Skin crease on toes

[JohnS35]

Hi All,

I'm 35, with lymphedema of the arms and legs. I wear compression which is managing the swelling quite well and I'm generally ok.

I've developed some swelling on the feet and got foot caps coming to manage this. It's not severe swelling and current shoes fit fine with no pain etc and the swelling goes down with elevation (so hopefully the right compression would reduce this etc). However, I've noticed that on the base of the second toe there is a skin crease that is more "pronounced" and darker. There's no infection or cellulitis.

Can someone explain what this means/implies? This should be mitigated with the foot caps from any progression of the swelling but would be nice to understand what these changes mean.

[Lynora]

Can you apply self lymphatic drainage techniques to your feet? Massaging into the skin of the top of the foot and the base of the toes, might help to prevent the lymph 'pooling'. Are you in the UK?

[JohnS35 in reply to Lynora]

UK yes. I'm picking up SLD now. From what's on the net, it seems focused on the main limbs. I've seen therapists on the NHS and privately for bandaging, measuring, MLD, etc.

My theory is that the swelling at the forefoot is being pushed towards the toes and thus rubbing where the natural skin crease is, causing this marked line. Compression stockings should reverse this behaviour (perhaps not the cosmetic difference), as it will encourage lymph fluid to go away from the toes with the compression and the gradient effect. Without foot caps, the swelling has free reign at the forefoot.

I can still pinch the skin which is good and there's no pain or tiredness so I'm also going to use inelastic wraps (have the Readywrap) to further compress the swelling.

Correct me if wrong but this skin difference is the sign to the condition not being managed? I.E. skin creases, warts, hard skin. I'm a little anxious in that I don't want to manage this just in time.

At home I elevate my leg and take the stocking to encourage the swelling to go down (it does). With foot caps this will be even better!

P.S. I've done CDT so I'm in the lifelong maintenance phase.

[Lynora in reply to JohnS35]

Have a chat with your MLD therapist - s/he should be able to teach you how to apply effective, targeted, SLD to the foot & toes.

What you do now, plus meticulous skin care should prevent skin changes.

[JohnS35 in reply to Lynora]

How significant are these skin creases? granted at the moment it's more cosmetic than anything else with no volume change or change in sensations but is this a significant progression? I've reached out to my therapist but not yet had a reply and it's not really possible to ask the consultants I've seen unless I book a self-funded appointment (expensive for just asking one question!).

I will look at SLD targeted to the feet and toes

One question on SLD - how do I know I am doing it correctly?

[Lynora in reply to JohnS35]

You can't really do anything wrong. Work slowly, and not to firmly, in little circles (I use the pads of my thumbs for the tops of my feet), along the base of the toes, then finish by stroking hand over hand over the ankles. Has your therapist taught you any SLD at all?

[Andy13]

Hi John, sounds like we have quite a lot in common e.g. primary lymphodema, swelling goes down a lot overnight, creases between foot and toes. However I'm 30 years further down the line than you. I've been wearing compression for over 30 years but not done much on skincare till recently however it is making a difference. So every morning, before I get up, I spend 5-10 minutes massaging a skin care product into my foot focusing on the ceases between my toes and foot while generally softening up the swelling in other areas. This seems to be further reducing the swelling (my foot hasn't looked so good for several years). I think it's very important I do this first thing in the morning when my swelling is at its lowest.

[JohnS35 in reply to Andy13]

Which cream do you use?

[Andy13 in reply to JohnS35]

Aveeno skin relief, Shea butter, why that one? Coz my wife got it for me and it's better than another I tried.