Why is skin care important?

It is important to look after and protect your skin to avoid any injury or infection. If you have lymphoedema or are at risk of it, you are also at risk of a skin infection called cellulitis. It is important to know the signs of an infection. Good skin care helps reduce this risk.

Keeping your skin in good condition

Lymphoedema can make your skin dry and itchy. This makes cracks and breaks in the skin more likely and increases your risk of infection. You can help your skin stay in good condition by:

  • Moisturising every day

    If your skin is in good condition, you can use any moisturiser. If you have dry skin or other skin problems, your lymphoedema specialist can suggest the best creams for you. You can buy moisturising creams from your local chemist. You can also get some on prescription from your doctor. When you put on moisturiser, make sure the last stroke is downwards (in the direction of hair growth). This stops the moisturiser blocking hair follicles (folliculitis).

  • Keeping your skin clean

    Wash with warm water every day. If you have dry skin, use soap-free cleansers.

  • Carefully drying the area after washing

    If the lymphoedema is in a limb, make sure you dry in between fingers or toes of the affected limb.

  • If lymphoedema affects your feet, use surgical spirit or alcohol wipes daily between your toes

    This helps prevent athlete’s foot (a fungal infection). You can use anti-fungal powder to treat signs of athlete’s foot, for example having peeling, itchy skin.

Avoiding cuts and grazes

You are more likely to get an infection if your skin is broken. It is impossible to avoid all skin injuries. But there are things that you can do to reduce the risk:

  • Wear long sleeves, gloves or long trousers when doing household tasks

    Doing some household tasks can increase your risk of injuring your skin. These include washing up, DIY, gardening or cooking. Wearing certain clothing, such as long sleeves or trousers, can help protect you from cuts and grazes.

  • Take care around pets that might scratch

    Try to keep them away from the affected area. Or think about clothing or blankets that could protect you.

  • Be careful removing unwanted hair that is in, or near, the affected area

    An electric shaver is the safest way to remove hair. Razor blades, waxing and sugaring can all damage the skin. Some people use hair removal creams, but these can be harsh on the skin. Always test a small area first.

  • Use nail clippers instead of scissors to cut your nails

    You are less likely to cut the skin with these. It is also best not to push back or cut your cuticles. Tell your doctor or lymphoedema specialist if you need extra help with the nails on your feet. They can refer you to a foot specialist (chiropodist). Tell the chiropodist that you have lymphoedema, or that you are at risk of it.

  • Talk to your lymphoedema specialist before taking up any new sports

    Exercise can help improve the symptoms of lymphoedema. But some sports can increase your risk of damaging the skin. Your specialist can talk to you about any care you should take for a specific sport. Or they may suggest other sports you can try instead.

  • Wear shoes that fit well, protect your feet and do not rub

    If you have lymphoedema in the leg, it is safest not to walk around barefoot. This is in case you step on something or stub your toe.

Avoiding bites and burns

Insect repellent

Using a good insect repellent can help to prevent insect bites. Your pharmacist can give you advice about the best one to get. Look for a repellent with at least 50% DEET. This is the active ingredient in insect repellent.

Sunburn

Sunburn can cause dryness and blistering. Try to wear clothes that cover you in the sun. Make sure you use a sun cream with a sun protection factor (SPF) 50. You should not use a sunbed.

If you get a cut, graze, burn or bite

If you do get a cut, graze or burn:

  • treat it as soon as you can, even if it is only small
  • wash and dry the area thoroughly
  • put antiseptic cream on it
  • cover if necessary.

If you get an insect bite or sting that is on or near the affected area, try not to scratch it. Scratching may cause more damage to the skin. Using antihistamine cream may help reduce itching. Speak to your GP for advice if the break does not heal, or shows any sign of infection .

Avoiding skin damage

Lymphoedema alert bracelet

When seeing health professionals, always tell them about your lymphoedema. This is because they may need to give you injections, vaccinations, a drip (infusion), or acupuncture. If you need to have any of these, they should try to avoid putting needles into the affected area.

There is no strong medical evidence to say this will increase your risk of getting lymphoedema. But most experts see it as a precaution to reduce the risk of infection. It may be helpful to wear a lymphoedema alert bracelet. This will remind healthcare professionals that they should not use the affected arm for needles. These are available from the Lymphoedema Support Network (LSN).

Tattoos

Talk to your doctor or nurse before getting a tattoo on the area affected by or at risk of lymphoedema.

Avoiding temperature extremes

Extreme temperatures, like being too hot or too cold, can sometimes make swelling worse. Here are some tips for avoiding this:

  • Avoid using saunas, hot tubs and steam rooms.
  • Try not to sit too close to a fire or other heat source.
  • Always test the temperature of the water before you have a bath or shower, to avoid scalding yourself.

Managing problems caused by lymphoedema

Recognising infection

It is important to know the signs of an infection. Getting treatment for an infection as soon as possible puts less stress on the lymphatic system. This can stop lymphoedema getting worse.

If you get an infection in the skin (cellulitis), the area may become:

  • red and hot
  • painful
  • more swollen.

You may also:

  • have red streaks going up or down from the infected area
  • have a high temperature (fever)
  • feel generally unwell (like you are getting the flu)
  • lose your appetite.

If you have any of these signs, contact your GP straight away. They will usually prescribe a course of antibiotics, which you should start straight away. If it happens over the weekend, do not wait to see your GP. Contact your out of hours GP service – these are different depending on whether you live in England, Scotland, Wales or Northern Ireland. You should also contact your lymphoedema specialist. They will usually tell you to stop all lymphoedema treatment.

Do not wear any compression garments if you have a skin infection and it is painful. Contact your lymphoedema specialist for advice, you may need pain relief from your doctor. Rest the swollen area in a comfortable position. For example, you could support the whole limb with a pillow. You should not exercise until the infection has gone.

You should wear your compression garment again as soon as you start feeling better, and it is comfortable. You should still wear it, even if you are still taking antibiotics.

Guidance on antibiotics for lymphoedema

In the UK, there is guidance that your GP must follow on using antibiotics to treat cellulitis when you have lymphoedema. It is important your GP follows this guidance when prescribing antibiotics for lymphoedema.

The guidance is called the consensus document on the management of cellulitis in lymphoedema. It is available from the British Lymphology Society.

Some people with cellulitis need to go to hospital to have antibiotics into a vein (intravenous treatment). This normally happens when cellulitis is more severe or becomes worse after taking antibiotics at home.

Treating lymph fluid leaking from the skin (lymphorroea)

Lymphorroea is when lymph fluid leaks from the skin in the affected area. It is not common but can happen when:

  • an area is very swollen
  • the skin is very dry
  • the area of swelling is difficult to treat, for example the genital area
  • there is a break in the skin
  • a blister filled with lymph fluid appears on the surface of the skin and breaks.

If you have lymphorroea, keep the area clean. The broken skin can easily cause an infection, such as cellulitis. You should see a lymphoedema specialist as soon as possible. They will try to stop the skin from leaking.

The specialist can show you ways of managing lymphorroea at home. It may also help you to have some light bandaging. This can reduce 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 for signs of infection.
  • Apply moisturiser around the area that is leaking.
  • Lift your limb when you can. For example, 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. But do not tape it to the skin. Gently hold it in place with a soft bandage. Only put on a lymphoedema bandage if your lymphoedema specialist has shown you how to do it.

Having lymphorroea can be upsetting, but specialist support can help you. We also have more information about body image that may help.