Article previously published in the Cutaneous Lymphoma Foundation's Forum 2015 Issue 1 newsletter. Reviewed by the Cutaneous Lymphoma Foundation’s Medical Advisory Council - September, 2019
Dryness of the skin, irritation, and itchiness are very unpleasant manifestations of cutaneous lymphoma. Fortunately, a lot can be done to improve the condition of the skin with over-the-counter creams or ointments. One of the most potent interventions that can be done at home is a “wet wrap.” This procedure deeply moisturizes skin and, even after a single use, the condition of the skin is often greatly improved.
Here is a step-by-step outline for an at-home wet wrap:
- Take a short bath (5-7 min); do not scrub, rub or scratch open skin areas.
- Do not dry skin after bathing - this step is crucial – instead, let the water fall from your body freely; whatever moisture left on the skin will be used for the next step.
- Apply ointment directly onto the wet skin – although this step may be messy, it is necessary to lock in moisture.
- Apply an over-the-counter ointment such as Aquafor Advanced Therapy, or Vaseline ointment all over the body. Use downward strokes to apply the ointment and do not rub against the hair growth to prevent folliculitis from developing. Low to medium potency topical steroid ointments may be used in the same way if recommended by your provider.
- Dress with clean, old soft cotton pajamas (long sleeve top and bottoms), then cover with a second set of dry pajamas. Remain covered for a minimum of four hours, but overnight for best results.
- Following the removal of the pajamas, apply a fragrance free cream or ointment moisturizer liberally.
Repeat this procedure on a daily basis. You will begin to notice the difference the morning after the first use. This regimen can be intensified with topical steroids that can be used instead of ointments and should be applied immediately after bathing (always consult your dermatologist before any at-home remedies). Three to seven days is usually sufficient to restore even the driest skin.
Thick Skin Remedies
The other variant of dry skin that requires additional attention is very thick skin on palms and soles. Many patients intuitively want to remove this extra thick skin with the help of pumice stones or files. This type of exfoliation may be done once a month, however, it is not recommended to rub your skin with pumice stones on a daily basis. Continuous rubbing sends a signal to the damaged skin and actually causes the skin to produce even more cells to restore what is being lost, thus leading to chronic thickening. One of the reasons for thickening of the palms and soles besides cutaneous lymphoma, is a loss of moisture due to skin damage. With the purpose of restoring damage, gentle chemical removal of the excessive surface layer of the skin in addition to moisturizing may be helpful.
- A sea salt bath is a recommended first step. Salt acts like a pump, drawing moisture and nutrients from the deeper levels of the skin up to the epidermis. Use 4 tablespoons of Epson salt or sea salt without any perfume additive per half gallon of warm water. Use a small plastic tub for convenience and soak hands and/or feet for 20-30 min.
- After the bath, dry skin and apply an ointment that will help to loosen the tight connections between the cells of the cornified layer of skin. You may use one of the following preparations: Carmol 20% (hands) or 40% (feet), Amlactin 12% or Lac-Hydrin 12%, Salicylic acid 6%.
- To intensify the effect, put on a pair of cotton gloves (found at your local pharmacy) after ointment application, and wear them for four to six hours or overnight.
- After removing the gloves, apply a thick emollient such as Aveeno Skin Relief Moisture Repair Cream, Aquafor Advanced Therapy, Curel Intensive Healing, Lubriderm Daily Moisture, or Vaseline Repairing Moisture.
Sometimes, the skin of the palms and soles becomes so thick that cracks open leaving very painful linear fissures. Any ointments or creams will be impossible to use due to deep burning sensations. The best way to treat those fissures is to seal them. Several medicinal glues are available in the pharmacy for this purpose: Demabond, New-Skin, and Nexcare. But Super glue (Krazy glue) will work as well. The glue will remain in the fissure until the new skin regrows completely, and eventually the new skin will push the glue out leaving new, healed skin. If thick skin and painful fissures persist, talk to your provider about whether other treatments, such as oral antibiotics or oral retinoids, would be helpful.
This article is informative only. At-home skincare does not negate the need for prescription medications, but can complement the treatment of cutaneous lymphoma. Always consult with your doctor or health care specialist for medical advice.