One of the questions that is often asked by our members on the online support group is, "Why do we often have skin problems?" Is it because of medication? The environment? Central heating in winter? Or is it down to our lymphoedema?
There isn't one simple answer. What we do know is skin is our largest organ, and whether you have lymphoedema or not we owe it to ourselves to take loving care of it. Prevent our skin from drying out, check for cuts, grazes, rashes and treat immediately to stop infection getting in.
Bath or Shower?
When you have your bath/shower make sure you test the water temperature. Optimum shower temperature 32°- 42 ° Celsius. Ours is kept on 38° c because this suits me and my husband. It's a personal choice. We are lucky as our shower has its own thermostat. Extreme cold water temperatures are not good for lymphoedema skin, neither is anything too hot.
Drying your skin - Use a clean towel
Make sure you dry your skin thoroughly. Pay attention to drying between fingers, toes, skin folds.
If your skin is normal rub dry, if you have fragile skin, thinning skin or damaged skin, carefully pat dry. Be careful not to damage your skin further.
Note: Thinning skin may occur as we get older.
Wash your skin everyday
Use soap free cleansers (Aqueous Cream) that will not dry your skin out.
Use a clean towel. Dry you skin carefully, pay attention to between the fingers, toes and skin folds
Moisturising is an effective way to avoid dry skin, after your bath or shower get into the habit of treating your skin daily.
If you wear a sleeve or any form of compression garments, then moisturise at night before you go to bed.
Preferably use a non-scented low pH level soap and moisturiser as they are less likely to dry out the skin.
Moisturise from within by drinking more glasses of water.
Treat Yourself: Although it is recommended to use soap free cleansers or non-scented soaps for that special event when you want to feel good don't forget to combine your favourite shower gel, moisturiser, and perfume.
Why is skincare so important?
Living with lymphoedema you may be more likely to develop skin infections to your affected area or limb because lymph fluid drainage is reduced, and you have a compromised immune system. Your aim is to protect the integrity of your skin, to prevent skin breakdown, prevent cellulitis, and other fungal infections. Skin infections may worsen your lymphoedema and make it harder to manage.
Check your skin daily for changes, look for breaks in the skin, leakage of lymph fluid, unusual redness or more swelling than normal, and watch for indentations caused by clothes, jewellery or shoes being too tight.
Remember with skin care as with most things in life there is no one size fits all. We are all different, we have different skin types, and the skin care I use may, not suit you. Skin care is a personal choice, however, do work with your lymphoedema nurse practitioner as you might need specialist creams. If you live in the UK, ask if specialist creams or lotions are available on prescription.
Our skin is our largest organ - selfcare - love your skin
Moisturise everyday, make it part of your daily routine.
Pay particular attention to your elbows and heels. When you do this daily it only takes a few minutes and you owe it to yourself to look after your skin.
CAUTION: Keep moist areas of your skin dry. Take extra care to dry between your toes as this can be a source of infection.
It is extremely important that those of us who live with lymphoedema should take good care of our skin to prevent infection like cellulitis.
Check daily for:
Breaks in the skin
Treat immediately by washing area thoroughly, apply antiseptic cream. Use insect repellent when necessary.
Caution is advised to your affected limbs of any invasive procedures.
No invasive procedures to the affected area
No Blood pressure readings/blood tests, injections or IVS
Wherever possible use the opposite side to your treatment.
Keep skin hydrated through daily moisturising. However, other ways to hydrate your skin is to moisturise from within. Drink plenty of water.
If you cannot face drinking water try a glass of warm water with a slice of lemon or lime.
Alternatively try herbal tea.
Stay away from caffeine like coffee and fizzy drinks as they may increase your swelling.
Whenever you try new skin care products always remember to do a patch test.
A patch test will determine if you are allergic to the substances in the emollients you use.
To do a patch test at home put some cream on the inner side of your wrist or on the inside of the elbow as these are the most delicate areas.
Check for redness or a rash. If you get a reaction discontinue use of cream.
Lymphoedema skin can be super sensitive so please take good care of it.
Breaking the Itch/Scratch Cycle
Creams, Gels, Lotions & Ointments
Emollients (both paraffin-based and paraffin free)
Keep away from fire, flames, and cigarettes. Compression/dressings. clothing and bedding that have been in contact with an emollient can easily catch fire. Washing fabrics at high temperatures may reduce the build-up of emollient but does not remove completely.
Be careful not to slip when using emollients in the bath or shower, or on a tiled floor. Protect the floor with non-slip mat, or towel.
Cross infection use, the back of a spoon or spatula to remove emollients from a pot or tub to prevent contaminating the emollient.
Caution: If you experience any type of skin reaction like a burning sensation, rash or redness please seek advice from your GP, Nurse or Pharmacist.
Which skin care product is best?
For lymphoedema skin it is important that you are guided by your lymphoedema practitioner or health care provider. The aim of creams, gels, lotions, ointments, and sprays is to prevent transepidermal water loss (TEWL) which is the main cause of dry skin. Emollients are applied directly to the skin to hydrate and soothe. They form a protective layer to the skin to hold in moisture.
There are a wide range of medical emollients available, do remember you have a personal choice. For example I prefer a cream and do not like a gel, talk to your lymphoedema practitioner.
Creams: often cosmetic and are oil-in-water emollients, can be used regularly
Lotions: more water than oil and feel lighter than creams can be used daily
Ointments: oil only emollients, greasy in texture and more often used when treating TEWL
Sprays: Used for hard to reach areas that are sore or infected and should not be touched. Sprays are absorbed quickly by the skin.
Emollients – are used when your skin feels dry and tight, they help to replace lost moisture. They can be applied directly to the skin with smooth, light strokes following the direction of hair growth (this will prevent the hair follicles being blocked). No need to rub in. Emollients can be applied often, after showering, washing hands, housework, crafts, gardening, or swimming.
My favourite shower aid
Foot Towel to dry in between your toes. Essential to keep this area dry to stay
Lotion applicator. If you have limited mobility this handy tool helps.
IMPROVING MY KNOWLEDGE
Please note in 2021 I did the following course/webinars so that I could better understand the importance of skin care while living with lymphoedema.
Skin Intelligence Academy - CPD Certification on Tissue Viability and Emollients
Dermatology Webinar Series - How to conduct a Virtual Diabetes Foot Screening
If you have Eczema you may find this App useful.