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Caring for your skin when you have lymphoedema

This page tells you about caring for your skin when you have lymphoedema. There is information about

 

A quick guide to what’s on this page

When you have lymphoedema you need to look after your skin because any injury or infection can make the swelling worse.

You need to

  • Keep your skin clean and dry
  • Moisturise your skin at least once a day
  • Clean cuts or grazes straight away with clean water, put an antiseptic cream on, and cover the area
  • Protect your skin from the sun by wearing a high factor sun cream, or cover up with clothes
  • Wear oven gloves when putting things in and out of the oven, and gardening gloves when gardening
  • Take care when cutting your nails or shaving
  • Use an insect repellent containing at least 50% DEET– if you are bitten or stung, try not to scratch the area and do use antihistamine cream
  • Avoid extremes of temperature that can dry your skin – including hot, cold or windy weather and hot baths, saunas and steam rooms
  • Don’t wear tight clothing, jewellery or shoes
  • Avoid sitting or standing for long periods of time
  • Avoid having injections, blood taken, or your blood pressure checked, on the affected arm
  • Know the first signs of infection – reddening, a feeling of warmth in the area and flu like symptoms
  • See your doctor as soon as possible if you have signs of infection

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating lymphoedema section.

 

 

Why you need to look after your skin

When you have lymphoedema you need to look after your skin because any injury or infection can make the swelling worse. This is because injury or infection can further damage the lymphatic system in the area.

If you have a skin condition such as eczema or psoriasis you may need to see a doctor who specialises in skin conditions (a dermatologist). Any skin breaks can make you more likely to get an infection. Keeping your skin healthy, intact and well moisturised helps to prevent this.

 

Looking after your skin

You can do a number of things to help protect your skin and lower your risk of infection or injury.

  • Keep your skin clean and dry – use a soap substitute such as aqueous cream, Oilatum or Neutrogena soap bars or an E45 wash
  • Moisturise your skin at least once a day
  • Clean cuts or grazes straight away with clean water, then put an antiseptic cream on and cover the area
  • Protect your skin from the sun by wearing a high factor sun cream or cover up with clothes
  • Use an insect repellent containing at least 50% DEET– if you are bitten or stung, try not to scratch and use antihistamine cream
  • Avoid hot baths, saunas and steam rooms because this can increase swelling
  • Avoid extremes of temperature that can dry your skin – including hot, cold or windy weather
  • Don’t wear tight clothing or jewellery
  • Avoid sitting or standing for long periods of time
  • Avoid having injections, blood taken, or your blood pressure checked on the affected arm – there is little evidence to show that this increases your risk of swelling or making it worse, but doctors advise this just in case
 

Moisturising your skin

To keep your skin moist you need to use a moisturiser (emollient). Emollients help to prevent loss of water from your skin by creating a protective layer. There are different types of emollients, including bath oils, soap substitutes and moisturisers. You can get Diprobase and E45 from your chemist. If you have a moisturiser that you like to use, check with your nurse whether you can use it. Avoid perfumed body lotions because they can dry the skin.

You need to moisturise your skin every day. How you do this and what you use depends on the condition of your skin. To stop moisturising cream clogging your hair follicles, apply the cream with downward strokes. 

If your skin is in good condition you need to use a moisturiser that you can apply easily. This can be a cream or a lotion and will help to keep your skin hydrated.

If your skin is dry and flaky you need to moisturise more often or use a moisturiser that is thicker and greasier. This helps to stop further loss of moisture.

If your skin has become scaly you need to wash it with a moisturising soap substitute and then moisturise afterwards with a thicker greasy moisturiser. This helps to soften the scaly areas so that you can remove them easily. 

You may need to put the cream on twice a day. It helps to put it on before you go to bed at night so that it has time to absorb overnight. Then in the morning you can put on your compression garment after cleaning and moisturising the skin.

 

Tips to help lower your risk of infection and injury

These tips can help to reduce your risk of infection or injury

  • Protect your hands from cuts and scratches when you are doing any household jobs such as washing up, gardening or DIY
  • If you have arm lymphoedema wear oven gloves and long sleeves to avoid burns when getting things in and out of the oven
  • Be careful to avoid scratches when handling pets – clean the area straight away if you are scratched
  • Don’t use a wet razor or waxing to remove hair – you can use a clean and well maintained electric razor or hair removing cream
  • Be careful when cutting your nails, and use nail clippers – if it is difficult to cut your toenails see a chiropodist regularly
  • Wear well fitting shoes and avoid going barefoot if you have lymphoedema of the leg – this lowers your risk of blisters or injuring your feet
  • Wash and dry your feet thoroughly, including between your toes – if you have had fungal infections before, you may need to use athelete’s foot powder to prevent getting it again
  • Look out for any thickening of the skin, changes in colour, and any blisters or spots – contact your lymphoedema specialist if you have these

It is important to know the first signs of infection so that you can seek treatment as soon as possible. The first signs of infection are

  • Reddening of the skin – this may start in one area and get larger, it may include the whole limb or can cause red lines
  • Swelling
  • Heat
  • Pain

Other symptoms include a high temperature, flu like symptoms (such as aching limbs and tiredness), or generally feeling unwell. Infection in people with lymphoedema can cause inflammation (cellulitis) or an acute inflammatory episode (AIE).

Early treatment helps to stop an infection, and also stops your lymphoedema getting worse. So if you think you have an infection, see your doctor straight away. Don’t wear your compression garments. Your doctor will prescribe antibiotics. You may need to have them into your bloodstream (intravenously) at first to get the infection under control. Then you can take them as tablets or capsules. The most commonly used types are amoxicillin or flucloxacillin. If you are allergic to penicillin your doctor or specialist nurse may prescribe clindamycin.

If you have a number of infections within a short time you may need to take antibiotics each day to prevent further infections. You may need to take them for up to 2 years.

Sometimes lymph fluid can leak on to the surface of the skin. This is called lymphorrhoea (pronounced lim-for-ree-a). It is straw coloured fluid. It can happen if you scratch the skin. It can also happen if you hurt the area when the skin has become scaly or when the area has become swollen quickly. If you notice that you have fluid leaking from your skin tell your doctor or nurse. They can treat it with dressings, skin care, and bandaging.

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Updated: 1 April 2014