About Skin Conditions
The skin is the body’s largest organ and functions to protect the body from irritants. When encountering an irritant, signals are sent to the brain to isolate and destroy the irritant often causing redness, swelling, fever, and itching. In the case of some skin conditions, such as contact dermatitis, this reaction is caused when coming into contact with an external trigger. Other conditions like eczema, psoriasis, and scleroderma produce similar manifestations in response to an internal immune system trigger.
Limitations associated with skin conditions can include light sensitivity, suppressed immune system, skin irritations, fine and gross motor movement, mobility, temperature sensitivity, pain management, and stress management.
Skin Conditions and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Skin Conditions
For people with skin conditions and related limitations, the degree of limitation will vary among individuals. Be aware that not all people with skin conditions will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Skin Irritations: Many skin conditions result in irritation to the skin, including rashes, sores, and lesions.
- Provide alternative personal protective equipment (PPE) or uniform when possible
- Have PPE or uniform custom-made
- Exempt from uniform requirement unless job-related and consistent with business necessity
- Avoid infectious agents and chemicals
- Limit invasive procedures (activities that could exacerbate skin condition)
Ultraviolet Sensitivity: Individuals with skin conditions that decrease their tolerance to ultraviolet light may need accommodations to limit sun exposure and certain indoor lighting.
- Provide schedule that avoids direct high-sun exposure
- Provide protective clothing
- Provide ultraviolet light filters
- Provide alternate lighting
- Provide ultraviolet filters for computer screens
Suppressed Immune System: Skin may be impacted by weakened immune system or autoimmune disease.
- Allow frequent breaks to rest, to use medications, or to prepare specialized food
- Allow use of flexible scheduling and flexible leave
- Allow work from home
- Provide sensitivity training to co-workers
- Reduce or eliminate workplace stress
- Provide computer input devices and work surfaces that can be washed and sterilized
- Provide regular cleaning and sanitizing of office equipment, furniture, workstation, restroom, and break room
- Provide ultraviolet sanitizing wand (only if the individual is not ultraviolet-sensitive)
- Allow access to a refrigerator
Temperature Sensitivity: Some skin disorders may result in increased sensitivity to temperature.
- Modify work-site temperature and dress code
- Use fan/air-conditioner or heater at the workstation
- Allow work from home during extremely hot or cold weather
- Maintain the ventilation system and redirect air-conditioning and heating vents
- Provide an office with separate temperature control
Pain Management: Skin sensitivity or lesions may result in pain that disrupts an employee’s ability to perform work functions or maintain stamina throughout the work shift.
- Allow flexible scheduling and flexible leave
- Allow work from home
- Allow frequent breaks
- Reduce or eliminate physical exertion in the workplace
- Provide access to a refrigerator
- Allow telephone calls to support person, or attendance at support group meetings during business hours
Situations and Solutions:
A waitress with psoriasis did not want to wear the short sleeved uniform required under her employer’s dress code because her arms had an obvious rash
The employer modified the dress code for the waitress and allowed her to wear a long sleeved version of the uniform.
A retail clerk with a skin disorder had been leaving flaking skin around the store.
HR talked with the employee and he agreed to wear a long sleeve t-shirt under the company uniform, which was a short-sleeved polo shirt.
A chef could no longer wear latex gloves due to an allergy that developed from shingles on her arm.
He was accommodated with latex-free gloves.