In last month’s blog, we talked about infection prevention. One of the strategies was to use more acidic soaps & lotions. This month, let’s investigate the composition of your skin & why those products are better for preventing infection.
Skin is composed of two main layers: the epidermis and the dermis. The outside layer (epidermis) doesn’t have blood vessels but the next layer does. (If a skin injury or wound causes bleeding, you know its depth is at least to the dermis.) The outer layer (sometimes called the acid mantle or hydrolipid film) has special qualities that prevent water loss & make it a good barrier to infection. One quality is being composed of lipids which reduces water loss and keeps your skin flexible. As the name “acid mantle” suggests, another quality is having a lower pH (or being more acidic than neutral). That’s a good trait because we carry around harmful bacteria all the time (including bacteria that cause common infection(s) in lymphedema: Staphylococcus & Streptococcus). The acidity comes from sebum lipids (of your sebaceous glands – or oil glands) & sweat that excrete a wax-like substance to a hair follicle. 1, 2, 4
Because of the acidic-lipid properties, you need to use products that are similar to your skin – both in pH level & with characteristics that aid in reducing water evaporation. Because immunity is compromised in tissue with lymphedema, you need to take good care of your skin as it is the first line of defense. We’ll discuss product ingredients, causes of compromised skin & product recommendations in the upcoming course & ebook on lymphedema management. For now, ideal products should have a pH between 5-7, contain barrier-forming lipids (like ceramides) & possess moisturizing characteristics (such as urea). You can find additional information here.
Most soaps & lotions are more alkaline (pH of 10-11)1 which can change the pH level & bacterial resistance of your skin. Alkaline products also reduce the thickness of your skin and break down the lipid coating.2
Besides soaps & lotions, other factors impact skin integrity. Some of these factors include: sun, hydration, nutrition, smoking, obesity, medications & age. So use sunscreen, drink water, eat healthy, don’t smoke, lose weight, be healthy — & stay young (let me know if you figure that one out!).
In February, we’ll answer the question: Why People with Lymphedema are Prone to Infection.
1 Foldi, M, Foldi, E. (2006). Foldi’s Textbook of Lymphology (2nd ed.), p. 623-627. Germany: Urban and Fisher.
2 Bryant, R. Nix, D. (2016) Acute & Chronic Wounds (5th edition), p 40-41, 46-59. Elsevier Inc.
3 attribution: <a href=”http://www.freepik.com”>Designed by macrovector / Freepik</a>
5 attribution: <a href=”http://www.freepik.com”>Designed by brgfx / Freepik</a>