Thursday, September 11, 2014

Calmoseptine Leg Wraps



RELIEF FOR ITCHING

puppy itch

(Photo: Vicki Rogers)

Lipedema, particularly when it has progressed to include lymphedema, leaves the skin vulnerable to infections and cellulitis, and skin care is a big part of any new lipedema patient’s learning curve. Before I was diagnosed with lipedema, I had been hospitalized with cellulitis in my legs, and the infection left red blotches on my already unlovely legs. (If you look carefully at the photo in the previous post, you can see this.)

One of the worst things you can do with skin that is affected this way is to scratch an itch. Scratching may temporarily relieve the itch, but it causes trauma to skin that’s already been invaded or violated in some way. So in the season of bug bites and heat rashes, what’s an itchy person to do?

Tom Kincheloe, a certified lymphedema therapist in South Carolina, posed this question on a number of online groups related to lymphatic disorders. Here is his list of ideas, compiled from the collective wisdom of patients and professionals:

Here is a compiled list of all the ideas that were submitted by several
different groups (including Men’s) as well as a few from professionals not in
the groups:

1. Blowing fan on wraps to keep cool
2. Eucerin Calming Itch Relief
3. Topicort spray
4. Neurontin/Gabapentin, Lyrica (oral medications for nerve pain, sensations)
5. Shower (hot water for a few seconds) — NOT with wraps on. PLEASE BE CAREFUL AS HEAT CAN EXACERBATE LYMPHEDEMA!!
6. Back massager (for temporary itch relief through wraps)
7. Calmoseptine (topical)
8. Grape Seed Oil (available in grocery stores)
9. Niacin in an oil carrier (custom Rx)
10. Borage lotion
11. Calamine Lotion
12. Vermont’s Bag Balm (available at some pharmacies, farm feed stores)
13. Aquaphor
14. Aquaphor mixed with Gold Bond powder (assuming Anti-itch powder)
15. Ice packs (available in small, thin size for insertion under wraps for temporary relief)
16. Zim’s Crack Creme (www.crackcreme.com)
17. Castor Oil
18. Cocoa Butter
19. Epaderm
20. PrameGel Gel (generic: pramoxine) a topical anesthetic
21. Tahitian Noni International Skin Supplement

Other suggestions:

Consider the possibility of allergic reactions to materials and especially detergents. Commercial detergents used to clean materials such as stockinets may cause some itch reactions to particularly sensitive skin. If you suspect this to be the case, wash the stockinet thoroughly before re-applying. Ask your therapist for an additional stockinet to wash BEFORE you wear it in case you do have a reaction.

Some people are sensitive to certain types of chemicals in common laundry detergents, especially under compression wraps. Just because you don’t itch elsewhere, don’t be too quick to rule out detergent as the cause. This skin being wrapped may be more sensitive, especially when combined with pressure, moisture and heat (body). Consider the possibility of using a non-allergenic type detergent or simply switching to another brand. Another idea: wash the stockinet by hand with Dawn Dish Detergent to remove any trace of commercial detergents.

Another problem that has occured concerning stockinets: Some are made with 100% cotton and others are made with polyester or polyester/cotton blends. Consider switching from one type to another if your therapist has both fabrics available.

If you have pets, consider animal dander and hair as possible sources of skin irritation and itching. While you might not be allergic to animals in the normal sense, dander and hair from animals might possibly cause allergic reaction to hypersensitive skin especially when wrapped. Keep the wraps well covered (e.g. wear long pants that cover the wraps) to prevent dander and animal hair from slipping down inside the wraps.

Some notes (and warnings) about itch remedies and scratching:

Please be aware that if you try any of the above remedies, that you do so AT YOUR OWN RISK! Before taking ANY oral medications for itch control, please check with your physician first. Some medications and herbal remedies may react with
other medications. Follow the usual routine of contacting your physician immediately if you develop any unusual symptoms. WATCH FOR ALLERGIC REACTIONS WHEN TRYING ANYTHING NEW! Remember, too, that what works for one may not work for another.

Neurontin (generic: gabapentin) is a relatively inexpensive prescription medication that fits into the category of “multiple use” meds. It is used primarily with nerve-related problems such as nerve pain, restless leg syndrome, phantom pain/sensation in amputees, nerve tics, relief from radiation treatments and other uses. It has NOT been tried for management of itching that may be related to nerve compression that I am aware of but it was suggested as a possible use. Therefore we would not rule it out.

Fungal cremes, lotions and sprays (e.g. Flurocinanide, over-the-counter fungal applications) may help with itching but should NOT be used if fungal infections are not present. This can, according to professionals, cause stronger fungicide-resistant spores to form.

Likewise, cortisone-type applications are medications that should not be used without first consulting with a physician.

And last, but not least, if you MUST scratch, PLEASE do not use your fingernails! Fingernails can break the skin allowing creation of portals where bacteria can enter. Fingernails also often harbor a variety of bacteria including those that cause cellulitis and MRSA type infections. If you must scratch, use a dry, clean washcloth and rub the area GENTLY to avoid breaking the skin. Use your fingers to gently rub the itching area (wash them first). Never, ever use your fingernails or other sharp objects!

If anyone else wants to chip in and add to the list, please do so — we always have room for more!

Itching is a frustrating symptom often faced by those with lymphedema/lipedema and other ailments that can eventually, especially when scratching, lead to exacerbated conditions and complications such as infections. Itching can also cause patients being treated to become non-compliant with their treatment regimens. It should not be disregarded as a serious side effect to both lymphedema and treatments.

Thanks, Tom, for letting me republish this!

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