Skincare Advice for People living with Lipoedema

Skincare is an important part of lipoedema management. Skin needs adequate moisture to function properly.  Keep skin clean and well hydrated with the use of a daily moisturiser and drinking adequate water/fluids to prevent skin drying out, cracking and getting sore which can lead to an increased risk of infection.

This will minimise the risk of developing any skin infections such as cellulitis or a fungal infection. Moisturisers can be bought over the counter at a pharmacy or if skin is very dry and flaky it would be best to have this prescribed by a GP. Moisturiser may be applied at any time but if wearing compression garments it may be best to apply cream at night following removal of garments.

Fungal infections are prone to develop in between the toes or on the nails on the feet and also in any skin creases or skin folds, such as at the backs of knees, groin area or under breasts. Symptoms of a fungal infection can vary, and a rash can be dry or moist and itchy or very red, sore, and sometimes with pustules. Sometimes toenails can become dry and brittle. The GP or Pharmacist can prescribe an appropriate anti-fungal treatment. Fungal infections can be spread to other people so it’s important to wash clothes, bedding and towels often and to take care to use a cotton wool bud to apply treatment and wash hands after applying antifungal cream. 

Summer and Winter Skincare

A high factor sunscreen should be applied and will help to protect the skin from sun damage – which could lead to blistering and infections. Also an insect repellent in the summer can help prevent bites and scratching which could increase the risks of developing cellulitis. Be mindful that cold weather can also dry our skin – so applying moisturiser and avioiding dehydration in winter is important too.

Cellulitis 

Cellulitis is a sudden, non-contagious infection of the skin, characterised by redness, swelling and heat accompanied by pain and tenderness.

This can be caused by a cut or bite or by other skin conditions, such as very dry skin, eczema, psoriasis or ulceration. Sometimes however, cellulitis can happen spontaneously especially if there is a history of previous an episodes. The risks are greater in lipoedema with secondary lymphoedema because when the lymphatic system is compromised the risks of infection and developing cellulitis are higher than normal. 

If an area of skin or limb becomes red, develops a rash, becomes hot and or painful, then it is very important that medical advice is sought as this may be an indication of cellulitis, which is a bacterial infection of the skin. Cellulitis can also present as flu-like symptoms such as a high temperature, tiredness and general aches and pains.

If you think that you may have cellulitis it Is important to seek medical advice as soon as possible – do not delay. The treatment is oral antibiotics for two weeks or in some cases intravenous antibiotics. If left untreated there are risks of developing sepsis, a more serious systemic infection. 

The British Lymphology Society have produced an updated (2022) Cellulitis advice document. Repeated infections should be discussed with the GP – prophylactic doses may be indicated. 
The cellulitis consensus document – https://www.thebls.com/documents-library/guidelines-on-the-management-of-cellulitis-in-lymphoedema