Oedema – build-up of fluid

What is oedema?

Oedema (pronounced ‘uh-dee-ma’) is a swelling caused by a build-up of fluid. It often affects the legs and ankles but can affect any part of the body. Oedema causes swelling under the skin, and can also cause:

• stretched, shiny or discoloured skin
• pain and discomfort
• stiff joints
• leaking of fluid from the skin
• a feeling of tightness or heaviness. 

What are the causes of oedema?

Oedema can be caused by:

• illness, including cancer, heart failure and kidney failure
• side effects of medications
• not moving for long periods
• a very low level of protein in your blood (hypoalbuminemia).

What are the treatments for oedema?

If you think you have oedema, let your nurse or doctor know. They can suggest ways to help. You might be referred to a specialist physiotherapist, occupational therapist or nurse for advice.  They will look for the specific cause of your oedema. If they can identify it, they’ll treat it directly. If they can’t find a cause they will help you find ways to get relief from the symptoms. 

Options for managing oedema include:

• using compression stockings
• putting your feet up when sitting
• keeping active – even gentle exercise can help
• medication.

These techniques all encourage the fluid to drain away and reduce the swelling.

What is lymphoedema?

Lymphoedema is a swelling in the body caused by blockage or failure of the lymphatic (pronounced ‘lim-fa-tick’) system. The lymphatic system is made of lymph nodes (glands) and a network of tiny tubes (lymph vessels). The fluid in your body drains into lymph vessels so it can be carried back to your heart and into your blood. 

If there is a problem with the lymphatic system, the fluid isn’t drained away properly and builds up under the skin.  

Lymphoedema most commonly affects your arms or legs, but can also happen in other areas of your body. 

When lymphatic fluid builds up in the body, it can cause problems including:

• swelling
• pain or discomfort
• a feeling of tightness or heaviness
• difficulty moving
• leaking of fluid from the skin
• thickening of the skin
• skin infection – lymphoedema means you have a higher risk of infection if you have a cut or scratch in your skin. 

Lymphoedema can be distressing for some people. It can change the way you think about your body and make you feel low or worried. 

What are the causes of lymphoedema?

There are lots of reasons why a person might have lymphoedema. It’s often caused by cancer and treatments for cancer, including radiotherapy and surgery.

What are the treatments for lymphoedema?

If you think you have lymphoedema, speak to your doctor or nurse about your concerns. If it’s a new problem, they can offer you tests to find out what’s causing the lymphoedema. They can also refer you to a specialist team for assessment, if one is available in your area. You can contact the Lymphoedema Support Network   to find out about your local lymphoedema service.

Lymphoedema can’t be cured but there are things that can be done to manage it. There are four main way to treat it:

• Compression – wearing special clothing or bandages that gently squeeze the part of your body that’s affected and encourage the fluid to drain away.
• Massage – a special type of massage called Manual Lymphatic Drainage encourages the fluid to drain away. This massage can be done by yourself, a carer or family member, or by a healthcare professional.
• Skin care – keep your skin clean and moisturised. Clean any cuts or scratches with an antiseptic and cover them with a plaster – this can help to reduce the risk of infection. If you have lymphoedema in your arm or leg, it’s important to have blood tests or blood pressure tests done on the affected arm or leg.
• Exercise – moving your body, even a little bit, helps the lymphatic fluid to drain away.

Diuretics (water tablets) are not recommended in the treatment of lymphoedema.

There are also specialist treatments available in some areas. Your doctor, nurse, or lymphoedema specialist will help you find the techniques that work best for you.

Fluid retention | healthdirect

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2-minute read

Fluid retention is seen as swelling in one or more parts of the body where fluid gets trapped. It is most common in the ankles and feet. If you have symptoms of fluid retention, it’s a good idea to see a doctor to check the cause and whether any treatment is needed. There are ways you can help yourself.

What is fluid retention?

Fluid retention is also called oedema or water retention. It occurs when parts of the body swell due to the build-up of trapped fluid.

You may have fluid retention if you have:

• swelling or puffiness under the skin
• skin that looks or feels tight or shiny
• skin that indents when pressed, or does not bounce back after being pressed for a few seconds
• discoloured skin
• aching limbs or joints
• weight gain
• a noticeable increase in size of your abdomen

See your doctor if you have any of these symptoms.

If you have shortness of breath, difficulty breathing or chest pain, see your doctor immediately as these can be signs of pulmonary oedema (fluid in the lungs) which needs to be treated right away.

Fluid retention is usually a sign of another problem. It can also cause pain, damage to the skin and difficulty with walking.

What causes fluid retention?

Some people get fluid retention due to illnesses like:

Certain medications cause fluid retention, such as:

A problem in one part of your arm or leg can cause fluid retention further down your arm or leg, if you have:

• a problem with your lymphatic system, which drains fluid from tissues
• a vein condition, such as deep vein thrombosis
• the build-up of fat, usually in the legs
• a burn or other type of injury

You can also get fluid retention if you are pregnant, overweight or malnourished.

How is fluid retention treated?

The treatment depends on the cause – talk to your doctor.

Many people will find their problem with fluid improves with more exercise, a healthy diet, less alcohol and less salt.

Some people are prescribed medicines called diuretics to help their body get rid of excess fluid via urine. Some people need to change the medicines they are taking after talking to their doctor.

If the fluid is in just one part of the body, then you might get some relief from:

• wearing compression garments
• massaging the tissue by stroking toward the heart
• elevate the affected part above your heart when you can
• doing exercises as advised by your doctor

Talk to your doctor about how much salt you eat, as salt can increase fluid retention.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: April 2020

Edema: Causes, Symptoms & Treatment

Overview

Normal versus swollen ankles.

What is edema?

Edema is swelling that is caused by fluid trapped in your body’s tissues. Edema happens most often in the feet, ankles, and legs, but can affect other parts of the body, such as the face, hands, and abdomen. It can also involve the entire body.

Symptoms and Causes

What causes edema?

