Care and cleaning basics for a facial prosthesis

A facial prosthesis is a made object worn on living skin all day, which is a hard life for a piece of silicone. Care instructions exist to protect two things at once: the prosthesis and the skin under it. This page summarizes what hospital patient information and laboratory research say about cleaning and handling. It is general background. The routine given by your own prosthetic team, which depends on the material and on how your prosthesis is held on, always comes first.

Daily cleaning in the leaflets

Cambridge University Hospitals publishes patient information for both common types of prosthesis. For an adhesive-retained prosthesis it says to wipe the outer surface with your fingers and a small amount of soap lather under cold or lukewarm water, never hot, and to dry it gently with a cloth. Edges are thin and can tear easily, so they need extra care. The leaflet for implant-retained prostheses adds that the side that touches the skin is cleaned once a day with a soft toothbrush, lukewarm water and mild liquid soap, and the magnets are scrubbed gently with the brush and soap lather.

Both leaflets say the prosthesis should be stored in a clean, dry container, front side down on tissues, to prevent curling and damage. Both say not to attempt to modify the prosthesis; if it needs adjusting or has been damaged, the patient should contact the maxillofacial laboratory to arrange a review.

Adhesive and the skin underneath

For adhesive-retained prostheses, the Cambridge leaflet describes skin that must be clean, dry and free of earlier adhesive residue, and creams or moisturizers on the skin before application are listed among things to avoid. It describes applying a thin layer of adhesive to the edges, waiting until it turns clear, and then holding the prosthesis in place for 30 to 60 seconds. Water-based adhesive is removed with soap and water, while solvent-based adhesive needs a small amount of the supplied remover on a tissue. The leaflet says to remove the prosthesis slowly by the thickest edge to avoid irritating the skin and tearing the edge. Such details differ with the product and the team, which is one more reason the written instructions from your own clinic matter.

Around bone-anchored implants

When a prosthesis is held by implants, the skin around the posts needs its own routine. The Cambridge leaflet for implant-retained prostheses does not give step-by-step skin care. It says each patient is supplied with a separate leaflet on maintaining the implants and the skin around them. A review of implant-retained craniofacial prostheses explains why: the most frequent problems come from the place where the abutment passes through the skin, and it names thinning of the skin and personal hygiene as important factors. Skin reactions in that review range from none through redness and moist redness to infection serious enough that the abutment has to be removed. See bone-anchored implants for the wider picture.

What laboratory research adds

Why not use something stronger? Laboratory studies suggest harsher products have a price. A 2022 study in the International Journal of Biomaterials simulated one year of cleansing on silicone samples and tested four methods. Plain distilled water produced the least color change and a 2 percent chlorhexidine solution the most, with antibacterial soap and chlorhexidine liquid soap between them. Precolored silicone changed color less than silicone colored by hand. The authors note that many cleansing agents have been recommended, including water, neutral soap and chlorhexidine, but they should be used carefully because they can affect the material's physical properties. This was a test on silicone specimens, not on people, and it is background rather than a recommendation.

Other findings come from a 2024 review in Materials, which reports that prosthesis replacement is often driven by discoloration, poor maintenance and tearing, that ultraviolet light chemically transforms organic pigments, and that a fungus of the genus Penicillium was isolated from worn nasal prostheses with black discoloration. It also says the effect of cigarette smoke on silicone has been studied very little, although smoke and beverages are accepted as staining factors. A review from Queensland University of Technology adds that biofilm can form on prosthetic surfaces, penetrate the material, and cause defects. None of these is a reason for alarm. Together they explain why instructions emphasize gentle cleaning, drying and storage, and why prostheses are replaced periodically. Cambridge University Hospitals tells patients its prostheses should last 12 to 18 months, with six-monthly reviews. For the materials themselves, see materials, and for what happens to color, colour matching.

Wear and protection

The leaflets advise against wearing the prosthesis in bed and against wearing a nasal prosthesis for contact sports such as rugby. They suggest that with an implant-retained prosthesis the skin should get some time without it, usually in the evening. Sun exposure comes up indirectly: the hospital's explanation for fading is that ultraviolet light and skin oils change the colors. How these routines fit into everyday life is on living with a facial prosthesis.

When to call the team

Contact the clinical team that looks after you, without waiting for the next scheduled review, if the prosthesis is damaged, no longer fits properly, or needs adjusting. The same goes for skin that is red, sore, swollen or weeping under or around the prosthesis or an implant site, because skin reactions around implants range from mild to serious infection. If you are unsure whether something is urgent, ask. Do not repair, trim or re-shape a prosthesis yourself, and do not use a product the team has not approved on the prosthesis or the skin beneath it. For a sudden change in the face itself, for example drooping on one side, seek medical help promptly; the page on facial nerve problems explains the warning signs.

In brief

Hospital guidance for facial prostheses is gentle and simple: cool or lukewarm water, mild soap, thin edges handled with care, dry storage and no home repairs. Laboratory work suggests harsher disinfectants can speed color change. Anything that looks like irritation, infection or damage is a reason to call the clinical team.