Skin care protocol: suggesting a routine

Skin care remains a fundamental part of care for those with lymphoedema. This can either be done by the individuals themselves, or, in certain circumstances, can be therapist-led. The British Lymphology Society (BLS) have advocated the importance of good skin care as far back as 2001 (BLS, 2001). They have historically classed it as one of the ‘four cornerstones of care’. However, there remains little in the way of evidence-based advice that can promote a minimum standard of care.

When discussing the importance of skin care for patients with lymphoedema, it is essential to remind ourselves what the skin does and how it relates to the lymphatics. Many diagrams of the skin do not include the lymphatics; therefore, it is not always clear how one has an impact on the other, and vice-versa. Figure 1 shows how the superficial lymphatics appear in a cross-sectional diagram. The proximity and position of these in relation to the other structures offers some explanation as to why there are interactions.