Edema has many possible causes:

• Edema can occur as a result of gravity, especially from sitting or standing in one place for too long. Water naturally gets pulled down into your legs and feet.
• Edema can happen from a weakening in the valves of the veins in the legs (a condition called venous insufficiency). This problem makes it hard for the veins to push blood back up to the heart, and leads to varicose veins and a buildup of fluid in the legs.
• Certain diseases — such as congestive heart failure and lung, liver, kidney, and thyroid diseases — can cause edema or make it worse.
• Some drugs, such as medications that you are taking for your blood pressure or to control pain, may cause or worsen edema.
• An allergic reaction, severe inflammation, burns, trauma, clot(s), or poor nutrition can also cause edema.
• Too much salt from your diet can make edema worse.
• Being pregnant can cause edema in the legs as the uterus puts pressure on the blood vessels in the lower trunk of the body.

What are the symptoms of edema?

Signs that you might have edema include the following:

• The affected area is swollen.
• The skin over the swollen area might look stretched and shiny.
• Pushing in gently on the swollen area with your finger for at least 5 seconds and then removing your finger will leave a dimple in the skin.
• You may have trouble walking if your legs are swollen.
• You may be coughing or have trouble breathing if you have edema in the lungs.

Management and Treatment

How is edema treated?

Your doctor will ask you questions, conduct a full exam, and might order tests to determine why you have edema.

Edema can be temporary or permanent, depending on its cause. Edema is treated according to the condition that is causing it. For example:

• If edema is caused by lung disease, such as emphysema or chronic bronchitis, quitting smoking would be advised if the patient smokes.
• For patients with chronic heart failure, these measures would be advised: treating coronary artery disease; monitoring weight, fluid, and salt intake; and cutting down on excess alcohol.
• If the cause is related to a medication, stopping the medication will cause the swelling to resolve. Talk to your doctor before stopping any medication.

In addition to treating the underlying diseases, there are a few other steps you can take to keep fluid from building up in your body:

• Put a pillow under your legs when you are lying down or sitting for prolonged periods. (Keep your legs elevated above the level of your heart.)
• Do not sit or stand for long periods of time without moving.
• Wear support stockings, which put pressure on your legs and keep fluids from collecting in your legs and ankles. These stockings can be purchased at most drugstores.
• Ask your doctor about limiting your salt intake.
• Follow your doctor’s directions for taking prescription medications. Your doctor might want you to take a diuretic (commonly called a “water pill”), which helps your body get rid of excess fluid.

Other important tips:

• Protect any swollen areas from additional pressure, injury, and extreme temperatures. Injury to the skin over swollen areas takes longer to heal and is more likely to become infected.
• Call your doctor immediately if you have any pain, redness, or heat in a swollen area; have an open sore; or experience shortness of breath or swelling of only one limb.

What to Do If You Have Edema

Favorite Orgs for Essential Information About Edema

American Heart Association

This leading heart association offers a wide array of resources on heart disease, including heart failure, which can result in swelling (edema). The website lists practical tips for dealing with edema and available treatments.

Heart Failure Society of America

This website was started as a forum for heart failure experts to discuss all things related to heart failure, heart function, and congestive heart disease. The patient section of the site has information on apps to manage heart failure and a toolkit with information on living well with the condition.

HeartFailure.org

Developed by two heart failure specialists, the website outlines the basics of heart failure. There’s also a prevention section with in-depth information on proper diet to reduce the risk of fluid retention or edema, and what you need to know about sodium or water intake.

Mayo Clinic

The Mayo Clinic, a world class heart treatment center, has created a list of many diuretics — a type of medication that can help treat edema. Your doctor is likely to choose drugs included on this list, which makes it a good resource for you to learn about taking the drugs properly and immediately reporting any concerns.

MedlinePlus

MedlinePlus is a health resource from the National Library of Medicine with all materials reviewed by medical staff. This handout on fluids and diuretics offers tips on how to limit weight gain and excess fluids with tips on trying a hard candy instead of a drink when you are thirsty or rinsing your mouth out with cold water and then spitting out the water.

Favorite Apps for Managing Edema

Health Storylines

This free app, produced in partnership with the Heart Failure Society of America, lets you track many important things related to edema, such as weight and symptoms like a feeling of fullness or swelling. If your weight shows a steep gain over a day or two, you get a prompt to call the doctor. Patient reviews say the medication tracker is limited to a set list, so before signing up, check to see if your drugs are listed.

HF Path

This free app from the American Heart Association lets you track vital information, such as medication schedule, symptoms, and weight. The app sends an alert if your log indicates edema serious enough to call the doctor. The app also has online courses on heart failure problems such as edema as well as the option for group chats with others who have heart failure.

Favorite Online Support Groups for People With CHF and Edema

American Heart Association

While CHF-associated edema doesn’t generally have its own support group, it’s a common issue. You’ll find many discussions in this forum on weight gain and swelling that can help you answer questions and find support.

Edema Management | MaineHealth

Edema is swelling that can range from mild to severe. Edema can lead to trouble walking and even difficulty taking a breath. Sometimes symptoms are so severe that people limit or stop their daily activities.  Providers at MaineHealth can help get edema under control and improve a patient’s overall health.

What is edema?

Edema is a collection of fluid under the skin, which is most likely to be found in the lower legs, ankles and feet. It is possible to see edema in other parts of the body, like the hands or stomach. Edema occurs when fluid leaks from small blood vessels. The fluid goes into nearby tissues, which swell.

What are edema symptoms?

Edema appears as swelling under the skin on parts of your body. Patients also may notice the following:

What causes edema?

• High-salt diet

• Premenstrual signs and symptoms

• Pregnancy

• Immobility

• Spending too much time sitting or standing

• Being overweight

• Blood clots

• Low albumin (blood proteins)

• Tumor

• Heart disease, liver disease, kidney disease

Sometimes when a patient has an acute medical problem, such as an allergic reaction or infection, there is edema.  It is important to get medical care for the underlying problem.

How is edema treated?

If your edema is mild, your body will balance the fluid out on its own. If your edema is more serious, your doctor may prescribe you to go on a diuretic. A diuretic is a medication that helps to relieve excess fluid from your body by making you urinate more frequently. If your edema persists, your provider will look for the causes of edema. This could mean that your provider changes your medication instructions, changes your medication prescriptions, or treats a more serious medical problem.

Home treatment

• Get plenty of movement to increase circulation in your body

• Frequently raise the affected area of your body, so that it is above the level of your heart

• Massage the area affected by edema

• Use bandages or compression socks to keep pressure on the edema

• Consume less salt

• Keep the swollen area clean, dry, and moisturized

Edema | Boston Children’s Hospital

What is edema?

