Preventing Lymphedema





Most experts say following these basic guidelines lower your risk of developing lymphedema or delay its onset.

Try to avoid infection

Your body responds to infection by making extra fluid to fight the infection. Removal of or damage to lymph nodes and vessels makes it harder to move this extra fluid, and this can trigger lymphedema. Good hygiene and careful skin care may reduce the risk of lymphedema by helping you avoid infections. Follow these tips to help you care for the hand and arm on the side of your body that had surgery:

Whenever possible, have your blood drawn, IVs, and shots given in your unaffected arm. Also have flu shots and vaccinations in your unaffected arm or somewhere else, like the hip. Tell your doctor or nurse that you are at risk for lymphedema and wear a medic alert bracelet.




Keep your hands and cuticles soft and moist by regularly using moisturizing lotion or cream. This will help keep your skin from chapping and cracking. Push your cuticles back with a cuticle stick rather than cutting them with scissors. Keep your arm clean. Clean and protect any skin openings caused by cuts, scratches, insect bites, hangnails, or torn cuticles. First, wash it with soap and water. Then use an over-the-counter antibiotic cream or ointment and cover the area with a clean bandage. Keep your arm clean. Clean and protect any skin openings caused by cuts, scratches, insect bites, hangnails, or torn cuticles. First, wash it with soap and water. Then use an over-the-counter antibiotic cream or ointment and cover the area with a clean bandage. Check with your doctor, nurse, or pharmacist if you are not sure what to use.



Wear protective gloves when doing household chores that use chemical cleansers or steel wool, when gardening or doing yard work, and maybe when washing dishes




Wear a thimble when sewing to avoid needle and pin pricks to your finger



Use an electric shaver to remove underarm hair; it may be less likely to cut or irritate the skin than a blade razor or hair removal cream.




Use an insect repellent to avoid bug bites when outdoors. If you are stung by a bee in the affected arm, clean and put ice on the area, raise the arm, and call your doctor or nurse if the sting shows any signs of getting infected.




Avoid extreme cold. It can cause rebound swelling as you warm up and chapping of your skin, which may lead to infection.




Try to avoid burns. Like infections, burns can cause the body to make extra fluid that may build up and cause swelling when lymph nodes have been removed or damaged. Tips to avoid burns include:

Protect your chest, shoulder, and arm from sunburn. Use sunscreen labeled SPF 15 or higher and try to stay out of the sun during the hottest part of the day. Use oven mitts that cover your arms. Avoid oil splash burns from frying and steam burns from microwaved foods or boiling liquids. Avoid high heat, such as from hot tubs and saunas. And do not use heating pads on the affected areas. Heat can increase fluid build-up.



Avoid constriction or squeezing of the arm may increase the pressure in nearby blood vessels. This may lead to increased fluid and swelling (much like water building up behind a dam). Some women have linked this with the start of lymphedema. Lymphedema has also been linked with air travel, possibly because of the low cabin pressure. Tips include:

Wear loose jewelry, clothing, and gloves. Avoid anything that forms a snug band around your arm or wrist. Do not use shoulder straps when carrying briefcases and purses. Wear a loose-fitting bra with padded straps that do not dig into your shoulder. After mastectomy, use a lightweight prosthesis (breast form). A heavy prosthesis may put too much pressure on the area. Do not have your blood pressure taken on the affected arm. If both arms are affected, blood pressure can be taken on your thigh. On long or frequent flights, wear a compression sleeve. A well-fitted compression sleeve may help prevent swelling by helping to squeeze the lymph fluid through the remaining vessels before it builds up. But careful fitting is required, since any garment that is too tight near the top can actually reduce the lymph flow. Ask your doctor or physical therapist if you should be fitted for a sleeve to wear during air travel. You may also want to discuss ways to safely raise your arm above the level of your heart and exercise it during long flights.



Exercise and Avoid Muscle Strain

It's important to use your affected arm for normal everyday activities to help you to heal properly and regain strength. This includes doing things like brushing your hair and bathing. Using your muscles also helps drain lymph fluid from the limbs. If you’ve had surgery or radiation treatment, ask your doctor or nurse when you can begin to exercise and what type of exercises you can do. But keep in mind that overuse, which can result in injury, has been linked with the start of lymphedema in some women. It's a good idea to follow these tips:

Use your affected arm as normally as you can. Once you are fully healed, about 4 to 6 weeks after surgery or radiation treatment, you can begin to go back to the activities you did before your surgery.

Exercise regularly but try not to over-tire your shoulder and arm. Before doing any strenuous exercise, such as lifting weights or playing tennis, talk with your doctor, nurse, or physical therapist. They can help you set goals and limits so that you can work at the level of activity that is right for you. Ask your doctor or physical therapist if you should be fitted for a sleeve to wear during strenuous activities. If your arm starts to ache, lie down and raise it above the level of your heart. Avoid vigorous, repeated activities, heavy lifting, or pulling. Use your unaffected arm or both arms as much as possible to carry heavy packages, groceries, handbags, or children.



Try to avoid gaining weight

Extra fat requires more blood vessels. This creates more fluid in the arms and chest, and places a greater burden on the lymph vessels that are left. At least 2 studies have found that gaining weight after mastectomy is linked to a higher risk of lymphedema. Women who are more overweight (obese) were more likely to have severe lymphedema.


Caring for cuts, scratches, or burns

Wash the area with soap and water. Put an antibiotic cream or ointment on the area. Cover with a clean, dry gauze or bandage. For burns, apply a cold pack or cold water for 15 minutes, then wash with soap and water and put on a clean, dry dressing. Watch for early signs of infection: pus, rash, red blotches, swelling, increased heat, tenderness, chills, or fever. Call your doctor right away if you think you may have an infection.



How to care for cuts, scratches, or burns

Wash the area with soap and water. Put an antibiotic cream or ointment on the area. Cover with a clean, dry gauze or bandage. For burns, apply a cold pack or cold water for 15 minutes, then wash with soap and water and put on a clean, dry dressing. Watch for early signs of infection: pus, rash, red blotches, swelling, increased heat, tenderness, chills, or fever. Call your doctor right away if you think you may have an infection.



When to call your doctor or nurse

if you notice any swelling, with or without pain, that lasts for 1 to 2 weeks

if any part of your affected arm, chest, breast, or underarm area (axilla) feels hot, looks red, or swells suddenly. These could be a sign of infection and you may need antibiotics

if you have a temperature of 100.5°F or higher (taken by mouth) that is not related to a cold or flu

if you have any new pain in the affected area with no known cause



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