Skin Irritation from a Wearable...We have a PROBLEM!

For a consumer or patient, nothing is more...well irritating, then getting skin irritation at the site where your wearable device is worn. Whether it is a smartwatch, earbud or medical device, when the skin itches, burns and is red and inflamed you don't want to wear the device. For some individuals who use medical monitoring devices that are crucial to their health (like a continuous glucose monitor or a personal health monitoring device) there is an immediate negative impact on your wellbeing. So any skin irritation from your wearable is a PROBLEM!

Skin irritation from a wearable is FRUSTRATING!

Was the skin irritation from an allergy? did you get burned? Is there some defect in the device or the material with which it was made?

Any of these are possible.

My approach to skin irritation and wearables is to look at the skin rash and ask a lot of questions. Skin irritation from an allergy, burn and from irritants can often look similar. By understanding the context around which the skin irritation occurred and by seeing what the skin irritation looks like, a more accurate diagnosis can be made. When a large group of users wearing the same device have similar experiences of skin irritation, then we have to pay close attention to that device and clarify whether the root causes is a material issue, a design flaw or a problem with how the individuals are using the device (wear-characteristics).

What are some common causes for skin irritation and wearables? In no particular order:

• Irritant Contact Dermatitis (ICD)

• Allergic Contact Dermatitis (ACD)

• Thermal contact burns (TCB)

• Inflamed hair follicles

• Hives

I'll take a deeper dive into what some of these diagnoses are in future blogs.

Now to figure out which of these are the likely diagnosis, one has to have the right information at hand. That's not always easy to collect. In clinic, every physician obtains a clinical history differently based upon their training and experience. Dermatologists are trained to ask specific skin-directed questions and use standardized descriptors of the active skin rash. My experience with companies is that the questions asked and the terminologies used are often inconsistent making it hard for someone reviewing the information to provide accurate diagnosis.

For that reason BOHLD has developed a standardized set of questionnaires that will collect relevant information about skin rashes which have occurred while wearing a device. There are different questionnaires optimized for wrist-worn, ear-worn, face-worn or chest/arm worn locations. The questionnaires are designed to extract subtle details that might separate one of the diagnosis listed above versus another and give the reviewing consultant as much information as possible to make an accurate diagnosis. BOHLD-developed questionnaires are actively being used by several industry-leading companies that make consumer or medical wearables. Please contact BOHLD if you are interested in learning more about these questionnaires.

Wrist-Questionnaire Sample