Edema refers to swelling in the body’s tissues caused by a buildup of fluid, most often in the feet, ankles, face, eyelids, or abdomen.

It can have many causes, including:

• sitting or standing in one position for too long
• eating salty food
• some medications
• sunburn

It can also be a symptom of a more serious condition, such as:

What are the symptoms of edema?

Symptoms may include:

• swollen feet
• swollen ankles
• swollen face or eyelids
• swollen abdomen

Your child may also have one or more of these symptoms:

• tiredness after minimal activity, like climbing stairs
• weight gain
• trouble breathing
• a cough that gets worse at night or when lying down (this may be a sign of acute pulmonary edema, or excessive fluid in the lungs, which requires emergency treatment)

What causes edema?

Because many conditions are associated with edema, it can have many causes. Here are some conditions that could cause edema:

Liver disease

A healthy liver helps to regulate the level of fluid in the body. If the liver is damaged, it may not be able to do this, leading to fluid buildup.

Kidney disease

If your child has kidney disease, their kidneys may not be able to remove enough fluid from their body.

Heart disease

Several types of heart disease can cause edema, including:

Since the heart pumps blood to the organs, poor cardiac function can cause edema in several ways:

• If your child’s heart isn’t pumping blood efficiently, blood can build up in the parts of their body furthest from the heart, such as the legs, ankles, and feet.
• This puts increased pressure on the tiny blood vessels called capillaries, which may begin to leak blood into the nearby tissues, causing swelling.
• Because of poor heart function, the kidneys sense less blood fluid available, and begin to conserve water and sodium.
• Without enough blood supply, the kidneys have a harder time doing their job of ridding the body of excess fluid.
• Eventually, this excess fluid builds up in the lungs.

How is edema diagnosed?

Edema itself is not hard to diagnose. Your child’s doctor will ask about their medical history, and eating and drinking habits.

The doctor will look at the swollen areas, and check to see if the skin appears stretched and shiny, and may order some lab tests. These might include:

In some cases, the doctor may also order an imaging test, such as a chest x-ray, to get more information about what is causing the swelling.

How is edema treated?

Treating your child’s underlying condition will often take care of the edema, too. Your child’s health care team may also recommend:

• diuretics: medicine that rids the body of extra fluid through urination
• limiting the amount of salt in the child’s water, to discourage water retention
• avoiding very hot and very cold temperatures, and sudden temperature changes
• elevating the swollen body part above the heart for a short period of time

How we care for edema

Our pediatric experts at the Boston Children’s Hospital Benderson Family Heart Center, Division of Nephrology, and Division of Gastroenterology, Hepatology and Nutrition are all experienced in diagnosing and treating edema in children, no matter what its cause.

Seroma: What Is It, Symptoms, Causes & Treatment

Seroma is a complication that can occur after any surgery, and it corresponds to the build-up of fluid below the skin, close to the surgical scar. This build-up fluid is more common after surgeries in which the skin and fat tissue have been cut and manipulated, such as in plastic surgery, abdominoplasty, liposuction, breast surgeries or after a caesarean delivery. However, they are the result of an inflammation, and not caused by the procedure itself.

A small seroma is usually reabsorbed naturally into the body within 10 to 21 days. However, in some cases, the doctor may need to carry out a small procedure which consists of inserting a syringe under the skin and removing the excess fluid. To reduce the risk of having a seroma it is normally recommended to use compression bandages after surgery.

Main signs and symptoms

The presence of a seroma can be identified if the following signs and symptoms are present:

• Transparent or clear fluid under the wound;
• A swollen spot;
• Fluctuation in the area;
• Pain in or around the wound;
• Redness and increased temperature in the area surrounding the wound.

There may be a reddish or brown coloring when the seroma is mixed with blood, which is more common soon after surgery and tends to become clearer as the healing process continues.

A seroma usually appears during the first 2 weeks after surgery as a result of the build-up of fluid in the dead space between the layers of the skin. If you see or feel symptoms that indicate a seroma, talk to the surgeon so he can check the situation and see if treatment is needed.

What can cause a seroma?

Seromas can appear after any type of surgery, depending on how a person’s body recovers. However, this type of complication is more common in:

• Extensive surgeries such as breast removal in cancer cases;
• Cases requiring the placement of drains after surgery;
• Surgeries that cause lesions in various types of tissues;
• People who have a previous history of seromas.

Although it is a very common complication, it can be easily avoided by using a bandage over the scar and avoid doing intense exercise unless otherwise indicated by the doctor.

If there is an increased risk of developing a seroma, the doctor usually inserts a drain during surgery so that the built-up fluid may leak out as the wound heals.

Treatment options

The treatment of a seroma is only needed when there is a great build-up of fluid or when there is pain, as in the less severe cases the body itself reabsorbs the excess fluid. However, when necessary, the fluid is removed using a syringe or a drain, which is a small tube inserted underneath the skin until it touches the seroma, allowing the fluid to be drained.

If you need pain relief, a doctor can prescribe painkillers or anti-inflammatory drugs like Paracetamol or Ibuprofen, for example.

On the other hand, treatment for an encapsulated seroma is more complicated, requiring corticosteroids or surgery for its removal. Ultrasonic cavitation is also a method that can be used because it is based on a high-power ultrasound that is able to reach the area that needs to be treated and creates reactions that stimulate the removal of the fluid.

In cases where the seroma gets infected, the treatment is usually done with antibiotics prescribed by the doctor. For an encapsulated seroma, the doctor may recommend surgery to remove the fluid and to make the scar look nicer.

medi compression hosiery for edema treatment

medi compression hosiery for edema treatment

Compression hosiery for edema treatment

Compression hosiery for the treatment of lymphatic edema and lipedema

Flat knit compression jersey is used for the treatment of lymphatic edema and lipedema of the hands and feet.The main purpose of its use is to prevent the re-development of edema, for example, after the end of the course of anti-edema therapy.

In the treatment of lipedema, flat-knit compression hosiery is used to slow down or even stop the development of edema.

