Ask Nick

Patients, therapists, caregivers, and family members who have a question or concern about prosthetics can ask APO practitioner Nick Ackerman, CP.

Nick is a graduate of the prosthetics program at Northwestern University Orthotics Prosthetics Center and was certified by the American Board for Certification in 2005. In 1981, at the age of 18 months, Nick became a bi-lateral, below-knee amputee and has been a patient at APO since that time. Questions can be e-mailed to

I have diabetes. Do you have an advice for skin care?

I'm glad you asked. It's very important for all diabetics to take care of their skin, and even more so if you wear a prosthesis. First of all, if your prosthesis is not fitting well, if it's loose or pistoning, and you are getting skin irritations, make an appointment with your prosthetist. Minor adjustments can make a world of difference and help prevent a minor skin irritation from turning into something worse.

Also remember that if you are wearing a prosthesis, it’s important to keep it clean too. Wash your liner and socks regularly; before bedtime is best. Alternate your liners every day.

Use a medicated soap and warm water, lather, scrub and rinse well. Completely dry the liner with an absorbent towel and then let it ventilate overnight.

Your prosthetic sheath also should be changed and washed daily. Wash with a mild detergent and rinse thoroughly. Squeeze out (don't wring) the excess water, and let it air dry. For best results, follow the manufacturer's cleaning instructions.

The same goes for prosthetic socks, which need to be changed and laundered daily. Again use warm water, a mild detergent (no bleach) and rinse, rinse, rinse. Squeeze out the water and air dry the socks overnight or as long as it takes.

Now, some basics on skin care. Below are some tips from the American Diabetes Association that should help.

  • Keep skin clean and dry. Use talcum powder in areas where skin touches skin, such as armpits and groin.
  • Avoid very hot baths and showers. If your skin is dry, don’t use bubble baths. Moisturizing soaps may help. Afterward, use a standard skin lotion, but don’t put lotions between toes. The extra moisture there can encourage fungus to grow.
  • Moisturize your skin to prevent chapping, especially in cold or windy weather.
  • Treat cuts right away. Wash minor cuts with soap and water. Do not use Mercurochrome antiseptic, alcohol, or iodine to clean skin because they are too harsh. Only use an antibiotic cream or ointment if your doctor says it's okay. Cover minor cuts with sterile gauze. See a doctor right away if you get a major cut, burn, or infection.
  • During cold, dry months, keep your home more humid. Bathe less during this weather, if possible.
  • Use mild shampoos. Do not use feminine hygiene sprays.
  • See a dermatologist about skin problems if you are not able to solve them yourself.

- Nick Ackerman CP