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Cuts, insect bites and first aid when you have lymphedema

Wash, dry, antiseptic cream, cover; no scratching bites; gloves, 50% DEET, an electric razor; a pocket kit; the cellulitis signs that mean antibiotics now.

By The Renu lymphatic and massage team · 6 min read

If you cut, scratch or graze a limb with lymphedema, wash it straight away with soap and water, dry it, put on antiseptic cream and cover it. For a bite or sting, wash it, cool it, raise the limb and do not scratch. Then watch the area for the signs of cellulitis: redness, warmth, pain, swelling, fever or chills. The National Lymphedema Network says any suspected infection in the limb is an urgent medical event, because cellulitis causes further lymphatic damage, and prompt antibiotics are essential. Prevention is a small kit and a few habits: gloves for gardening and the oven, repellent with at least 50% DEET, an electric razor, and sunscreen.

A scratch from the cat, a mosquito bite at the lake, a nick from the vegetable knife. On most skin these are nothing. On a limb with lymphedema they are the start of the only lymphedema emergency that happens at home: cellulitis. The good news is that the first aid is ordinary and the kit fits in a coat pocket. This page is the plan.

Why infection is the setback we work hardest to avoid

The National Lymphedema Network’s 2026 position statement says cellulitis in the limb significantly increases the risk of lymphedema progression by causing further lymphatic damage, that people with lymphedema are at significantly increased risk of skin infections, and that any suspected infection in the limb must be treated as an urgent medical event with prompt antibiotics. The Lymphoedema Support Network explains the vulnerability: the lymphatic system both drains fluid and patrols for infection, so when it is damaged, the area it serves is more open to infection, and cellulitis is the most common one.

Cancer Research UK adds the practical consequences: an infection can make the swelling worse, treatment is usually 14 days of antibiotics, and people who get repeated infections may need a low daily dose for up to two years. The whole point of the routine below is to never need that.

First aid for a cut, scratch or graze

Stop any bleeding with gentle pressure through a clean cloth (NHS).
Wash it straight away. Macmillan’s travel advice: clean it straight away with soap and water. Cancer Research UK says clean water. The NHS suggests rinsing under tap water or using sterile wipes.
Dry it. Pat with a clean towel or gauze rather than rubbing (NHS).
Antiseptic cream. Cancer Research UK says to apply an antiseptic cream over the area if you are not allergic to it; Macmillan and the NHS lymphoedema guidance say the same.
Cover it. A plaster or dressing, kept clean and dry, changed as often as needed, and removed after a few days once the wound has closed (NHS).
Check it twice a day until it has healed, and keep the daily skin routine going around it.

Macmillan: speak to your GP if the broken skin does not heal or shows any sign of infection. The NHS adds that a cut larger than about 5 cm, or one you cannot stop bleeding, needs medical care in its own right.

First aid for a bite or sting

Remove a stinger by scraping sideways with a fingernail or the edge of a bank card, not tweezers, which can squeeze more venom in (NHS). Ticks are different: fine-tipped tweezers or a tick tool, grasped close to the skin, pulled slowly upward.
Wash with soap and water (NHS).
Cool it. An ice pack wrapped in a cloth for at least 20 minutes if it is swollen (NHS). Never ice directly on lymphedema skin.
Raise the limb if you can (NHS).
Do not scratch. The NHS warns the bite could get infected; Cancer Research UK says try not to scratch and use an antihistamine cream. An oral antihistamine or a hydrocortisone cream can calm itching and swelling (NHS).
Watch it. The NHS says to see a pharmacist if the area feels hot, looks red, is painful or has pus or fluid coming out; on a lymphedema limb we would go straight to a doctor.

Call emergency services for any sign of a serious allergic reaction, such as swelling of the lips, mouth or throat, difficulty breathing or dizziness (NHS).

The habits that prevent the wound in the first place

Gloves. Cancer Research UK lists gardening gloves and oven gloves; its infection page says to protect your hands from cuts and scratches during household jobs. Pets count: the West Suffolk NHS daily-care advice includes scratches from pets among the things to avoid in a swollen area.
Repellent. Macmillan: at least 50% DEET. Cover up with long sleeves or trousers in the evening.
Hair removal. An electric shaver is the safest way (Macmillan). Cancer Research UK says an electric razor or hair removal cream can be better than shaving, and that waxing, plucking and sugaring can damage the skin.
Sun. Sunscreen of at least SPF 30 with a high star rating (Cancer Research UK), or SPF 50 (Macmillan), because the NLN describes sunburn as thermal injury that creates a portal of entry for bacteria.
Nails and feet. Clippers not scissors, no cuticle cutting, shoes on. Our foot and nail care page has the full routine.
Needles and cuffs. The NLN recommends avoiding blood pressure measurements, injections and blood draws in a limb with lymphedema where another limb can be used.
Skin that never cracks. Daily washing with a mild, pH-balanced product and regular moisturising, as the NLN puts it; the full daily skin-care routine is on its own page.