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Use of compression hosiery in the treatment of edema

Lymphatic edema or lymphedema develops due to the accumulation of fluid in the tissues leaving the vascular bed.Very often, the development of lymphedema can be associated with other diseases. For example, lymphedema may develop after surgery for cancer, or it may be associated with heart failure, kidney failure, or cirrhosis of the liver. A number of medications, such as glucocorticosteroids or antidepressants, can also contribute to the development of lymphedema.

Compression hosiery for the treatment of lymphatic edema and lipedema is prescribed by a doctor. Since the treatment of edema is very individual, such jersey is usually made to order.

Medi compression hosiery for the treatment of edema is characterized by high comfort and durability: only the highest quality materials are used for its production. For patients suffering from hallux valgus (hallux valgus), mediven 550 knitwear with a special loose knit zone in the big toe is offered. Also, the patient has a choice of many different colors of knitwear. Finally, a wide selection of patterns, ornaments and additional options such as different toe options or Y-shaped heel area allows you to customize the product.

Elephantiasis

Pathology of the lymphatic system

Although the lymphatic system is as important as the circulatory system, much less is known about it. The lymphatic system covers the entire human body as a network and performs many important functions. It not only plays an important role in the body’s immune system, but also removes up to four liters of lymph fluid from organs and tissues every day.

This liquid contains many solutes such as proteins and metabolic products. If the lymphatic system malfunctions, the normal drainage of lymphatic fluid from tissues and organs is impaired. The affected areas of the body, usually the arms and legs, develop massive swelling. Elephantiasis is an extreme stage in the development of lymphedema.

This condition of the lymphatic system can be either congenital (primary lymphedema) or the result of an intervention (secondary lymphedema).According to experts, in Germany, about three million people suffer from diseases of the lymphatic system.

Diagnostics and treatment

Learn how lymphedema develops

Lymphedema

90,000 symptoms, causes, diagnosis, treatment, what is dangerous, massage, prices for lymphedema treatment

This material has been updated on 03.09.2021

Anastasia Dosmambetova

helps her mother treat lymphedema

My acquaintance with lymphedema happened a few years ago when my 45-year-old mother fell ill with it.

Symptoms of lymphedema – or lymphostasis – made it difficult to live a normal life, and the doctors said that he would not be able to fully recover. We spent more than 10,000 RUR on treatment before we learned how to relieve swelling and pain in lymphedema.

I will tell you about what kind of disease it is and how to deal with it in this article.

See your doctor

Our articles are written with a passion for evidence-based medicine. We refer to reputable sources and go for comments from reputable doctors. But remember: the responsibility for your health lies with you and your doctor. We do not write prescriptions, we make recommendations. It is up to you to rely on our point of view or not.

What is lymphedema

Lymph is a transparent viscous liquid that moves in the body along a special network of thin vessels that flow in different parts of the body into rounded formations – lymph nodes.This is a kind of backup track for blood vessels. Such a system is needed to cleanse cells and tissues: proteins, water, salts and toxins enter the lymphatic vessels, which subsequently end up in the veins and, after going through a filtration process in the liver and kidneys, are excreted from the body with urine.

An article on the Cleveland Clinic website about the structure of the lymphatic system

Unlike blood, lymph does not flow in a circle, but only in one direction: from the limbs and head to the chest area.The lymph moves due to the contraction of the muscles of the whole body, and there should be no reverse flow – for this, there are special valves in the lymphatic vessels.

The lymphatic system is similar to the circulatory system, but there are two different types of vessels that carry different fluids. Source: uchitel.pro

The human body produces up to two liters of lymph per day. If something is wrong with the lymphatic system, lymph begins to accumulate in the space between the organs, forming edema. This is lymphostasis, or lymphedema.

Lymphedema or lymphostasis?

In fact, lymphedema and lymphostasis are one and the same disease. Modern doctors use the term “lymphedema” more often because it matches the Western name for the disease.

But nevertheless, the term “lymphostasis” is still often encountered – therefore, in the article we will use both options.

Classification and causes of lymphostasis

Lymphostasis occurs due to damage to the lymphatic vessels. In 90% of cases, it affects the legs, 10% – the arms, sometimes – the face, trunk or genitals.

Edema and elephantiasis: what is the danger of lymphedema – “Health Info”

There are two main types of lymphedema: primary and secondary.

Primary lymphedema is a congenital disease due to abnormalities of the lymphatic vessels, which is diagnosed in children, or hereditary changes in the lymphatic system of a limb suffering from lymphedema. In the latter case, signs of lymphedema usually appear during puberty.

Medical and social examination, rehabilitation and disability in lymphedema of the lower extremities – Ministry of Health, 2013 PDF, 802 KB

Secondary lymphedema appears for various reasons:

1. infectious diseases;
2. injuries: bruises, fractures, penetrating wounds; 90,090 90,089 obesity;
3. Breast cancer and the consequences of their treatment.

Infectious diseases, capable of provoking lymphedema, are erysipelas and phlegmon. Erysipelas, or erysipelas, is a skin disease caused by streptococcus, it has clear boundaries on the skin and is accompanied by damage to the lymphatic system. Phlegmon is an acute purulent inflammation caused by staphylococcus, less often Escherichia coli or anaerobic bacteria – Clostridia.

Mastectomy lymphostasis is another cause of secondary lymphedema.This is severe swelling that occurs in the arm in 25% of women who have undergone breast removal. During a mastectomy, some of the lymph nodes are usually removed, and the lymphatic system may not function well, leading to lymphedema. Lymphedema can also occur before surgery if the swelling inside the breast presses on the lymph nodes.

Lymphedema of the hand after mastectomy – Innovative Vascular Center

Symptoms of lymphostasis at different stages

The main symptom of lymphostasis is edema of the extremities.In the early stages, it may not be very noticeable and almost painless, but when pressure is applied to the skin, a fossa remains. In severe cases, it becomes painful, can affect the neck, abdomen, back.

Sometimes, due to edema, the legs or arms increase in size so much that the patient is no longer able to work with them. Moreover, due to a swollen limb, it can be difficult for him to move even around the house, and the pain sometimes haunts him day or night. It is pointless to treat edema with hot or cold compresses, you should definitely consult a doctor.

Another alarming sign is the appearance of scarlet spots, which is accompanied by pain, itching and burning. Such symptoms indicate skin lesions: lymph accumulates in the intercellular space and provokes frequent inflammation, dryness, and thickening of the skin. This is dangerous because a person with leg lymphedema may develop ulcers there that are difficult to heal.

