Infection and lymphoedema

Infection can make the swelling (lymphoedema) worse. See your doctor straight away if you think you have an infection. Early treatment helps to stop an infection.

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’re doing household jobs such as washing up, gardening or DIY.
  • With 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 they scratch you.
  • 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’s 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 might need to use athelete’s foot powder to prevent another one.
  • Look out for any thickening of the skin, changes in colour, and any blisters or spots – contact your lymphoedema specialist if you have these.

First signs of infection

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

  • a high temperature
  • flu like symptoms (such as aching limbs and tiredness)
  • generally feeling unwell

Other symptoms are:

  • reddening of the skin – this might start in one area and get larger, include the whole limb or cause red lines
  • swelling
  • heat
  • pain

Infection in people with lymphoedema can cause inflammation (cellulitis) or an acute inflammatory episode (AIE). This type of infection can cause damage to the lymphatic vessels. You can become very unwell with cellulitis and will need antibiotic treatment.

See your doctor straight away if you think you have an infection. Early treatment helps to stop an infection and can stop your lymphoedema from getting worse. Go to your local Accident and Emergency department if you have an infection over a weekend. Don’t wear your compression garments until you've had treatment for the infection.

Treating infection

Your doctor will prescribe antibiotics. You might need to have them into your bloodstream (intravenously) at first. Once the infection is under control, you can take them as tablets or capsules. It is important that you take antibiotics for 2 weeks.

The most commonly used antibiotics are amoxicillin or flucloxacillin. Your doctor may prescribe erythromycin or clarithromycin if you are allergic to penicillin. 

You might need to take a low dose of antibiotics each day if you have several infections within a short time. This is to prevent further infections. You may need to take them for up to 2 years.

The British Lymphology Society (BLS) has a consensus document that gives advice to doctors. It guides them on the use of antibiotics for people with lymphoedema. You can take this with you to your doctor. 

Leaking fluid

Sometimes lymph fluid can leak from the surface of the skin. This is called lymphorrhoea (pronounced lim-for-ree-a). The fluid is straw coloured.

It can happen if you scratch the skin when it is swollen. It can also happen if you hurt the area when the skin has become scaly. Sometimes lymphorrhoea occurs when the area has become swollen quickly.

Tell your doctor or nurse straight away if you have fluid leaking from your skin. They can treat it with dressings, skin care, and bandaging.

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