11.Lymphedema and skincare
The outpatient service of lymph care in Kameda General Hospital aggressively provides a guidance of not only compression therapy and lymph drainage but also skincare.
The skin is said to be the biggest organ in the body, and protects the body from the environment outside the body. However, various factors may prevent function of the skin. One factor is "edema" caused by lymphedema. Edema causes expansion and thinning of the skin, leading to decreased defensive strength against extraneous stimulus. In conservation therapy for lymphedema, although skincare is likely to be overlooked, it is more important than we think.
Habituation of daily skincare is important.
The skin plays more various roles than we think. The important roles are barrier function of cuticle, bacteriostatic action, thermal modulation, and excretion. Because advanced edema caused by lymphedema decreases these functions of the skin, stimulus including bacteria or allergens that cannot usually intrude into the body are likely to enter into the body. Also, because accumulated lymph fluid with abundant nutrients frequently causes infections, cellulitis and lymphangitis may often occur as mentioned at the sixth column. Once infection occurs, lymphedema may be exacerbated. Therefore, it is important to incorporate skincare into daily life and to notice abnormality of the skin in daily care as early as possible.
Then, what should we do for skincare? As mentioned above, the skin becomes thick due to edema caused by lymphedema, resulting in decrease in its softness and increase in its hardness. In addition to that, because the skin cannot keep moisture, it becomes dry. Therefore, it is important to prevent dryness and to help the skin easily work by keeping the skin clean and maintaining moist environment.
Skin losing barrier function
To keep the skin clean
When you wash your body in a bath, how do you do this? Many people feel that washing one's body with a nylon scrub body-towel is comfortable because of decreased itching. However, such the way to wash the body does not remove dirt, and only hurts the skin.
Then, what is the best way to wash the body? It is recommended to make a lather with a body-soap or a soap that is usually used and to wash the body with hands. The reason is that dirt is absorbed in many dents on the surface of a lather. Although you feel such a way to wash the body is insufficient, dirt is actually removed, and barrier function is maintained because the skin is not damaged beyond necessity. Many convenient products to make a lather are currently marketed.
You should use a body-soap or a soap with neutral to mild acidity that is similar with that of the skin. If you use such a soap, you do not lose barrier function of the skin beyond necessity.
To maintain moisture environment
Various skincare goods to maintain moisture environment are currently marketed. If you want the goods that easily apply to the skin and you are nervous about sticky feeling after use, soft products of lotion-type or gel-type are recommended. If your skin is very dry, cream-type products are recommended. Also, there is a way in which cream-type or oil-type products are additionally applied to cover the surface of the skin after lotion-type products are applied to the skin. Moisture lotion should be applied to the skin about 15 minuets after taking a bath.
For persons who currently use elastic clothing, because wearing elastic clothing immediately after moisturizing may weaken fiber, leading to decrease in necessary compression, it is recommended to wear elastic clothing after a while.
Points to apply a moisturizing agent
- Apply the agent within 15 minuets after taking a bath (or after touching water).
Applying the agent as early as possible after taking a bath is expected to have an effect not to miss moisture inside cuticle.
- Gently spread the agent into a thin layer throughout the skin.
Avoid to physically stimulate the skin on applying the agent.
- Apply a proper amount of the agent.
A standard amount for the hands of adult is 0.5 g (from fingertip to the first joint of a finger in a tube-type agent, 1-yen coin size in a lotion-type agent).
Caution in skincare
Because excessive skincare may cause inflammation, caution is needed. If abnormalities occur on the skin, you should visit your primary doctor or at the department dermatology without your own judgement. In lymphedema, the skin is sensitive because of the conditions subject to stimulation. Because there are products that do not match with your skin, you should carefully select products. As for products for lymphedema patients, please ask doctors or nurses at your visit.