Lymphedema of the lower limbs – Uptodate

The absence of a pattern of the saphenous veins can also be a symptom of lymphedema.But you should not be guided by it: the veins may not be visible on the limbs under the skin and in healthy people.

This is what trophic ulcers look like (18+)

Pathogenesis of lymphostasis

When the activity of the lymphatic system is disrupted, an imbalance occurs between the volume of lymph production and the pumping function of the lymphatic vessels. This leads to tissue edema and disruption of metabolic processes in the body. Lymph builds up in the spaces between the organs and lymphedema begins.

During the first stage of lymphedema, changes in the appearance and function of the arm or leg are often subtle or almost imperceptible.Swelling appears, but it can go away after rest or if the limb is raised higher.

Lymphedema and lymphorrhea: how to deal with edema and prevent complications – “Workshop of Care” and the “Vera” Foundation PDF, 1400 KB

At the second stage, the edema becomes constant, but soft, painful sensations appear, limb mobility worsens.

At the third stage, the edema becomes dense and increases in size, the skin may turn brownish-gray. At this stage, the changes can become irreversible if you do not go to the doctors for help.Ideally, this should be done at the first stage.

What is the danger of lymphostasis

If you do not treat lymphostasis, you can remain disabled. In the third stage of the disease, lymph can flow out of the body through cracks in the skin, and it will be impossible to return the limbs to a healthy appearance and mobility.

Neglected inflammation and trophic ulcers without treatment can lead not only to complete immobility of diseased limbs due to severe persistent edema, but also to death due to infectious complications.

Why we decided to see a doctor

In our case, lymphedema was a distant consequence of trauma. When my mother was in the sixth grade, a classmate accidentally hit her in the right leg. As a result, one of the cartilage in the foot was flattened. Usually, in such situations, doctors performed an operation to replace the damaged cartilage, but my mother came across an inexperienced specialist. He simply advised to keep the leg in hot water to relieve the swelling.

This treatment only made things worse – soon the foot grew to a terrifying size.Another doctor criticized a colleague’s methods and prescribed an ointment for bruises. The foot and ankle returned to normal, and that was the end of the treatment.

What to do? 17.02.20

How to insure yourself against a medical error before the operation?

Since then, a slight swelling around the ill-fated cartilage has become familiar to my mother. The swelling appeared and disappeared depending on the season and the load on the leg.

What does lymphostasis look like? Mother’s legs outside of periods of exacerbation of lymphedema – feet look the same

In 2017, my mother complained that her healthy left leg began to swell.She was not exposed to any impact or injury. As we later learned from a doctor, fluid transfer to the other leg is common in lymphedema.

The second alarming symptom was scarlet specks, similar to nettle burns, which itched and caused discomfort. They appeared on the right shin.

It was the suspicious marks on the injured leg that made my mother seek help from a doctor. On the recommendation of a neurologist friend, she went to a phlebologist for a consultation.He wrote out a direction for ultrasound of the vessels of the legs. Mom underwent the procedure at the Rostov-on-Don cardiology center.

1500 R

Cost of ultrasound of the vessels of the lower extremities

With the results of the examination, my mother returned to the phlebologist. Having studied them, he made sure that the vessels of the veins were in order, and excluded diseases associated with disruption of the functioning of the blood vessels. Then he was diagnosed with lymphedema.

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Diagnostics of lymphostasis

For a correct diagnosis, it is best to contact a phlebologist. The doctor conducts an external examination, examines the medical history and, if necessary, prescribes blood tests: general, biochemical, coagulogram.

Instrumental studies are often assigned.

Doppler ultrasonography of the vessels of the lower extremities is an ultrasound examination that shows the condition of the veins in the legs.It is safe for health, helps to identify associated vein problems and distinguish lymphedema from varicose veins. The average cost of a research in Moscow is 1500-2000 R.

Lymphography – X-ray diagnostics of the patency of the lymphatic tract. To do this, a contrast agent is slowly injected into the lymphatic vessel and one or more X-rays are taken.

Lymphography is needed to find the site of inflammation, as well as to clarify the nature and degree of damage to the lymph nodes.The study is safe for health: the dose of X-rays received usually does not affect the body. The average cost of a study in Moscow is 10,000-15,000 R.

Lymphoscintigraphy, or lymph node scintigraphy is a diagnostic method in which radioactive isotopes are injected into the body subcutaneously or intradermally. They are carried by the lymph through the vessels and emit gamma rays, which are captured by a gamma camera.

As a result, special images are obtained – scintigrams, which help to find places where the patency of the lymphatic vessels is impaired.Lymphoscintigraphy is safe for health: radioactive isotopes are removed from the body within one to two days. The average cost of a study in Moscow is 5,000-10,000 R.

How to treat lymphostasis

It will most likely not be possible to completely cure this disease. It is chronic in nature, and therapy in most cases is reduced to eliminating symptoms. The fact is that the lymphatic vessels are very thin, and if they were once damaged, it is difficult to restore their patency.This means that in any case, lymph will accumulate under the skin from time to time, and the goal of treatment is to prevent it from stagnating there for a long time.

What does the treatment of lymphedema include?

Yuri Gustelev

Ph.D., vascular surgeon of the phlebological center “Antireflux”

Today the only effective way to treat lymphedema is complex decongestant therapy. It includes manual lymphatic drainage massage, compression bandaging, skin care and exercise therapy.

Drug therapy, including venotonic drugs, is not used for lymphedema. Physiotherapy is ineffective.

Manual lymphatic drainage massage is a special massage technique that stimulates the outflow of lymph. The massage is light and rhythmic, based on a combination of stroking movements. They force the lymph to rise to the center of the body through the lymphatic vessels. One session takes about an hour. Soreness of lymphatic drainage massage depends on the degree of neglect of lymphedema.

Pneumatic hardware massage is an analogue of manual lymphatic drainage massage, for which special couplings are used, where air is rhythmically injected. Hardware massage is less expensive than manual massage and has proven to be effective in research.

Bandaging is, in a sense, consolidating the effect of the massage. A bandage – an elastic bandage or compression hosiery – is selected by a specialist, taking into account the degree of neglect of the disease and the individual characteristics of the patient’s health.

