Insect bites, scratches cause lymphedema?


Question from Jenny: I am at risk for developing lymphedema, and have read that I must avoid insect bites and scratches and cuts on my arm. However, the surgeon who performed my mastectomy said people no longer worried about that and that he would use blood pressure cuffs.
Answers - Maria Theodoulou, M.D. Any patient who's had a lymph node dissection may be at risk of lymphedema. Insect bites do not necessarily cause lymphedema unless they become infected. If you do scratch or break the skin around an insect bite, or even if your pet scratches you, it doesn't necessarily mean you're going to develop it. Just examine the skin and make sure it doesn't become infected. If the area that has been scratched or stung starts to look red and swollen, then see your physician immediately to get an antibiotic to prevent infection It can also prevent the occurrence of lymphedema down the line.

Any stress to the area can put a patient at risk, but we worry more about bigger stresses than small ones, like a scratch. We avoid blood pressure cuffs, not because of the procedure itself but because of the risk of the cuff being left on too long with excessive pressure. That increased stress can cause some future problems. You should not be blackmailed by fear of what might happen and worry about the everyday risk of developing the swelling of the arm. Pay attention to your arm, to cuts and scratches. Jump on any infections quickly with your doctor. If you use appropriate treatments in a timely fashion, most lymphedema can be avoided.
Marisa Weiss, M.D. As Dr. Theodoulou has said, your skin is your best friend against infection. Using a regular moisturizer to keep the skin supple, so it doesn't crack, is a good idea. I have some patients who have a nervous habit of picking the skin around their fingers. This is something you have to really control. Just wearing a cotton glove for a few hours a day may be able to help you break that habit. Avoid biting your nails as well as the skin around the finger-bed. Wear sunscreen in the summer and avoiding sunburn on the arm of the affected side is important. Sunburn to any part of the body is not considered healthy.
Maria Theodoulou, M.D. It's important that the skin under the lymphedema pressure sleeve is checked frequently to make sure there hasn't been a breakdown of the skin. Even during cool weather, that arm skin should be checked on a regular basis to make sure we are not ignoring a potential area of infection.

On Wednesday, June 1, 2005, our Ask-the-Expert Online Conference was called Summertime Issues: Treatment and Personal CareMaria Theodoulou, M.D., Tamara Shulman, Ph.D., and moderator Marisa Weiss, M.D. answered your questions about the various summertime issues that relate to breast cancer treatment and personal care.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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