Lymphedema is a chronic condition that causes swelling in a limb or other part of the body, typically due to a disruption in the lymphatic system. This condition often occurs after trauma or treatments such as surgery, chemotherapy, or radiation, particularly in breast cancer patients. These treatments can damage or remove lymph nodes, impairing the body’s ability to drain lymphatic fluid.
While lymphedema is chronic, careful management of symptoms can slow or halt its progression. Common treatments include manual lymphatic drainage (MLD), compression garments, exercise, and weight control. However, people with lymphedema are also at an increased risk of developing certain skin conditions. Here, we'll highlight these skin concerns and offer tips on how to prevent or treat them effectively.
Lymphedema Cellulitis
Lymphedema cellulitis is a bacterial skin infection that can occur when lymphedema is poorly managed. Cellulitis affects the deeper layers of the skin and can spread to the underlying soft tissues.
Symptoms include:
- Redness and warmth in the affected area
- Increased swelling
- Pain and tenderness
If left untreated, cellulitis can spread and become a serious condition, leading to sepsis (a potentially life-threatening immune response). It's crucial to seek medical help immediately if these symptoms appear. Early treatment typically involves antibiotics, rest, and elevation of the affected limb.
Lymphedema Infections
The swelling from lymphedema often leads to skin folds, particularly in areas like the groin or between the toes. These folds can trap moisture, creating an environment that fosters fungal infections.
Prevention Tips:
- Keep affected areas clean and dry.
- Apply a barrier cream (such as a dimethicone or zinc-based cream) to protect the skin from excess moisture.
- Use antifungal creams if a fungal infection develops.
Lymphedema patients should practice vigilant skincare, including the use of specialized products like Lymphoderm Bathing Solution and Elite Therapeutics Body Creme, available from Lymphedema Products, to maintain proper skin hygiene.
Erysipelas
Erysipelas is a bacterial infection that affects the upper layers of the skin and superficial lymphatic vessels, most often caused by beta-hemolytic streptococcus (strep). While strep is commonly associated with throat infections, it can also invade the skin, particularly in individuals with lymphedema.
Symptoms include:
- Bright red, swollen, and warm skin
- A clear demarcation between affected and unaffected skin
- Fever and chills
Immediate medical attention is required to treat this condition, which typically involves antibiotics.
Lymphangitis
Lymphangitis occurs when bacteria infect the lymphatic vessels themselves, often entering through a small cut, abrasion, or break in the skin. This infection can progress rapidly, and it is marked by the appearance of red streaks extending from the site of infection.
If you notice any streaks or feel intense pain, seek medical treatment promptly. Lymphangitis can be treated effectively with antibiotics if caught early.
Contact Dermatitis
Contact dermatitis is an allergic reaction that occurs when the skin comes into contact with certain irritants or allergens. In the context of lymphedema, it may occur beneath compression garments or wrappings.
Prevention:
- Apply a barrier lotion, such as one containing dimethicone, before putting on compression garments.
- Use hypoallergenic and breathable materials for your compression wear.
Lymphedema Rubra
Often mistaken for cellulitis, lymphedema rubra is characterized by red, inflamed skin. However, it is not caused by an infection, but rather by the release of histamine, a protein involved in allergic reactions.
Since it mimics cellulitis, rubra can be misleading. While it won’t respond to antibiotics, it’s important to note that this condition signifies inflammation, which could lead to tissue fibrosis over time. Improving lymphedema management may help reduce symptoms.
Intertrigo
Intertrigo is a condition where the skin becomes discolored and irritated, typically in moist areas such as skin folds. This irritation can lead to fungal or bacterial infections if left untreated.
Prevention:
- Keep the skin dry by washing and drying thoroughly.
- Apply barrier creams to reduce moisture buildup in skin folds.
Folliculitis
Folliculitis is the inflammation or infection of hair follicles, leading to the development of small red bumps around the follicles. Lymphedema patients are more prone to this condition due to the changes in skin health.
Prevention:
- Maintain meticulous hygiene in areas with hair follicles.
- Keep the skin dry and use barrier lotions if necessary.
Comments
Thank you. This essay was very helpful and one I will probably return to in the future.
So happy to have seen this information. I would be happy to continue with all new information on Lymphedema of legs
Thank you very much and most appreciated.
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I was diagnosed with venous insufficiency lymphedema and wear compression stockings and have lymphedema machine to compress. Luckily I don’t have any skin issues. Sometimes I feel heavy in the chest. What else can you recommend?
Ok I just read your message, I have been wondering why I fell heavy and swollen in my chest and my left leg is heavy and past couple days my skin in the calf feel irritated I tried to take pictures but bit is hard being a widow.. thank You for your info I have a appt with the DERMONOLOGY Specialist this week I Hope She Is Knowledgeable so hard to find doctors to know or even try to help patients with LYMPHEDEMA 01 January 2022
Can you send me up to date information on lymphedema for my leg? I am having a lot of trouble with garments, due to the swelling is in my left groin as well, what are the best creams/moisturizer to use.
I’m going through the exact same thing. My groin area starts swelling when I am driving. My dermatologist prescribed Triamcinolone Acetonide Cream & same thing in Ointment USP, 0.1%. She also showed me how to gently wrap my legs with what is considered a skin cast. The cream & the ointment are prescriptions. I use the cream during the day & if my skin is severely dry or I’ve scratched a skin bump & caused it to turn into a sore, then I have rolls of Calamine, gauze & the self adhering flesh colored wrap in rolls to do a skin cast on my legs, after putting a thick covering of the ointment Triamcinolone Acetonide on my legs. The steps are ointment, Calamine wrap, gauze wrap & self adhering flesh color wrap. You don’t wrap tightly because we swell, but not sloppy loose either. You wrap each layer overlapping the edges as you work from the knee down, or from the thigh to above the knee. I hope this is helpful to you. Your doctor can prescribe the cream & ointment of the product I mentioned. I buy everything for the skin casts on Amazon or my dermatologists sends me home with a bag of supplies.
who is best to see for diagnosis and treatment – dermatologist, vascular clinican, PCP, rheumatologist, who???
treatments described above sound expensive. is treatment covered by medicare?
how does this affect the auto-immune system?
Can lymphedema cause skin infections in your face
Great descriptions. Very helpful.
Linda
I have been diagnosed with Lymphedema and cellutis. I am having skin issues. Since my outbreak in Feb my skin has peeled several times and continues to flake off. I look like Ihave full body dandruff.
Does this eventually subside?? Go away??