Banding prevents lymph from accumulating again in areas with damaged vessels, which prevents the reappearance of edema. Without a bandage, the massage will have only a short-term effect: the result of the impact will not be fixed, and the liquid will freely return to the cavity between the organs.

Who conducts massage and bandaging for lymphedema

Yuri Gustelev

Candidate of medical sciences, vascular surgeon of the Antireflux phlebological center

Lymphatic drainage massage should be carried out by a specially trained medical worker: a massage therapist or a doctor.After the massage, it is necessary to correctly apply a multi-layer non-stretching bandage to the limb.

This is the lymphedema treatment session. You need to spend it daily. In advanced cases, it may take up to 40 sessions to eliminate the swelling.

Physiotherapy involves a set of exercises, the implementation of which strengthens blood vessels and maintains the effect of massage and bandaging. Physiotherapy is prescribed by a specialist, he can be found in specialized clinics and medical centers.The exercise therapy doctor calculates the load taking into account the degree of neglect of the disease and the individual characteristics of the patient.

Surgical treatment. Surgical operations to eliminate lymphedema are not always effective, therefore they are prescribed mainly to patients who are not helped by conservative treatment. In addition, even a successfully performed microsurgical intervention to suture lymphatic vessels or transplant lymph nodes does not guarantee that the patient will not have to regularly go for massage or wear compression underwear in the future.Therefore, the expediency of the operation should be discussed with the attending physician.

Skin care for lymphostasis

In case of lymphostasis, it is recommended to regularly moisturize the skin. Dryness can lead to cracks and infections easily.

It is important to quickly treat scratches and cuts, use insect bite repellents, and shave your legs carefully to avoid cuts. If you suspect a wound infection, consult a doctor.

Lymphedema – “Women’s Health” PDF, 697 KB

Lymphedema and Lymphorrhea: How to Fight Edema and Prevent Complications – “Workshop of Care” and the Faith Foundation PDF, 1400 KB

The injured limb is recommended to be washed regularly and kept clean.If it is a hand, you should not wear jewelry on it, it is important to use gloves when cleaning. There is no need to wear bracelets and tight shoes on the leg, so as not to squeeze the skin.

How much we spent on venotonics

After the phlebologist diagnosed my mother, he prescribed venotonics – drugs that stimulate the work of veins. For a course of venotonics for a whole year, we paid 12,000 R. The doctor did not mention massage, compression underwear, or exercise therapy. Then we did not yet know how doctors – supporters of evidence-based medicine recommend to treat lymphostasis, therefore we limited ourselves only to those prescriptions that were given to us.

Oddly enough, the treatment partially helped: the swelling decreased, trophic ulcers disappeared, the pain went away.

12,000 R

we paid for drugs that are not included in the clinical guidelines for the treatment of lymphedema

While I was working on the article, I read foreign clinical guidelines for the treatment of lymphedema and talked with experts. It came as a surprise to me that, in fact, drug therapy is considered, at best, an auxiliary method of treatment.

We can say we were lucky: the disease probably receded for a number of reasons. But there is no guarantee that it will work again next time, because lymphedema is an incurable disease. Therefore, I look closely at massage parlors, choose compression underwear for my mother and estimate how much the treatment will cost next time.

Does exercise help with lymphostasis

With lymphostasis, exercises are needed to maintain the effect of massage and banding, as well as to strengthen blood vessels.Lymphatic drainage gymnastics is useful for any course of the disease, but does not replace massage and bandages. Exercises are selected by the exercise therapy doctor, taking into account the condition and physical characteristics of the patient.

In case of leg lymphedema, it is recommended to practice in compression stockings and repeat each exercise 5-10 times. For example, in a prone position, it is useful to stretch your legs forward, slide your heels on the floor, raise and lower your legs, and do bicycle and scissor exercises.

Treatment of lymphostasis: expert advice – Phlebology Center

Is it worth using alternative methods of treatment

Traditional methods for lymphostasis are not shown and can even harm, because time will be lost.The use of herbal compresses or the use of hirudotherapy are pointless. There is no evidence of their effectiveness: they are not even mentioned in scientific publications.

Modern trends in the treatment and prevention of lymphedema of the lower extremities – “Questions of balneology, physiotherapy and exercise therapy”, 2018 PDF, 201 KB

Rehabilitation after treatment of severe stages

In severe lymphedema, lymphatic drainage massage, physiotherapy exercises, compression bandages and knitwear are prescribed.During rehabilitation, the patient continues to perform exercises that restore the functions of the injured limb, and gradually returns to normal life.

Prices for the treatment of lymphostasis

Treatment of lymphedema in accordance with international clinical guidelines cannot be obtained under the compulsory medical insurance and even under the VHI. The exception is situations when lymphedema develops as a complication of the treatment of cancer: some cancer centers provide patients with lymphatic drainage massage sessions, teach physiotherapy exercises.But most often, you have to treat lymphedema at your own expense.

20 329 R

lymphedema treatment costs per month in Rostov-on-Don

Let’s calculate the approximate cost of therapy.

Treatment of lymphedema per month – 20,329 R

It is important to make a reservation: most likely, lymphedema treatment sessions will not be needed every month – it all depends on the severity of the disease and the effect of the massage. The cost will also change: you do not need to renew the compression garments on a monthly basis, and after training in physiotherapy exercises, you can probably do without consulting an exercise therapy doctor.But from time to time, you still have to go to an appointment with a phlebologist in order to control the disease and adjust its treatment regimen.

Prevention of lymphostasis

Avoid injury. Any cut, scrape or burn can cause skin infections. Make sure that your shoes are comfortable and do not chafe, and do not go barefoot where you can step on a sharp object. If you have hand lymphedema, wear gloves when working in the garden and use a thimble when sewing.

Keep your limbs high. If your hands are swollen, knead them more often during the day, lifting them above your head. If your legs – do not stand for a long time in one place, do not carry weights, and when sitting – use a bench for the feet, this will facilitate the outflow of lymph.

Observe hygiene. Skin and nail care is not an aesthetic, but a medical issue for you. Examine the skin of the affected limb daily to notice any changes, sores or thickening of the skin in time.Cut your nails carefully: not too short so they don’t grow in and cause inflammation, but not too long so as not to accidentally scratch your skin.

