One of the biggest worries with a pinless halo is skin breakdown. Because the halo is right on the skin, it constantly rubs. Other braces can come off to allow the skint to breathe, but not the pinless halo. We were warned that this is usually the biggest issue.
Abby has had her pinless halo for about 2 1/2 months now. (WOW!!) We have been very diligent at bathing her and checking carefully for skin breakdown. She had issues around her jaw for a while, which we were able to address and basically cure! Our recent battle has been around her ears. Her left ear has been in a lot of pain from the brace rubbing against it.
This morning, she was screaming in pain to the point where I really felt that I needed to see what the issue was. I knew it was rubbing, but could only see redness. This seemed like more than just a little irritation. After shining a flashlight and getting creative with looking under the halo, I realized that one part had caused a pretty deep gash on the lobe of her ear and it had become infected. This was completely covered by the halo, so we had no way of knowing. Matt took her to the doctor this afternoon. After consulting with CHOP, the pediatrician gave her an oral antibiotic. CHOP also said that they would notify the brace company so that additional padding could be added when she goes for her next appointment. If she gets a fever, we are to head to CHOP. But, we are hoping that the antibiotic will take care of it!
If your child has a pinless halo, be relentless about skin care, but also listen to your child! If something hurts, investigate it. You may not be able to easily see the problem, but you need to address it before it becomes more of an issue. I wish I had caught this sooner, but it was just really hard to see!