By: Karla Merola, LPTA, CLT
Healthy skin is appreciated for its cosmetic benefit, but its role in immune system function as the first barrier of defense, and vitamin D production should not be overlooked. Unfortunately, people diagnosed with lymphedema have an increased challenge maintaining a healthy skin barrier. Excessive swelling resulting in the overloading and slow damage of the lymphatic system is a hallmark sign of lymphedema. The high protein fluid retained under the skin results in a cascade of effects in the body systems, especially the integumentary system aka the skin. Typical skin changes and concerns include dry skin, hyperkeratosis (thickening of skin), papillomas (bumps in the skin), and increased risk of infection. As a result, extra care needs to be taken to maintain a healthy skin barrier.
Regular application of a slightly acidic lotion such as Eucerin is a must to address the drying effects of the protein rich swelling. Use of these types of lotions not only rehydrates the skin, but its slightly acidic formulation re-establishes the skins natural pH levels which deter microbe colonization. Make sure lotion is applied every day to clean skin.
Hyperkeratosis, and papillomas are signs of stage III lymphedema. While hyperkeratosis is of concern due to its negative cosmetic effects and reduction of skin elasticity, papillomas tend to weep and can be access points for microbial infection. These signs take months, if not years to occur, and can be avoided and corrected by adherence to lymphedema care regiment including manual lymphatic drainage, and use of appropriate bandaging or garments.
Excess fluid stresses the skin barrier by over-stretching it and results in increased chance of skin tears. Additionally, the protein rich fluid is a magnet for bacteria. Regular skin checks are therefore a must to avoid infection. Be especially careful around high moisture areas such as between toes, and groin area. Dry these areas well to avoid maceration. It is also critical to be on the look-out for cellulitis, which if left untreated can be life threatening. Cellulitis can begin as a small red spot, but spreads quickly and begin to look streaky. Look out for anything red, hot, and swollen, and make certain to seek medical attention as soon as possible.
It is important to recognize that skin integrity is negatively affected by lymphedema. However, good compliance with prescribed lymphedema management techniques makes healthy skin an achievable goal.
If you are struggling with lymphedema our Certified Lymphedema Therapists can help. Contact our office for an appointment.