Do not use compresses. Applying ice or a heating pad to the affected limb will not help with swelling, but only harm. Make sure that the affected arms or legs do not overheat and do not overcool: dress for the weather, do not go to the bathhouse or pool, unless the doctor has authorized.

Avoid tight clothing. Reconsider your wardrobe and give up items and jewelry that tighten your arms and legs: wearing them can contribute to the appearance of edema. By the way, if one hand is swelling, it is better to measure blood pressure with a tonometer on the other. Do not forget to warn doctors about this fact.

Save

1. Lymphostasis is a chronic disease of the lymphatic system, which is manifested by swelling of the hands and feet, sometimes by pain and skin changes.
2. In the event of unexplained edema of the extremities, it is important to consult a physician or phlebologist and exclude other possible diseases that require urgent treatment.
3. Curing lymphedema once and for all, most likely, will not work: in most cases, you have to relieve swelling from time to time with the help of massage sessions, bandaging and physiotherapy exercises.
4. Lymphedema ointments and tablets are ineffective. If a doctor prescribes them, it is worth getting a second opinion from another specialist.
5. In order for edema to appear less often, you need to adjust your lifestyle, take care of yourself from injuries and excessive physical exertion.

Excess fluid, swelling – symptoms, diagnosis, treatment methods.

Treatment methods

The choice of treatment tactics is based on the etiology and pathogenesis of edema. If swelling of the face is a symptom of the disease, it is treated by a specialized doctor. The fight against facial pastiness, which was caused by unfavorable factors, is the task of cosmetologists.

Treatment is carried out by complex methods and includes the correct daily regimen, a gentle diet, various cosmetic procedures. The latter group includes methods aimed at improving lymphatic and venous outflow and restoring the normal structure of facial tissues.Among them are marked:

• Mesotherapy.
• Microcurrents.
• RF-lifting.
• Lymphatic drainage massage.
• Ultrasound therapy.
• Vacuum action.
• Darsonvalization.
• Ozone therapy.

Our clinic offers several effective techniques that allow you to quickly and painlessly eliminate the pasty face. An individual program is drawn up for each patient after consulting a doctor and the necessary diagnostics.

Diagnostics and treatment in the clinic “Medicine and Beauty”

All doctors of our clinic possess modern methods of early diagnosis and treatment of a wide range of diseases in the areas of gynecology, urology, surgery, proctology, dermatovenerology, gastroenterology, etc. They have the skills of functional and ultrasound diagnostics, endoscopic research methods.

The clinic is equipped with expert class medical diagnostic equipment from leading European, Japanese, Korean and Russian manufacturers registered with Roszdravnadzor: PENTAX, MEDISON, ARAMO, SAMSUNG, UNIKOS, MATRIX, etc.We cooperate with leading laboratories and offer a full range of laboratory research. We work without days off and holidays, every day from 8.00 to 21.00.

This gives our patients the following benefits:

1. Efficiency and safety. The professionalism of our doctors guarantees high efficiency and complete safety in the treatment of diseases. Our clinic employs doctors of the highest category, candidates of science with over 10 years of experience.
2. Diagnostic Accuracy. The clinic is equipped with expert class equipment and offers a full range of modern laboratory tests from leading laboratories in Moscow at minimal prices.
3. Convenience and affordability. Convenient location in the center of Moscow and minimal prices for diagnostics and treatment make our clinic accessible to every patient.
4. The latest treatment methods. Proprietary treatment methods, strict adherence to the standards of medical care, guarantee the fastest and most effective treatment for each patient.

We guarantee high quality of service, efficiency of diagnostics and treatment. Contact us, we are always happy to help you! Reception and appointment for a consultation – by phone +7 (499) 372-05-62.

Lymph congestion: how it manifests itself | Marina Kostrova’s body aesthetics studio

lymph

lymphatic system

lymphatic drainage massage

lymphostasis

13.01.2020

At some point, the body ceases to cope with lymph cleansing, lymph fluid stagnation forms.What are the signs that you can tell if the problem has already formed?

The main symptom is swelling (you know how swelling looks like: a trace of the socks, a swollen face, thickening of the fingers),
Feeling of constant fatigue,
Deterioration of the skin condition (acne on the face and body),
Sweating,
Palpation reveals that lymph nodes are enlarged, and touching them is painful,
Gaining excess weight,
Strong personal odor (this happens because the lymph is saturated with bacteria and cannot excrete them except through the skin),
Tonsils do not work (they are part of the lymphatic system and stop working as a barrier to viruses).

In addition, it is important to know that excess fluid is formed to neutralize toxins in the body and it somehow reduces their concentration. As soon as we perform lymphatic drainage massage, the excretory systems work intensively for several hours, as the body is cleansed of toxins. At the same time, the body gets rid of unnecessary fluid.

From the unpleasant, but useful property of fat: adipose tissue deposits toxins and toxins, and with physical exertion, sufficient water and massage, along with the breakdown of fat cells, toxins are also removed.

Helpful advice!
In the morning, if you want to wake up and immediately be on, react quickly (and not wake up for an hour and a half on the way to work), in the evening before going to bed, do a light self-massage from the hips to the knees, from the shoulders to the elbows, in the groin and clavicular area by rubbing on lymphatic lines.
And, of course, try Mikulin’s exercises!

We are waiting for you for a massage!

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Fluid in the knee joint (effusion).Diagnostics and treatment

Online appointment

Where does the excess fluid come from?

There are three main reasons:

1. Inflammatory diseases of the knee joint – synovitis, bursitis, arthritis, etc.
2. Degenerative-dystrophic diseases of the joints – knee arthrosis, Baker’s cyst, etc.
3. Post-traumatic conditions – fractures of the articular bones, damage to the meniscus , capsules or ligaments, hemarthrosis (hemorrhage in the joint cavity).

Less commonly, the cause may be allergic reactions, infections, tumors.

How to understand that fluid has accumulated in the knee joint?

Regardless of the causes of this problem, the symptoms are always about the same:

1. Puffiness. At first, it may be small and even disappear. But then it increases. The knees look asymmetrical because of it.
2. Redness and peeling of the skin at the site of effusion, sometimes itching.
3. Elevated temperature of a local part of the body or the whole organism as a whole.
4. Pain of varying intensity, but usually quite severe.In this case, it arises both during movement and at rest.
5. If there is pus in the effusion, the pain is throbbing and sharp.
6. Limited mobility – Bending and extending the knee is getting harder and harder.

