Maintaining Healthy Skin

INTRODUCTION

An essential part of the daily self-care routine to be performed by the patient or caregiver at home is the proper care of the skin, nails and feet. The routines are simple -- but very important!

HEALTHY SKIN

• Healthy and intact skin, that is free of any breaks, is the body’s primary line of defense against invading bacteria that cause infections.
• The health of the skin is protected by the acid mantle which is created by oil from the sebaceous glands and water from sweat glands. The purpose of the acid mantle is to slow the growth of harmful bacteria and fungi on the skin.
• The acid mantle is easily disrupted by the swelling of lymphedema as it stretches the skin.
• Washing with harsh soaps, exposure to the sun, wind, cold, and harsh weather are also destructive of the acid mantle.

Untreated lymphedema hardens and forms deep folds. © Lymph Notes

DISRUPTION OF THE SKIN

Lymphedema swelling can stretch the pores of skin and allow bacteria to enter. It may also allow lymph to leak out. 

• Any scrape, cut, or break in the skin allows bacteria to entering the tissues and can quickly cause an infection.
• Once in the tissues, bacteria thrive on the stagnant protein-rich lymph that causes the swelling of lymphedema. Here bacteria can thrive and can cause an infection that can spread quickly.
• In Stage 2 and Stage 3 lmphedema, becomes thicker, scaly, and forms folds that increases the risk of infection. These folds become deeper they form warm, dark, and damp areas that are ideal breeding grounds for fungal infections that are very destructive to the skin.

DAILY SKIN CARE 

• Examine the affected skin thoroughly each day looking for changes such as cracks, a rash, or signs of a developing infection.
• Use only a mild emollient soap. (Emollients are substances that soften and soothe the skin. They are also used to correct dryness and scaling of the skin.) Using a soap containing an emollient, such as lanolin or aloe, helps to restore natural oils by creating a barrier on the skin's surface.
• For an older patient or a diabetic with particularly fragile skin should use only soaps and lotions that are designed specifically for this purpose. An example of such a product is  Theraplex Emollient for severely dry skin. 
• Wash the tissues gently, and thoroughly, with warm (not hot) water.
• To minimize the danger of spreading infection, never share a washcloth or towel with someone else. Also use a clean washcloth each time you bathe.
• Remove all soap by thoroughly and gently rinsing the tissues. Soap  left behind will cause the skin to dry
• To dry the skin, gently pat it and take particular care to dry within the skin folds. A hair dryer on a very low setting can be used to dry awkward areas or between folds. However, never use the hair dryer on high heat!
• Moisturize the skin thoroughly using a low pH moisturizing lotion. This helps to restore some of the normal protective acid mantel. Moisturizing also helps the skin retain the elasticity that helps to avoid cracks/breaks.
• Protect against sunburn. Lymphedema affected skin is particularly sensitive to the sun and a compression garment does not protect it from the UV rays.

REFERENCES

• Sebum, Sweat, Skin pH and Acid Mantle [www.smartskincare.com/skinbiology/sebum.html]
• Living Well with Lymphedema by A. Ehrlich, A. Harrewijn PT, CLT-LANA, and E. McMahon PhD. Lymph Notes. 2005.
• The Lymphatic System by B. Lasinski MA, PT, CLT-LANA. Chapter 12 in Pathology: Implications for the Physical Therapist 2-E by C.C. Goodman, W.G. Boissonnault, and K.S. Fuller. Saunders, 2003.
• Mayo Clinic Newsletter Vol 7, Issue 3.
• Lymphedema Caregiver's Guide by M.K. Kearse, PT, CLT-LANA, E. McMahon PhD, and A. Ehrlich MA. Lymph Notes 2009.

© LymphNotes 2010. This information does not replace the advice of a qualified health care professional.

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Category: Self-Care for Lymphedema Updated: 2012-07-12