Dos and Don’ts for Lymphedema of the Leg

Certain activities may trigger the onset of lymphedema or may exacerbate the symptoms of existing lymphedema. Individuals affected by lymphedema and those at risk for developing it (everyone who has undergone lymph node excision and/or radiation treatments) should observe the following precautions. The “Dos” and “Don’ts” below are based on decades of experience and knowledge of clinical experts in lymphedema management.

Skin Care

• Keep your skin meticulously clean and check frequently for any cracks, fungal infections or rashes
• Moisturize your skin daily, especially after taking a shower or bath. Use appropriate ointments or lotions
• Dry your skin thoroughly with a soft towel after taking a shower or bath; do not scrub
• If you undergo radiation therapy apply the ointments recommended by your physician to any radiation redness on your skin and avoid direct exposure to sunlight
• Avoid cosmetics that irritate the skin

Clothing – Jewelry – Compression Stocking

• Avoid clothing that is too tight, such as underwear, socks or stockings that restrict
• Do not wear tight jewelry and avoid elastic bands around your ankle
• Wear your compression stocking or pantyhose all day, and if necessary, apply your bandages at night. Use rubber gloves when you put on your compression garment. See your therapist at least every six months (or sooner) to check the condition of the garment.

Avoid any Injuries to the Skin

• Shaving: use an electric razor to remove hair from the leg or abdominal area; do not use razor blades
• Nail care: you should keep your toenails short but be careful cutting your toenails, do not cut the cuticles
• Pets: be careful playing with your pets (scratches)
• Mosquito bites: wear insect repellants, avoid mosquito infested areas
• Injections: injections and blood draws on the swollen leg (or the leg at risk), in the buttocks on the affected side, or the abdominal area should be avoided whenever possible.
• To take care of minor injuries, always carry an alcohol swab, local antibiotic and a band aid with you
• Do not walk barefoot and wear solid shoes to avoid ankle injuries
• No piercing or tattoos on the leg or the abdominal area

Avoid Heat

• Avoid hot showers
• Avoid hot packs and/or ice packs on your leg, or the leg at risk
• Avoid saunas, hot tubs and whirlpools. Do not sit too close to a fireplace
• Avoid traditional massage on the leg and the lumbar area. Note: Manual lymph drainage is not considered to be a form of massage
• Avoid sunburn – while in the sun, use sunscreen, cover the leg with appropriate clothing or a dry towel

Exercises

• Discuss proper exercises and activities with your therapist
• Avoid movements that overstrain. Should you experience discomfort in your leg, reduce the exercise activity and elevate your leg
• Elevate your leg as often as possible

Nutrition

• Obesity may have a negative effect on your swelling; maintain your ideal body weight
• There is no special diet for lymphedema; keep your diet well balanced. Most nutritionists recommend a low-salt and low-fat diet, high in fiber
• Eating too little protein in the hope to have a positive effect on lymphedema (high-protein edema) is not recommended and may cause serious health problems. Reducing the protein intake will not reduce the protein component in lymphedema

Travel

• Avoid mosquito-infested regions
• Wear an additional bandage or stocking on top of your compression garment when traveling by car, train or air. Incorporate frequent stops, or get up from your seat frequently, elevate your leg(s) as often as possible

See your doctor if you:

• Have any signs of an infection, such as fever, chills, red and hot skin
• Notice any itching, rash, fungal infections, or any other unusual changes on the skin
• Experience pain, or an increase in swelling in your toes, foot, leg or lower body quadrant

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