If you’ve been living with lymphedema and noticed thick, rough patches of skin developing — especially on your legs or feet — you might be dealing with hyperkeratosis.
Hyperkeratosis is more than just dry skin. It’s a thickening of the outer layer of skin that often shows up in areas of long-standing lymphatic swelling. It’s not dangerous, but it can feel uncomfortable, tight, and sometimes even painful or prone to cracks and wounds.
As a Certified Lymphedema Therapist with over a decade of experience, I want to share how we help clients prevent, manage, and treat hyperkeratosis through evidence-based care, lymphatic coaching, and daily self-care practices.
Hyperkeratosis is a skin condition where the top layer becomes abnormally thick and hardened, often as a response to ongoing inflammation, fluid buildup, and impaired skin function. In clients with lymphedema, it usually shows up in areas of long-term swelling, especially the lower legs, feet, or genitals.
Hyperkeratosis can develop when:
Lymphatic fluid overloads the skin
Chronic inflammation is present
The skin barrier isn’t well maintained
Swelling remains unmanaged over time
Left unchecked, these areas can be more prone to cracking, infection, and discomfort.
Here’s what we teach inside our program to help clients minimize skin complications:
Use urea-based, lactic acid, or salicylic acid creams (like Amlactin or CeraVe SA) to both hydrate and gently exfoliate.
🧴 Tip: Apply moisturizer immediately after bathing while the skin is still slightly damp to lock in moisture.
2. Control Swelling Consistently
Hyperkeratosis often forms when lymphedema isn’t managed effectively. We support clients with:
Properly fitted flat knit or adjustable compression
Self-MLD training (manual lymphatic drainage)
Movement routines to support lymph flow
3. Avoid Skin Trauma
Even small skin injuries can worsen hyperkeratosis. That means:
No blade razors (use electric instead)
Avoid tight, rough fabrics or socks that dig into the skin
Wear protective, breathable clothing
4. Inspect Skin Regularly
We train clients to check their skin daily for:
Redness
Thickening or buildup
Cracks, scaling, or any signs of infection
Early detection allows for early care — often avoiding medical escalation.
At-Home Support for Hyperkeratosis
Once hyperkeratosis sets in, it takes consistent care to soften and manage the skin. Here’s a trusted step-by-step approach:
🌿 Soak & Soften
Take short, lukewarm soaks using Epsom salts or a gentle bath oil. This helps soften the thickened skin and prepares it for moisturizing. Avoid hot water (it can worsen swelling).
🧼 Exfoliate Gently
Use a soft washcloth, loofah, or pumice stone to lightly exfoliate thickened areas — but only after soaking. Avoid over-scrubbing or applying pressure.
👕 Dress Smart
Wear soft, breathable clothing that reduces friction. For clients using wraps or garments, we guide you on how to layer padding or liners to protect sensitive skin while maintaining compression.
Elevating the swollen limb above heart level 2–3 times per day can ease pressure on the skin and improve lymph flow. Even a few minutes can help.
When to Seek Medical Care
Sometimes, topical care isn’t enough. You may need a dermatologist or wound care provider for:
Prescription-strength keratolytics (like stronger salicylic acid or retinoids)
Cryotherapy (freezing off thickened plaques)
Electrocautery or laser options for resistant buildup
We help our clients navigate these decisions and know when to escalate care — while continuing to focus on proactive, daily management.
Final Thoughts
Hyperkeratosis might feel like a frustrating setback, but it’s actually a sign that your lymphatic system — and your skin — needs more attention, not less. The good news? You don’t have to face it alone.
Inside the Lymphatic Wellness Hub, we help you build:
A realistic daily skin care and compression routine
A personalized movement plan
Confidence in managing your condition for life — not just in a clinic
If you're looking for ongoing support that goes beyond products, we’re here for you.
👉 Book a free 15-minute call with our team to learn how our program works and whether it’s a good fit for your goals.