There are a variety of different bone anchored hearing devices on the market. This blog post will be specific to percutaneous bone anchored hearing devices or the style of bone anchored devices that use an abutment. In this style of device, there is a titanium post affixed in the skull that a hearing device is snapped onto.

Because the abutment post goes from the skull through the skin, the skin around the abutment needs special care. It’s important to take good care of it as it is a bit of a long-standing opening in your skin, somewhat like a complex piercing. One of the more common risks with an abutment is infection.

If you go searching on the forums of the internet, it may seem to you that tons of people have issues with their skin around their abutments. I think it is one of those situations where often the people who have issues are the ones sharing their stories, while those who don’t have concerns are silent. The research literature reports the incidence of significant problems is 7% of all people with these abutments. That is actually a fairly small group.

Certain health conditions can impact the likelihood of struggles with healing and infection around the abutment. For example, diabetes can greatly impact healing ability. Make sure you bring up any additional health concerns you have with your doctor as those may impact if an abutment style device is a good fit for your life.

It is recommended to clean around your abutment daily. This can be in the shower or bath when you clean your hair. It is important to remove any debris around the abutment and the best time to do this is when it is softened with warm water. I have found it important for my skin to use gentle shampoos and conditioners. I have sensitive skin in general, and when I used something harsher I found my skin more unhappy and sensitive around the abutment.

Oticon, the company of my device, also recommends using a soft bristle brush or cotton swab each day around the abutment to remove debris after washing. I found the brush too abrasive. Instead, I use clean fingers to scrub any debris. I will admit to being a person who always uses a lot of pressure when writing or drawing and so it could just be that I was brushing too vigorously. I have found it more comfortable when I just use my fingers.

If you are wondering what the debris is, it can be dirt but also can be some dry skin crust. Because the titanium post somewhat doesn’t allow the skin to close and fully heal, there is a certain amount of crusty debris to be expected. I know that sounds gross, but for me it is super minor, not really more gross than a touch of dander. A lot of drainage, swelling, huge scabs, and redness are not normal and should be monitored and shared with your health care provider.

I was also instructed to be very careful about the use of hair products and not to get them on the abutment. I have followed that closely. I make sure to inform my hair dresser so she doesn’t put product on the abutment. It is also important to be careful about the amount of heat put toward the abutment as it is metal and will transfer heat. Again I warn my hairdresser.

Oftentimes when someone is considering an abutment, there is concern regarding sleeping on that side of the head. I can’t really speak to how soon you can resume sleeping on that side, as I had brain surgery on that side of my head the same year so my results were skewed. It took me a long time to sleep on that side. I do it now, but I will admit the skin around the abutment does sometimes get sore when I sleep on it, so I tend to lay on that side less and roll over more.

There are definitely some skin care needs when you have a percutaneous bone anchored device. However, in my opinion, it is not hard to maintain day to day once you have created your systems. I certainly feel like the small trade off of a little extra care and thought is very much worth the large amount of benefit the hearing device provides. Access to sound, community, and connection is so incredibly important. I am willing to invest some maintenance to keep my skin happy so that I can enjoy my bone anchored device every day.