Just the Facts: Skin and Hair Problems on Dialysis

Just the Facts: Skin and Hair Problems on Dialysis

How does dialysis affect my skin?
Many people on dialysis have skin changes.
The skin may seem more fragile—it may
bruise or even tear easily. Dry, itching, or
cracking skin is common.
Some skin problems can be small. Others
can make you feel bad about yourself or even
cause you to not want to be seen by others.
The good news is, many skin problems can
be helped.

Why do I bruise more easily?
You may bruise easily if your dose of
blood thinner (heparin) is too high. Or, easy
bruising can occur if your blood level of
platelets—clotting cells—is too low.With
too few platelets, you might also have
bleeding gums. Some drugs, like prednisone
or coumadin, can increase bruising.

Why does my skin itch all the time?
Itching has many causes, so you will need
to be a detective. Often, itching is caused
by high blood levels of phosphorus. In your
body, extra phosphorus can bind with calcium
to form sharp, itchy crystals. Taking your
phosphate binders with food can help.
Other causes of itching include not enough
dialysis, or dry skin. Long, hot baths that
strip skin oils and alcohol-based products
may dry the skin as well.

Why do I itch only at dialysis?
If you only itch on dialysis, an allergy may
be the cause. One type of heparin (e.g., pork)
might make you itch, while another does not.
Or bleach used to clean the chair may be to
blame. Try putting a towel on the chair, or
alert the dialysis staff.

Why is my skin so fragile?
Skin that rips at the slightest bump, with
purple or brown, itchy blisters can be a
sign of a skin disease called “porphyria”
(por-feer’-ee-a). This problem can be
treated by a skin specialist.

Why is my hair falling out?
Hair is made of protein. If you become
malnourished, a few months later your hair
may break more easily and fall out. Eating
enough good protein will help, but it takes a
couple of months to see a change. Ask your
dietitian about good protein sources.
Hair loss can also be caused by thyroid
problems, zinc deficiency, drug reactions,
and other problems. Some patients have
had hair loss when the unit changes the type
of dialyzer (kidney) used. Talk with your
doctor about this, or ask for a referral to
a skin doctor.

How can I treat my skin and hair problems?
Problem How can I prevent it? What should I ask?

Every time I bump •Make sure you know how much •Do you think my heparin
into something, I get heparin you should get, to be dose is causing me to
a big bruise. sure you receive the right dose. bruise easily?
•Ask your doctor about your •Is my platelet level
platelet count or coumadin level (or InR) what it should be?
(called InR) if you are on coumadin.

This itching is •Try to figure out what is causing •Can you suggest some
driving me crazy! the itching. Is it better at some things I could try to help
times than others? What helps stop the itching?
or makes it worse? Does your •Are there any prescription
skin look normal, or different? lotions that you think
•Try a few over-the-counter lotions would help?
to see if one works for you. •Do you have samples
Some patients find that coconut I could try, so I can find
oil is soothing. one that works before
•Ask your doctor about lotions I have to pay for it?
that might help.
•Ask your doctor if an
antihistamine would help.

I feel too ugly to •Talk to your doctor as soon as •I don’t think my skin
go out. My skin is you notice a skin problem that problem is normal, even
cracked and blistered. affects how you feel about for dialysis patients. Can
yourself. you write me a referral
•Ask for a referral to a skin doctor. to a skin doctor?

What can I do while •Treat your hair gently—avoid •Could you please check
I wait for my hair harsh perms or colors. my thyroid levels?
to grow back in? •Don’t use tight rubber bands. •What is my protein
•Ask a stylist for tips to hide (albumin) level? (It should
thinning hair. be at least 4.0 g/dL.)
•Be sure to eat the right amount
of protein—talk to your dietitian.
•Try to figure out what is causing
the problem for you.

from: www.lifeoptions.org/catalog/pdfs/teaching/SkinAndHair.pdf