Tips from FIRST members

General care with ichthyosis and castings

Try not to scratch itchy skin under the site with a sharp object because it could lead to infection.
Monitor the site for signs of rubbing, redness, along with bister development. If present, reach out to your doctor.

Casting Material Options

Fiberglass - has the tendency to weigh less when compared to plaster, along with being more durable and breathable

Plaster - less expensive but also not waterproof which increases the risk of the cast cracking. Plastic wrap would be needed for bathing

Removable Cast - Beneficial if the patient has a history of repeated skin infections

Fiberglass Splint - If the injury site is swelling, a splint would be the best option instead of a cast because it will allow more breathing room. The doctor would also have the option of adjusting the splint if the swelling increases or decreases.

Waterproof Cast - produces less sweat and odor. It keeps the extremity cleaner. There is a decrease in skin complications.  Cons include: may take a long time for moisture to disappear, may not be covered by insurance plans, expensive

3D printed cast

  • More surface area exposed An individual can bath with the cast on the site
  • The individual would have the option to apply lotion
  • Allows medical professionals to check skin health and address wounds which will decrease follow up visits
  • Unique design
  • Plastic structures with round openings
  • Lightweight
  • Breathable
  • Assists in areas of comfort and hygiene

Braces - would allow air flow around the skin along with the option of bathing. Clarify with your doctor if the brace being utilized is waterproof

Castings and Bathing Techniques

Prior to casting, consider applying extra moisturizers to potentially minimize itching

Use antibacterial cleaning products to decrease the likelihood of infection

When considering a body cast, utilize a table and place individual near a water source to facilitate exfoliating the scalp, along with using a pillow for neck support. Would also help with conducting sponge baths

Non-bath alternatives - Use squirt bottles around the area and attempt to lotion the area the best you can

Helpful products may include:

Smooth Skin Body Peel
Sexapeel Instant Exfoliant Spray
No rinse body face pump cleansers like Cetaphil or Phisoderm

Castings and Itching

Use Benadryl and a cooling hair dryer

Utilize compressed air or a vacuum to move air through the cast

Consider using a cast cooler - creates a gentle vacuum on the outside of cast, bringing fresh air between skin and the cast. Air flow is directed through the lining of a breathable orthopedic cast removing moisture and cooling skin. Without touching the skin, bacteria, itch and odor are significantly reduced. Also reduces skin maceration, which occurs when skin is in contact with moisture for an extended period of time.

Additional Tips

Consider weekly cast changes at the doctor to allow for cleaning the limb and lotion it in office before putting on new cast

Bean bag chair - Helps in the case of a body cast and adds comfort/support

When talking to the doctor, make sure to bring up the ichthyosis because he/she may reconsider options.

Ask your doctor about cutting and putting Velcro straps on the cast so you'll have the ability to remove it when needed.

Apply moleskin or soft fabric over areas that are causing friction on the skin surface
If you’re unable to tend to the area, ask your doctor about low dosage antibiotics to decrease bacteria development.

Prophylactic antibiotics

Just be prepared that it'll itch like crazy, but don't allow him/her to put anything down in there to scratch it.

Download/Print PDF Casting & Ichthyosis

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This information is provided as a service to patients and parents of patients who have ichthyosis.  It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents.  Neither FIRST, its Board of Directors, Medical & Scientific Advisory Board, Board of Medical Editors, nor Foundation staff and officials endorse any treatments or products reported here.  All issues pertaining to the care of patients with ichthyosis should be discussed with a dermatologist experienced in the treatment of their skin disorder.

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