Skin care for lymphoedema

If you have lymphoedema, it is important to prevent infections that could make lymphoedema worse. Some general tips are:

  • Keep skin clean and use soap-free cleansers
  • Moisturise well
  • Avoid cuts and scratches, and treat any immediately by washing and applying antiseptic.
  • Avoid exposing the area to heat and sun, which can cause inflammation.
  • Use insect repellent.

If you have lymphoedema of the hand/arm or foot/leg, avoid activities that could cause muscle strain in the area, for example certain sports or carrying heavy bags. You should also avoid wearing tight clothes, jewellery or shoes.

It’s important to recognise the first signs of infection. If an area of skin becomes red, hot and painful, contact your GP immediately. This could be a sign of cellulitis, an infection that needs treatment with antibiotics. There is specific guidance on using antibiotics for cellulitis in people with lymphoedema. Sometimes, the skin can break and lymph can leak from it. This is called lymphorroea. If this happens, contact your lymphoedema specialist. They will try to stop the leaking and help you prevent further infection.

Skin care and lymphoedema

Looking after and protecting your skin is a very important way of preventing injury and infection. Any break in the skin can make you more likely to get an infection there.

Lymphoedema can cause your skin to become dry and itchy, making cracks and breaks more likely. Good moisturising can help to prevent this. You can buy suitable creams from your local chemist or get them on prescription from your doctor. Your lymphoedema specialist will give you further advice.

Reduce the risk of infection

  • Keep your skin clean and dry. Use soap-free cleansers that don’t dry your skin.
  • Moisturise gently every day with unperfumed cream or oil to help your skin stay supple and in good condition.
  • When applying moisturiser, the last stroke should be downwards (in the direction of hair growth) to prevent blocking of the hair follicles (folliculitis) with moisturiser.
  • Treat even small grazes and cuts straight away. Wash the area thoroughly, apply antiseptic cream and cover, if necessary.
  • See your GP straight away if you develop any signs of infection.
  • If possible, avoid having needles put into your affected hand/arm or foot/leg when you have blood taken, injections, a drip (infusion), or acupuncture. Although there’s no strong medical evidence to support this, most lymphoedema experts think it’s a wise precaution to take to reduce the risk of infection. Don’t get a tattoo on the limb that is affected or at risk.
  • It may be helpful to wear a lymphoedema alert bracelet to remind health care professionals that the affected arm should not be used for needles. These are available from the Lymphoedema Support Network (LSN).

Protect yourself from inflammation

  • Protect your skin from the sun by covering up with clothes or wearing suncream with a sun protection factor (SPF) of at least 30. Never use a sunbed.
  • Use insect repellent to prevent insect bites as they can lead to inflammation and infection. If you’re stung on, or near, the affected area, see your GP for advice.
  • Avoid extreme temperatures. Too much heat can increase the swelling so always test the water before you have a bath or shower. Avoid using saunas, hot tubs and steam rooms, and don’t sit too close to a fire or other heat source.
  • Be careful when playing sports that may result in an injury to an arm or leg that has, or is at risk of, lymphoedema.

Lymphoedema of the hand/arm

As well as the general advice above, here are some specific tips for people with, or at risk of, lymphoedema of the hand/arm:

  • Always protect the skin on your hand and arm to avoid cuts or scratches. Wear gloves for household tasks, such as washing up, DIY, or gardening. Be careful when handling any pets that might scratch. Wearing long sleeves, as well as gloves, will give extra protection when doing some of these activities.
  • To avoid burns, use oven gloves or pot holders and wear long sleeves when cooking and baking.
  • Avoid constriction, such as having your blood pressure taken, on your affected limb and avoid wearing tight elasticated cuffs.
  • Use nail clippers instead of scissors to lessen the risk of nicking your skin and don’t push back or cut your cuticles.
  • Never use a razor blade to remove unwanted underarm hair. Avoid getting cuts by using a well-maintained electric shaver. Don’t use waxing or sugaring to remove unwanted hair.
  • Hair-removal creams can be harsh on the skin so be careful and try a small test patch before using them on larger areas.
  • Avoid wearing jewellery or clothes that restrict the flow of fluid such as tight bra straps, tops with tight armholes, or rings, watches or bracelets that feel tight.
  • Don’t carry anything heavy, such as bags or shopping, with the affected arm as muscle strain can make the swelling worse.
  • Don’t do anything that involves vigorous use of the arm for long periods, such as using a vacuum cleaner, or gripping, such as ironing or driving for long periods. Rest frequently and do some exercises to stretch and relax the muscles to lessen the strain.