The pocket kit

Everything above, in a small pouch that lives in your bag:

Antiseptic cream (one you are not allergic to)
A few plasters and one or two larger dressings
Antihistamine cream or tablets
Insect repellent with at least 50% DEET
A small sunscreen, SPF 30 or higher
Alcohol-free wipes for washing when there is no tap
A note of your clinic’s number and, if your doctor has agreed to it, your standby antibiotics with the instructions for when to start them

For trips, the packing list for travel with lymphedema expands on this, and Macmillan’s advice to ask your GP or lymphoedema specialist whether to take antibiotics with you is worth doing weeks before you leave.

Stop and call: the cellulitis signs

The Lymphoedema Support Network says you may feel unwell first, as if flu is starting, with fever, shivers, aches, headache or nausea, before the skin changes. Then the area becomes red, hot and tender. Treat these as a same-day medical appointment, and say the word “lymphedema” when you call:

Redness, warmth, pain or new swelling in the limb (NLN); red streaks running up or down from a wound or bite (Macmillan).
Fever or chills (NLN), or a temperature of 37.5°C or higher or below 36°C (Cancer Research UK).
Flu-like symptoms with or without visible skin change.
On brown or black skin, redness that looks yellow, purple or darker than usual (Cancer Research UK).

Cancer Research UK says to contact your 24-hour advice line immediately if you think you have an infection, because early treatment can stop it becoming a more serious problem. The LSN says to contact your doctor immediately for antibiotics; while you are being treated, it advises removing compression garments until the area feels better, pausing manual lymphatic drainage and exercise, resting with the limb raised to about heart level, drinking plenty of water, and using paracetamol rather than anti-inflammatory painkillers such as ibuprofen. Someone who is severely unwell may need hospital admission for intravenous antibiotics.

Our page on how to tell if your lymphedema is infected goes into the early signs, and when to seek medical care covers everything beyond the skin.

After an episode

Once the antibiotics are finished and the skin has settled, come back for a review. At Renu, complete decongestive therapy with Meeghan Mackenzie, our Certified Lymphedema Therapist, restarts gently after cellulitis, because the limb is often more swollen and the garment may need refitting. If it was your second or third infection, bring that history to your doctor: the NLN’s position is that recurrent cellulitis, after the risk factors have been addressed, is the point at which preventive antibiotics are considered. The overview of lymphedema and lipedema explains why the skin stays vulnerable for life, and why this small kit earns its place in your bag.

Questions people ask

I scratched my swollen arm on a rose bush. What do I do right now?

Wash it straight away with soap and water, dry it, apply antiseptic cream if you are not allergic to it, and cover it; that is the sequence Macmillan and Cancer Research UK both give. Then check it morning and evening. Macmillan says to speak to your GP if broken skin does not heal or shows any sign of infection.

How quickly can cellulitis develop after a bite?

The sources we read do not give an hours-to-days figure, and it varies. The Lymphoedema Support Network describes cellulitis as sudden, and says you may feel unwell first, as if flu is starting, before the skin goes red and hot. That is why a bite or cut on the limb is watched closely for the first days rather than forgotten.

Should I keep antibiotics at home in case?

Ask. Macmillan's travel advice is to ask your GP or lymphoedema specialist whether you need to take antibiotics with you in case you develop cellulitis, and the NLN says people with recurrent cellulitis, for example more than three or four episodes a year, may be considered for preventive antibiotics once other risk factors are addressed. That is a conversation with your doctor, not a decision to make alone.

Can I use a razor on the affected leg?

An electric one. Macmillan calls an electric shaver the safest way to remove hair; Cancer Research UK says an electric razor or hair removal cream can be better than shaving, and that waxing, plucking and sugaring can damage the skin and increase infection risk.

What strength of insect repellent?

Macmillan says to look for a repellent with at least 50% DEET. Cancer Research UK adds the follow-up: if you are bitten or stung, try not to scratch, and use an antihistamine cream.