Other Treatments
Lipoedema symptoms can be managed using a variety of techniques and therapies ranging from specialist massage to skincare.
MLD is a specialist form of massage and skin stretching that is used to stimulate lymphatic flow, thus helping reduce oedema (fluid build-up). It should only be performed by specially trained therapists, so it’s essential to check qualifications before embarking on a course of treatment. In Lipoedema, there is not always a significant accumulation of fluid, but many women report that MLD helps to reduce pain and heaviness, and this therapy is also often recommended pre- and post-liposuction treatment. If oedema is present as well as Lipoedema, MLD is best used in conjunction with compression hosiery.
Self-Lymphatic Drainage (SLD) is a simplified version of MLD, and can be undertaken at home. It is often demonstrated and taught by a specialist clinic/therapist.
For further details and a list of registered MLD practitioners, contact MLDUK.
IPC provides a mechanical massage using air-driven pumps and comfortable, inflatable garments that are used over affected areas. Pneumatic compression devices provide pain reduction and may provide better control of swelling than self-manual lymphatic drainage. The use of IPC devices and early mobilisation can reduce the risk of deep venous thrombosis following liposuction – but should be discussed with the individual surgeon if part of a post-operative plan.
Individuals may purchase their own device to use at home under careful supervision – but caution is required and careful assessment should be carried out before they are initiated to prevent further problems. Not all individuals with Lipoedema can tolerate them, especially if pain/tenderness of the limbs is a particular problem. However, for some people, pressures in the new multi-chamber systems can be lowered sufficiently to ensure comfort and improvement in symptoms.
Skincare is an important part of Lipoedema management. Skin needs adequate moisture to function properly. It should be kept clean and well hydrated with the use of a daily moisturiser, and by drinking adequate water/fluids to prevent it drying out.
Dry, cracked and sore skin has an increased risk of infections such as cellulitis or fungal infections. Moisturisers can be bought over the counter at a pharmacy, but if skin is very dry and flaky, see your GP. Moisturiser may be applied at any time, but for people 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 toenails, and also in any skin creases or skin folds, such as the backs of knees, the groin area or under breasts. Symptoms of a fungal infection 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. A GP or pharmacist can prescribe an appropriate antifungal treatment. Fungal infections can be spread to other people, so it’s important to wash clothes, bedding and towels often. Take care to use a cotton-wool bud to apply treatment, and wash hands after applying antifungal cream.
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 risk of developing cellulitis. Be mindful that cold weather can also dry our skin – so applying moisturiser and avoiding dehydration in winter is important, too.
Cellulitis is a sudden, non-contagious bacterial infection of the skin, characterised by redness, swelling and heat accompanied by pain and tenderness. It 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 in people with a history of previous episodes. The risks are greater in Lipoedema with secondary lymphoedema, because when the lymphatic system is compromised, the risk of infection and developing cellulitis is higher than normal.
If an area of skin or limb becomes red, develops a rash and becomes hot and/or painful, it is very important that medical advice is sought as this may be an indication of cellulitis. 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 is a risk of developing sepsis, a more serious systemic infection. Repeat infections should be discussed with your GP, as prophylactic doses may be indicated.
For further advice, see the guidelines on the British Lymphology Society website.