Lymphoedema of the foot/leg

Here are some specific tips for people with, or at risk of, lymphoedema of the foot/leg:

  • Wear well-fitting footwear to protect your feet and to avoid getting blisters.
  • Don’t walk around barefoot in case you step on something or stub your toe causing damage to the skin.
  • Use nail clippers instead of scissors to cut your nails to reduce the risk of nicking your skin.
  • See a chiropodist (a foot specialist) for foot/nail care if you need extra help, and let them know you have, or are at risk of, lymphoedema.
  • Wash and dry between your toes carefully and use anti-fungal powder to prevent or treat signs of athlete’s foot such as peeling, itchy skin.
  • Wear long trousers to protect your legs when you’re gardening or doing DIY/household tasks.
  • Never use a razor blade to remove unwanted leg hair. Use a well-maintained electric shaver to avoid getting cuts. Don’t use waxing or sugaring to remove unwanted hair. Hair-removal creams can be harsh on the skin so be careful and try a small test patch before using them on larger areas.
  • Avoid tight clothing around the groin area. Avoid wearing ankle bracelets or toe rings that can become too tight.
  • Avoid standing in one position for a long period of time.

Recognising infection

It’s important to know the signs of an infection. Getting it treated as soon as possible puts less stress on the lymphatic system and can prevent lymphoedema from getting worse.

If you develop an infection in the skin (cellulitis), the area may become red, hot and painful and the swelling can get worse. Other signs include red streaks going up or down from the infected area, a high temperature, feeling generally unwell (like you’re coming down with flu) and loss of appetite.

If you experience any of these signs, contact your GP straight away. They will usually prescribe a course of antibiotics, which you should start immediately. If it happens over the weekend, don’t wait to see your GP. Go to your local A and E department. You should also contact your lymphoedema specialist, who will usually advise you to stop all lymphoedema treatment.

Don’t wear any compression garments if they feel uncomfortable, and rest the swollen area in a comfortable position with the whole limb supported along its length.

Guidance on the use of antibiotics

There is a consensus document on antibiotics for the treatment of cellulitis in people with lymphoedema in the UK. It’s available from the British Lymphology Society at or from the Lymphoedema Support Network - you can find it at or contact them for a copy. The document guides healthcare professionals on the correct use of antibiotics in such cases. It is written by a group of specialist doctors and reviewed yearly. It is important that your GP knows the correct way of using antibiotics if you have lymphoedema.

Antibiotics for cellulitis in someone with lymphoedema should be started immediately and taken for two weeks (14 days) as prescribed, until all signs of infection have cleared up.

It may also be useful to keep antibiotics with you at home or to take antibiotics with you when you travel abroad. You can discuss this with your GP or lymphoedema specialist.

The antibiotics suggested in the consensus document are:

  • amoxicillin and/or flucloxacillin
  • clarithromycin, if you’re unable to take penicillin
  • clindamycin, if the infection isn’t better after 48 hours.

Some people with cellulitis need to be admitted to hospital to be given antibiotics into a vein. This normally happens when cellulitis is more severe or becomes worse despite having antibiotics at home.

Treating lymph leaking from the skin (lymphorroea)

Lymphorroea happens occasionally when:

  • an area is very swollen
  • the skin is very dry
  • the area of swelling is difficult to treat, eg genitals
  • there is a break in the skin.

In some people, a blister filled with lymph can appear on the surface of the skin. It can break and the fluid can leak from it.

It’s important to take very good care of your skin if you have lymphorroea. The broken skin can be an entry point for infection that can cause cellulitis.

It’s important to see a lymphoedema specialist who will try to stop the skin from leaking and who may, in some cases, refer you for further treatment by a skin doctor (dermatologist).

The specialist will show you ways of managing lymphorroea at home. You may also benefit from having light bandaging and/or manual lymphatic drainage (MLD) to reduce the swelling in an area that is difficult to manage with a compression garment.

What you can do while waiting to see a specialist:

  • Keep the skin clean and look out for signs of infection.
  • Apply moisturiser around the area of the leak.
  • Elevate the limb when you can – raise an arm to the level of the shoulder or a leg to the level of the hip.
  • Regularly apply a clean, dry dressing to the area. Do not tape it to the skin; gently hold it in place with a soft bandage. Do not apply a lymphoedema bandage unless you’ve been shown how to do it.

Lymphorroea can be distressing and upsetting but specialist help and support can make a real difference. You may find our section about body image and cancer useful. Our section on emotions also has some helpful suggestions about how to cope with some of the feelings you may be experiencing.