Dialysis is often associated with skin changes. Over the years your skin can become more fragile and easily damaged. For the first few years I was on the BigD, I didn’t notice much change with my skin. But it does happen. There’s not much you can do about it except to be prepared and to take action to avoid damage.
It was only after I had my second transplant when I was taking some of the powerful anti-rejection drugs over a long period that dramatic changes occurred. The drug that had most impact was the steroid Prednisolone. Firstly the skin on the back of my hands and forearms became very thin; the merest knock causing a bruise. It is surprising how often we bump and knock our hands and arms during a normal day, especially when you are reaching for, lifting or shifting things. Little bumps and scratches that used to go unnoticed cause outsize bruises or tears that bleed profusely for a minute or so.
I have bumped the back of my right hand so often that it is permanently brown with old bruises. I often came home from work with my hand unaccountably bruised and sore. It wasn’t until I shook hands with one of those “really strong handshake guys” and the skin actually tore and began to bleed that I worked out what caused it. Now wherever possible, I avoid handshakes, or if I must, give one of those wimpy handshakes, with using just my fingers and thumb rather than the whole hand. I have always scorned people who shook hands like that, now I are one!
The same with my forearms: both are covered with scars that look like I have been on the losing end of knife fights since puberty. Until I learned to take extra care, I would tear the skin of a forearm every couple of days: dipping it into a box with a sharp edge, scraping it on a wall or the underside of a desk. Very embarrassing when you are in a business meeting, trying to impress: blood and professionalism are an uneasy combination.
Though it took me a while (I am a slow learner) in have now developed some damage avoidance techniques.
Now each time there is physical work to be done, I don some light gloves. Some people look twice at me, but that’s a small price to pay. I never work with my forearms exposed: I wear a reasonably heavy shirt with the buttons done up.
Another thing I have learned: don’t cover up cuts or tears with tissue paper or bandage. Once the bleeding stops, leave it open to the air. Then there’s no need then to drag off a semi healed scab a day later, and it takes only about four days to get back to working order.
My transplant failed over a year ago, but because I didn’t have the failed kidney out immediately, I have had to stay on Prednisolone all this time. I finally had the kidney about six weeks ago, and can at last wean myself off the drug (you can’t go off it cold turkey, steroid withdrawal causes unpleasant side effects, including mood problems). If like me, you have been taking Prednisolone for years, your adrenal glands can lose their ability to produce steroids naturally and can shrink in size. Your body needs time to adjust and get back its natural state. I have been dropping 1 mg per month, which seems to be OK.
I am very hopeful that once I am fully weaned off Prednisone my skin will return to its former robust, youthful self. Sadly, no sign of it so far, but I’ll let you know.