Take Care of your Skin
Take care of your skin!!Skincare for lymphoedema patients by Nicole Benner
Why is skin care important -with lymphoedema?
Skin care is of vital importance and should be stressed to each patient, even those "at risk" to lymphoedema.
Main aims of a good skincare routine
To improve and maintain skin integrity by concentrating on
• Protecting the skin
• Preventing infection
Preventative skin care
• Gently wash skin and avoid soaps containing perfume, alcohol and detergents. Use oil-based natural soap i.e. aloe vera, evening primrose or starflower based soap with as few synthetic ingredients as possible.
• Dry thoroughly especially in between digits.
• Moisturize daily with a bland cream i.e.E45, baby Johnson or Vaseline with aloe vera. 10% solution of jojoba, evening primrose or calendula in a general carviev oil (grape seed, sunflower, sweet almond.)
• Take great care cutting nails.
• Avoid getting the swollen limb sunburnt.
• Avoid insect bites, use insect repellent
• Avoid hot baths
• Use electric razor to remove unwanted hair
• Avoid injections and venepuncture on swollen limb
• Avoid blood pressure recording taken on swollen limb
• Always use gloves for washing up and gardening
• Avoid heavy lifting and housework
• Check skin for cuts, cracks, inflamed areas and fungal infection
• If inflamed treat promptly with anti septic ointment if no improvement contact GP immediately
• If fungal infection develop treat with anti fungal agent to prevent spread If susceptible to cellulites, carry emergency supply of antibiotics.
Helpful tips
Swollen arm
Clothes Avoid tight and constrictive clothing.
Avoid narrow and tight waistbands as this may cause pockets of swelling.
Care with choice of bra-lycra like material with deep sides and wide shoulder straps, which can distribute weight well across shoulder and back.
Avoid tight jewellery
If you get cold easily, try wearing additional layers of clothing rather than using hot water bottles or electric blankets. When outdoors, wear coat with substantial pockets at hip level so you slip hand in pocket to take strain off shoulders. Keep small marble or pebble in pocket to encourage keeping your hands/fingers moving.
Skin Core Use rubber gloves-Household/gardening/pets, guard skin against punctures or excessive pressure
use thimble when sewing.
Movement IExercise Exercise arm/hand every 15 minutes to avoid static position.
Don't carry heavy loads, carry handbag on other shoulder. Positioning Rest arm comfortably on armrest in sitting
Swollen leg
Clothes Avoid tight and constrictive clothing i.e. tight and narrow fitting underpants-use cotton and natural
fibres as allows skin to breathe.
Loose fitting trousers, boxer shorts with scrota! support, Lycra leggings-comfortable but care that they don't increase swelling lower down the leg
Tight elastic ankle cuff and socks may increase swelling Avoid clothes, which dig or rub against skin.
Footwear Comfortable and supportive shoes with laces or velcro straps or those which come up around the top of foot will provide additional support.
Shoes with thick and cushioned sole will minimize rebound effect of walking on hard pavement -use wooDy socks.
Wellies, firm boots for gardening/outdoors Slippers/light footwear indoors
Avoid prolonged use of runners as poor circulation of air.
Skin Care
Fungal agent e.g. mycil athlete
Toenoil care use of chiropodist
Avoid bare/stockinged feet due to increase risk of skin damage
Protective clothes if you have pets
Use rubber gloves to assist in putting on compression hosiery
If it is difficult for your stockings to stay up when wearing trousers over them, try wearing a large pair of tights over the compression stockings under the trousers to reduce fiction.
Movement/Exercise
Avoid prolonged standing, try marching on the spot.
Exercise and walk daily.
Positioning Rest with feet elevated on footstool
Compression Hosiery
Graduated external garment worn daily and only removed when going to bed at night.
Wash daily with soapy water and dried naturally.
It should be comfortable and snug fit around the limb
No loose pockets where fluid is allowed to collect
It should not cut into the limb at any point
Must be chosen to include all parts of the swollen limb i.e. swollen hand/fingers will need a mitten
Should not be allowed to crease (this forms a pressure point) or folded over at the top (produces a tourniquet effect)
Should be applied carefully distributing pressure evenly Hosiery last 4-6 months if two are supplied and worn alternatively
To achieve the correct size of garment it is important to be properly assessed and measured by the lymphoedema therapist.