Standard Treatment of Lymphedema--Skin and Nail Care

Two words summarize all the risk reduction practices and make them easy to remember: "Promote" and "Protect." That means you will promote the lymph flow in your affected arm/chest or other affected area, and protect the area from injury or infection.

(Please see the article written by Dr. Mei Fu and published in the Wounds International Preventing skin breakdown in lymphoedema › Practice development › Wounds International, Vol 1; Issue 4 › Wounds International regarding skin care, or see or print a copy of the article in pdf format here.) 

Prevent infection

• Keep the skin clean and dry thoroughly after washing.  Wash gently, and thoroughly, with warm water. To minimize the danger of spreading infection, never share a washcloth or towel with someone else. Ideally a clean washcloth should be used each time you bathe.  We recommend cleansing the skin with:

   

  • Basis Sensitive Skin Bar formulated to be both preservative and fragrance-free, eliminating up to 94% of allergic reactions to skin care products. It provides gentle, thorough, non-drying cleansing for all skin types. No harsh ingredients. No dyes or perfumes.

  • pHisoderm 100% fragrance free formula cleans thoroughly, removing dirt and oil. Special emollients leave skin feeling soft and smooth, not tight and dry.

   

• Keep your arm pits and the area under your breasts clean and dry to avoid fungal infection

• Keep your skin intact--inspect daily for any cracks or scratches and breaks in the skin 

• Moisturize your skin daily using a low pH moisturizing lotion to prevent microscopic cracks and prevent chapping or chafing of the skin--here are some recommended lotions:

• Lymphoderm which is a lotion designed specifically for lymphedema skin care.

• Vanicream which contains no parabens, lanolin, it's frequently used by dermatologists as a base for creating lotions. Very non-irritating.

• Eucerin Lotion is the #1 choice of physicians and pharmacists for treating dry, sensitive skin. Eucerin is effective and safe in the treatment of dry skin associated with lymphedema. It helps alleviate dryness and cracking that can lead to infection and possesses a low pH which is useful when skin infection is a concern.

• Elta Lite cream melts on contact, penetrating skin cell layers to provide superior long term moisturizing.

• Keep nails clean, and avoid cutting cuticles
• Use a soft nail brush to thoroughly clean under your fingernails throughout the day
• Use sunscreen or protective clothing to prevent sunburn--compression garments do not protect against the sun
• Use an insect repellent on any exposed skin
• Avoid razor nicks and burns--See Shaving Under Our Arms
• Wear rubber gloves when handling household cleansers and other chemicals
• Wear rubber gloves when washing dishes
• Wear sturdy work gloves when gardening or using tools
• Wear a thimble when sewing to avoid needle and pin pricks to your finger
• Use extra caution when cooking to avoid burns
• Avoid skin punctures from IVs, injections, and blood tests
• Discuss with your doctor the use of prophylactic oral antibiotics with any medical procedure that involves the affected parts of your body
• Don't forget your feet!  Keep them clean and dry and avoid athlete's foot.  You don't want to touch your feet or toes and then bring that fungus up to your hands and arms!  Check them frequently for any red cracks or other signs of fungal infection.  If in doubt, treat your feet with an anti-fungal cream or spray.
 

In case of nicks, scratches, burns, insect bites, abrasions or any skin break, wash the area well and apply a topical antibiotic. Watch for redness, itching, sudden swelling, warmth to the touch, rash, or fever, which may indicate an infection, and get medical help promptly.

Manicures Regular Manicures We can continue to get regular manicures.  We simply must take certain precautions.  It is always better to take your own manicure "tools" with you, and most salons give you a little "box" to keep them in at the shop. Do not allow your cuticles to be cut, but have them gently pushed back. Keep your hands well moisturized between manicures, and gently push your softened cuticles back gently with an orange stick. When coming home from your manicure be sure to give your fingers an "alcohol dip" to make sure they are germ free, and I also cream my hands with Lotromin (anti-fungal cream) in case I could have picked up any fungus. Also, we find the longer you keep your nails, the more little "shovels" you have for bacteria, germs, etc.  So, we always keep a nail brush near the anti-bacterial soap and wash and brush under the nails frequently throughout the day. Gel Nails/Acrylic nails We can even continue to use acrylic or gel nails at our manicures.  But we must take certain precautions to protect ourselves from infection. I personally used to get acrylic nails, but stopped that during chemo,  I then found after chemo that taking all the supplements I do and the Arimidex (one good thing about it) made my nails "hard as nails," as they say. So now, I have a thin layer of UV gel put over my own nails after the "white" being painted on.  There are much less chemicals involved in the gel then the acrylic or powder, and you need to put your nails under a special UV light to get them to "cure" (harden.) I bring my own tools and files and pedicure equipment, and my salon gives everyone a little "box" to keep their stuff in.  They also autoclave all of their equipment so if you don't have your own, they break out the equipment from a little plastic bag where it has been sealed after being autoclaved, same as at the dentist. I usually wait three weeks before having the "fill-ins" which leaves enough space near the cuticle so they can stay far away from it with the dremmel.  I also have my own dremmel heads in my box, the fat round one and the skinny fine one.  I have been using the same lady, and have explained to her my problem that I do not want my cuticles cut, and that she must be very careful with the dremmel or she will never see me again. Afterwards, she sprays my hands thoroughly with Sea Breeze, and when I get home, I give them an "alcohol dip" to make sure they are germ free, and I also cream my hands with Lotromin (anti-fungal cream)  and my feet with it also after pedicures, in case I could have picked up any fungus. So far I have not had any problems, knock on wood.  But I think taking the extra precautions if you want to continue to have your nails done is well worth it. The UV gel is a little more expensive, but it is much "smoother" after being under the UV light, so many times she can do without the dremmel altogether and just use a nail file or one of those square buffing things to smooth them before finishing. Also, we find the longer you keep your nails, the more little "shovels" you have for bacteria, germs, etc.  So, we always keep a nail brush near the anti-bacterial soap and wash and brush under the nails frequently throughout the day.  OneBadBoob

Page Last Modified 09/29/2015

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