Lymphoedema – Self care

Skin Care

To understand why skin care is important, we need to appreciate that our skin is the biggest organ in the body. Its continuous cover, with no breaks or dry skin; is the first line to defend our bodies from bacteria entering the layers beneath.

Lymphoedema of any kind predisposes the skin to dryness. This is due to the skin being stretched, undernourished and having reduced oil secretions. A prolonged period of lymphoedema can cause the tissue to become thickened, inelastic and fibrotic; reducing the effectiveness of the skin being the first line barrier to bacteria and any penetration of the skin. This could lead to infection and infection can increase lymphoedema and so the cycle can continue.

Cleanliness is essential to reduce the risk of infection and we recommend the skin is washed daily to reduce pathogens, contaminants and assist with natural skin exfoliation. Pay particular attention to skin folds and between fingers and toes. Soaps with a high alkaline pH can be harsh on the skin, making it dryer, so it is recommended a soap or soap substitute with a neutral pH is used with warm water and that fragile skin is patted dry rather than rubbed.

Moisturising the skin daily improves the skin hydration and provides a protective film. We recommend you moisturise at night to allow the emollient to absorb into your skin and prevent your compression garments becoming sticky and deteriorating. Application of garments is also easier if the emollient is absorbed into the skin overnight. Gently apply the cream and make sure the last stroke is smoothing down the direction of hair growth.

Daily observation of the skin is essential to look for signs of scratches, abrasions, or cuts. If found they should be treated promptly until the area heals. If the area changes, for example you develop a rash, there is increased swelling, redness or you develop flu like symptoms; you should seek medical support urgently as you may be suffering from an infection (cellulitis) and will need antibiotics promptly. Fungal infections are also common in lymphoedema and can also lead to cellulitis. It is important to see your GP if you develop athletes’ foot also known as tinea pedis to get the correct anti-fungal treatment.

Exercise and Healthy Eating

Exercise

One of the best ways of keeping you and your lymphatic system healthy is to be active. The lymphatic system does not have a pump, like the heart, so we need to help it along by using our large and small muscles. Any movement is better than none and there are activities to suit everyone.  Most importantly, this does not need to be vigorous exercise, indeed it can be short, regular periods of activity that can easily be built into you daily life. Any activity that involves moving, stretching, breathing more deeply is good.

The British Lymphology Society suggest finding 3 minutes to do an extra activity such as heel raises, leg, face, calf, or arm stretches – just while you are waiting for the kettle to boil or while the adverts are on the TV.

Remember, being active does not necessarily mean hitting the gym. You can keep yourself active with everyday activities such as gardening, walking the dog and remembering to move and stretch regularly throughout the day. However, there are many sports that are beneficial for people with lymphoedema, including swimming, water-based activities, yoga, pilates, Nordic pole walking and many more.

There are some particularly good chair-based exercises (see St Margaret’s lymphoedema exercises) for those who are restricted in their mobility, so everyone can increase their levels of activity.

Healthy eating

Eating a balanced diet is equally important for people who have lymphoedema, as being overweight can make the swelling worse.

Eating a healthy, balanced diet is an important part of maintaining good health and can help you feel your best. This means eating a wide variety of foods, in the right proportions and consuming the right amount of food and drink to achieve and maintain a healthy body weight.

If weight is not addressed, general movement becomes more difficult and uncomfortable and as a result, less exercise or activity is done. This in turn leads to more swelling – and it then becomes a vicious circle!

But eating more healthily is easier said than done! It can be so very confusing knowing what, or rather what not, to eat and drink. The NHS UK website is an easy place to start and gives clear and simple advice to follow. One of the recommendations is to follow the Eatwell Guide. You may find it difficult at first to follow the guide each day but if you try and adhere to the basic principles, even just once or twice a week, the process will become easier. Before you know it, you will be much more aware about the food you eat on a weekly basis and how this may or may not fit within a healthy, balanced diet.

Healthy eating + increased activity = healthier lifestyle