

Why does my skin itch?

Itching (or uraemic pruritus) is a symptom that can be caused as a side effect of your kidney disease or dialysis treatment, although the exact cause of itching in dialysis patients is not always clear. Possible causes may be high levels of the parathyroid hormone (secondary hyperparathyroidism), or high levels of phosphate in the blood (hyperphosphataemia).

Also, calcium released from the bones can deposit in the blood vessels, joints and skin which may lead to itching. Other possible causes are the retention of urochromes and uraemic toxins, iron deficiency and general inflammation. Skin traumas or allergic reactions which lead to histamine secretion are other possible causes.

What can I do?

To reduce the possible causes of itching, it is extremely important that you monitor your calcium-phosphate balance, follow your nutritionist’s advice to ensure low phosphate intake, and be sure to take your phosphate binders as prescribed by your physician. If you do have problems with itching, make a point to discuss the problem with your physician.

Remember, the problem can be caused by your kidney disease. Your doctor will try to help. He will probably check your phosphate levels and ensure that you are taking the correct dose of phosphate binders. He may also be able to advise you if there are any suitable creams or lotions you can use, or suggest alternative therapies which will help to alleviate the symptoms. As a dialysis patient, you may also experience dry skin. This can be caused by changes to the sweat or oil glands. Relieving dry skin can help to reduce itching. As there are often no visible external signs of itching, your doctors and nurses may not know you suffer from this common dialysis complaint. Be sure to talk to them about it and they will be happy to discuss all possible measures with you – to help you feel better in your own skin.

Tips for your skin care

With these general tips, you can take steps to minimise discomfort:

Avoid hot baths, generally a shower is recommended. But if you enjoy having a bath, try adding baking soda or oatmeal to the bath water, which can often provide relief.
Try to wear clothes made of cotton and other natural fabrics.
Strong perfumes in detergents, soaps and lotions may cause allergic reactions or aggravate the condition, so try to steer clear of them.
A good skincare routine, with daily cleansing and moisturising, can also help.
Above all, please try not to scratch! Scratching tends to make the itching worse, and may even damage the skin and lead to infection. Keep your nails trimmed to avoid scratching and excoriation.
Do everything you can to avoid falls or trauma to the skin in order to prevent abrasions which could aggravate the condition.