Posts Tagged ‘Skin’

Wound Assessment: Skin of Many Colors

Thursday, February 25th, 2016

Understanding the structural differences between light and dark skin is crucial for clinicians, and this free Wild on Wounds webinar will help – plus you’ll get awesome tips for assessing skin of color.

Wound Assessment: Skin of Many Colors


Chances are that when you studied skin and wound assessment in US textbooks, most of the case studies or photos involved patients with lighter skin tones – common to people of European decent.  Historically (and unfortunately), there’s been a lack of research, guidelines and consistency in treating skin of color.

This lack of diversity in educational resources can be downright dangerous. For example, without exposure to proper techniques, you might not recognize a Stage 1 pressure injury in a darker-skinned patient, because non-blanchable erythema (redness) is harder to see.

With the diverse US patient population, it is critical that clinicians understand how skin differs among people of various races and ethnicities. Knowing these differences is  essential for skin and wound assessment.

Learning starts here

Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS, WCEI Co-founder/ Clinical Instructor

Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS, WCEI Co-founder/ Clinical Instructor

Most of us have learned whatever we can about treating skin of color from our own experiences in the field. To remedy this, WCEI Co-founder and Clinical Instructor Nancy Morgan addressed this topic in her Wild on Wounds (WOW) national conference presentation, “How to: Skin of Color.”

Now offered as an on-demand webinar, Morgan discusses the specific characteristics of skin of color. She explains clinical conditions present differently in highly pigmented (versus lighter) skin. You can hear her entire presentation – and view it for free – with a special coupon code (listed below).

What makes skin darker?

Skin color is the result of melanin – a brown pigment. The purpose of melanin is to protect the skin by absorbing harmful ultraviolet (UV) radiation from the sun.  As we encounter UV rays, special cells called melanocytes produce additional melanin.

You may be surprised to learn that there’s no difference in the number of melanocytes between skin types. The palest and the darkest person will, on average, have the same number of these cells in their skin. However, the production and concentration of melanin in the epidermis (top layer of skin) is double in darker skin.

Does skin tone matter?

There are many skin tone classification scales used in the field, created mostly by and for dermatologists.  As Morgan states in her presentation, these scales aren’t helpful when it comes to wound care. “We have to do a very thorough visual inspection of the skin, and we have to talk to the patient about his or her baseline skin color.”

More webinar highlights

Besides exploring the basics of skin color and tone, you’ll find out more from Morgan’s webinar, including:

  • Skin conditions more common in darker skin, such as hyperpigmentation, keloid scarring, and xerosis.
  • Useful tips for performing a holistic assessment of a patient with dark skin.
  • Why some clinical conditions – such as sDTI, erythema or cyanosis – can be much more difficult to pick up in skin of color.
  • How other conditions, such as hemosiderin staining, may appear very different than they would in a patient with lighter skin.

Get your free webinarFree Webinar - Skin of Color

Are you ready to learn more about this topic and better address the wound care needs of your patients with dark skin?  Click here and use the code BLOG to access this 60-minute recording, which qualifies for an education credit.

More thoughts?

We’d love to know about your clinical experiences with skin of color. Did you receive any official training regarding this topic, or have you mostly learned from your own personal experiences? Is your facility proactive in making sure clinicians are knowledgeable in how skin tone and color effect proper wound assessment? Tell us about your observations and experiences by leaving your comments below.


Wild on Wounds℠ (WOW) is the national wound conference designed for healthcare professionals that are interested in enhancing their knowledge in skin and wound management. Clinicians come from all over the US to see, touch and participate in our hands-on workshops. They also learn about all the new and advanced wound care treatments and technologies to better help care for their patients.  For more information visit


Functions of the Skin

Tuesday, January 5th, 2010

Functions of the Skin (A Review)

The Skin

Lets review some basics about the skin. Sometimes a review helps us keep what should be obvious in perspective.

Protection: (From bacterial invasion and against external elements)

1. Protection from external environments like water, chemicals as well as mechanical forces, bacteria and viruses as well as ultraviolet radiation.
2. The skin prevents excessive loss of fluids and electrolytes always striving for homeostasis
3. It assists in Immunological response
4. The skin produces sebum which is a lipid-rich oily substance that is secreted by sebaceous glands. It provides an acidic coating and retards the growth or organisms
5. Melanin helps protect against Ultraviolet rays. Exposure to sunlight increases melanin production. Melanin production can depend on race and amount of exposure to sunlight

Holds the Body in Shape

* Along with other structures such as muscle, bone and cartilege, the skin helps keep our “shape”

Sense the environment, basic types of sensations

The skin has receptors within it that enable the brain and body to ‘feel’. These sensations are:

1. Pain
2. Touch
3. Temperature
4. Pressure

Retain Water

* The tightly packed cells of the stratum corneum provide protection against water loss. It helps hold it all inside the body.

Maintain Temperature- Thermoregulation

The skin assists the body maintain consistent temperature. This is called Thermoregulation.

1. Primary Mechanisms- Through Circulation and Sweating the body is able to regulate temperature
2. Blood vessels that suply blood to the skin can dilate (vasodilation) so that heat is caarried by the blood to the skin where it can be diffused into the air. Conversely, it can constrict (vasoconstriction) to prevent heat loss through the skin once body temperature has stabilized.

Immunological Response

* White Blood Cells (WBCs) in the skin can capture and destroy the bacteria that is invading the epidermis

Expressions and Emotions

1. The skin helps with the identification of a person
2. The skin plays a role in external and internal assessments of beauty
3. The skin lends to body image importance


* When exposed to ultraviolet B radiation from sunlight, cells in the epidermis convert cholesterol-related steroid to Vitamin D also known as cholecalciferol. The general result is the maintenance of Calcium and phosphorus levels in the bone and blood

Sometimes reviewing some of the basics about the skin or your profession can go a long way. It can help you have a better insight into caring for the skin. Remember the skin is the largest organ of the body. For more information about becoming wound care certified, please visit our Registration Page