Skin conditions, tattoos, scars and stretch marks

Skin is the surface every implement lands on, and this site has nearly five hundred pages without a word about what changes when that skin is not typical. This is the missing one. The section on steroid creams is the part I would most want somebody to read.

Consenting adults only. Everything on this page is about adults over 18 who have freely agreed to it.

Written from first-hand experience or extensive research by the editor.

Everything here concerns consenting adults over 18. I have no medical training, so this is the practical version of what changes when the skin on the target area is not typical. Conditions and medication in general are at health conditions and medication.

Eczema, psoriasis and dermatitis

All three mean a barrier that is already compromised. During a flare that skin is inflamed, often cracked open, and it breaks more readily than intact skin an inch away. Psoriasis plaques bleed from small trauma. People arrive expecting to be told no altogether. The answer is no on the affected skin, which is a much smaller thing, because the target area is bigger than one patch.

• Move the target. Work beside or below the flare, and land nothing twice in one place.
• Broad and soft instead of narrow and hard. A cane concentrates force into a line, and fragile skin splits along lines.
• Shorter sets, with a look at the skin between them in decent light.
• Stop at the first sign of it giving way, not the second.

And do not leave off your usual treatment so the area looks better on the night. You arrive worse off than if you had carried on.

Steroid creams, and skin thinner than either of you thinks

I have never once heard this raised in a negotiation.

Long-term use of topical steroids thins the skin they are applied to. That is a well recognised effect of the drug, which is why the stronger creams come with instructions about how much and for how long. Thin skin tears rather than grazes, and bruises from less.

Now set that next to what people are actually treating. Eczema and psoriasis on the buttocks and upper thighs are common, and a cream used on the same patch for ten years is unremarkable. She thinks of it as a rash she has had since her twenties. He cannot see it at all.

I got this wrong. Somebody I played with for over a year marked heavily, so I filed it under skin type and thought no more about it. Then she mentioned in passing that she had used a prescribed steroid ointment on a patch of psoriasis on her left thigh since her twenties. I had been caning across it for fourteen months. Nothing came of it, which is luck rather than judgement.

None of it makes the answer no. It makes the first session an assessment rather than an event. Start lower and look far more often than usual. If you have used a potent steroid there for years, ask the GP what the skin will take, then say so in the negotiation.

Tattoos

A healed tattoo is skin. It takes impact and marks the way the skin around it does, so a healed piece changes nothing.

A healing tattoo is an open wound and gets treated as one. Off the target area completely until it has healed, including light strokes and through clothing, and if it crosses the target area then the whole area is out of use for as long as the artist told you.

Whether years of heavy repeated impact does anything to the ink, I do not know. I have heard it claimed both ways, so ask the artist who did it.

Scars

Scar tissue is not the same material as the skin around it. Different elasticity, different sensation. Some scars are numb. Some are unusually sensitive, and a stroke across one hurts out of proportion to its force.

Numbness is the one people get backwards, because it sounds like an advantage. This activity runs on the person underneath feeling what is happening and saying so. Over numb tissue there is no such signal, so it takes less force and more checking.

A surgical scar raises a second question, which is what is underneath, and that one goes to a GP.

Self-harm scars come up often enough that leaving them out would be dishonest. Physically they behave like any other scar. The rest is not a skin question: if being struck there is doing something you would rather it did not, that has stopped being play.

Stretch marks

Physically, nothing. They are ordinary, most people have some, and they change nothing about how skin takes impact. They appear here because people ask, and the question is really about being looked at and found wanting. That has its own page at being seen when you hate how you look.

Moles, and anything that has changed

A mole that looks different from your others, or that has changed in colour, size, outline or feel, or has started to bleed, is a GP appointment. Book it rather than weigh it up against a Saturday evening. Otherwise moles need nothing beyond keeping a strap off a raised one.

Allergies, which are dull until they are not

• Leather. Most of it is chrome tanned, and chromium is a known contact allergen. A rash only where the strap landed is the clue.
• Latex. In gloves and in some floggers and clothing. People who have it know, so ask.
• Nickel. The commonest contact allergy there is, and it lives in cheap buckles, rivets, chains and studs. Nobody thinks of it, because the fitting was not what hit you.
• Lubricants, creams, oils and whatever else is in the aftercare drawer.
• Cheap dyed implements. Bright dye transfers onto warm damp skin, and colour that wipes off was never a mark.

A reaction shaped like an object rather than a stroke is a contact reaction. Stop using the item and see a pharmacist if it does not settle. Swelling of the face or lips, or difficulty breathing, is 999.

Saying any of it without a medical monologue

People say nothing because the only version they can picture is long, delivered undressed, with a diagnosis in it. One line the day before does the job.

• "There is a patch of eczema on my left cheek. Everywhere else is fine."
• "I have used a prescribed cream there for years, so the skin is thinner than you would expect."
• "My tattoo is three weeks old, so thighs are out until next month."
• "I cannot feel much across the scar on my right side, so watch it for me."

None of those names a condition you would rather not name, and each hands a top the part he needs. Anybody who takes it as a fuss has answered a question you had not got round to asking.

The rule underneath all of it

If you cannot see the skin, you are guessing. That covers near darkness, staying over clothing, checking by feel, and the last half hour of a long evening when nobody has stopped to look.

Skin that is not typical needs looking at more often rather than less, and the usual instinct runs the other way. Faced with a scar or a patch of eczema, most people glance away out of tact. Tact is wrong here. Look at it in proper light between sets, and say out loud what you can see.