Observing and Reporting Skin Problems

Observe a client’s skin whenever you are doing personal care. Look at the client’s skin at least once a day. If you do not have the opportunity to see a client’s skin, ask them if they have any concerns regarding skin changes.

Pressure Injuries (ulcers/sores)	Skin breakdown or injury caused by pressure and/or weakened skin that damages the skin and/or underlying tissues including the muscle. Pressure injuries are classified (or staged) by how deeply the skin and underlying tissues are damaged.
Stasis/Venous Ulcers	A chronically open area, caused by poor circulation of the blood in the veins. Early symptoms are a rash or a scaly, red area and itching. The skin around the ulcer becomes a discolored reddish brown. This occurs most often on the lower legs and feet.
Arterial Ulcers	Round open areas on the feet and lower leg due to lack of blood flow to the legs.
Rashes and Infections	Most rashes are raised, red, bumpy areas on the skin that are often itchy. Skin infections are a break in the skin, like a scratch, where bacteria or fungus have spread and caused an infection.
Burns	Skin that is damaged by fire, sun, chemicals, hot objects or liquids, or electricity. Burns are classified according to how deeply the skin is damaged. 1st-degree burns are when the skin is reddened and maybe swollen and tender. 2nd-degree burns usually have blisters, intense redness, pain, and swelling. 3rd-degree burns are the most serious and involve all layers of the skin.
Skin Cancer/ Lesions	Abnormal growth on the skin that usually doesn’t spread and is treatable. A more dangerous kind of skin cancer is melanoma. Melanomas are irregularly shaped and may be described as a “strange mole” or a mole that is changing. If a client has a strange mole, report this to your supervisor right away.

What to Look For

Redness or other changes in coloring
Swelling
Changes in temperature (warm or cold)
A break in the skin
Rashes, sores, or a gray or black scab over a pressure point
Odor
Pain

Observing any of these signs could be an indication of a skin problem and should be reported to the appropriate person in your care setting immediately.