In case of acute pain and severe shapeless swelling, it is recommended to see a doctor immediately.

Where and to whom to go?

Orthopedic traumatologists are responsible for diagnosing the causes of knee effusion.

In the center of neurology and orthopedics “Alan Clinic” the initial appointment with an orthopedist-traumatologist lasts 1 hour, during which the doctor:

1. Collect anamnesis (ask questions about your condition, past diseases, medications, etc.).NS.).
2. Examine the swollen joint.
3. Performs special orthopedic tests to assess the general condition of the spine and musculoskeletal system.
4. Will establish a diagnosis or send for additional examinations to clarify the diagnosis. This can be ultrasound, MRI, CT, arthroscopy, puncture, biopsy, blood and urine tests.
5. In case of acute pain, he will offer emergency pain relief procedures – blockade, puncture (pumping out fluid).
6. Prescribe a course of complex therapy.
7. Will prescribe a rehabilitation course after treatment.

Make an appointment with an orthopedist

Emergency help – puncture of the knee joint

Puncture is a drawing of fluid with a syringe. It can be prescribed for both treatment and diagnosis.

In the center of neurology and orthopedics, puncture is carried out in several stages:

1. Pumping out excess fluid from the joint.
2. Rinsing the joint cavity with antiseptics.
3. Introduction of anti-inflammatory drugs into the joint.

If necessary, puncture is performed under ultrasound control.

Anti-inflammatory drugs injected into the knee area significantly improve the condition:

• reduce swelling and inflammation;
• relieve pain;
• improve blood microcirculation.

Puncture also helps in making the diagnosis. The liquid is not just pumped out, part of it is taken for analysis.

Puncture is not a panacea! Treatment and rehabilitation needed

Puncture provides relief for a maximum of several days.It temporarily relieves symptoms, but does not cure the disease. The disease continues to develop and may progress to a more severe stage.

Effusions with accumulation of purulent exudate are especially dangerous. They can lead to blood poisoning.

Other forms of effusion are fraught with reduction or even complete immobility of the joint. To maintain the full range of motion in the lower limb, it is necessary to eliminate not only the symptom, but also the cause.

Fluid in the knee joint: Treatment in Kazan

In the center of neurology and orthopedics “Alan Clinic” complex non-surgical therapy is carried out.

Treatment in 3 stages

1st stage : Relieve pain, inflammation and swelling of tissues.

2nd stage : Improve blood supply, restore nutrition and regeneration of connective tissues (ligaments, tendons, muscles, cartilage). Stop or slow down the destruction of the joint and inter-articular discs.

3rd stage : Develop the knee joint and consolidate the effect of the treatment. Increase the range of motion of the joint. Strengthen the muscle-tendon and ligamentous apparatus.Improve the stability of the knee joint.

Team of specialists

A whole team of specialists from various rehabilitation fields works with each patient. The higher the degree of complexity of your disease, the more specialists can be employed to work with you.

More than 20 treatment methods

The treatment rooms of the Center for Neurology and Orthopedics have more than 20 treatment methods. All of them have successfully proven their safety and high efficiency in the treatment of joint diseases in people of various ages, including children and adolescents.

A unique treatment program is selected for each patient, taking into account the characteristics of the organism of this particular patient.

Great importance is attached to the compatibility of different procedures. When prescribing several therapeutic manipulations on one day, such combinations of techniques are selected that are most effective in your case.

Among our methods:

1. Osteopathy – aimed at restoring the normal functioning of the musculoskeletal tissue
2. Isometric kinesiotherapy is a special system of exercises aimed at rejuvenating large connective limbs.It is used for rehabilitation after injuries and injuries, as well as for joint stiffness and after inflammatory processes.
3. Exarta – a set of exercises performed on a specially designed installation (harness). Promotes neuromuscular activation and muscle tone stabilization.
4. Kinesio taping – the application of a special elastic patch on injured areas of the body. Reduces some of the stress on the joint and muscles and thus helps to get rid of pain faster.Stimulates the anti-inflammatory process, improves lymph drainage, facilitates the movement of lymph, facilitates the movement of joints, gently stabilizes the joints.
5. Manual therapy – with the help of hands the therapist influences the entire body of the patient. Facilitates the general well-being of the patient. Provides blood flow to the damaged joint. Restores the motor functions of the knee. Creates the prerequisites for the start of the recovery process. Reduces the intensity of the clinical manifestations of the disease.
6. Plasmolifting – the introduction of purified autoplasma into the affected area. Promotes the restoration and regeneration of the cartilage tissue of the joints and ligaments.

Knee effusion significantly reduces quality of life, restricts movement and can lead to serious consequences. Do not lead to immobility and operations – see a doctor in time!

Appointment for diagnostics and treatment

Gevol Liquid-fluid for skin care around nails 10901 15ml

Description

Gehwol Fluid is designed to care for problem areas around nails, restore healthy skin and treat ingrown nails.Essential oil of the clove tree, which is part of the Gevol remedy for ingrown nails, perfectly heals and eliminates pustular and infectious lesions around the nails. The drug relieves pain during inflammation, relieves burning and itching. Thyme essential oil (thymol) has a disinfecting, anti-inflammatory and bactericidal effect, it is excellent for the treatment of ulcers, abscesses and small wounds. Also, thyme oil saturates the skin and nail plate with tannins and minerals, vitamins (including vitamin K, which is not produced by the body, but is necessary to ensure good blood clotting).The drug improves skin elasticity and strengthens the walls of superficial vessels, reducing the likelihood of injury during the pedicure procedure.

Application

Use Gehwol Fluid daily 1-2 times a day for treatment. Apply 1-2 drops of the drug to problem areas of the skin and leave until completely absorbed. The product is suitable for softening the skin around an ingrown toenail and relieving soreness.

Gevol Liquid-fluid for skin care around nails 10901 15ml available.Find out how to buy goods with free delivery to Yekaterinburg, Nizhny Tagil, Pervouralsk, Serov, Rezh, Verkhnyaya Pyshma, Bogdanovich and other cities of the Sverdlovsk region and Russia on the Delivery page.

Gevol Liquid-fluid for skin care around nails 10901 15ml
GEVOL

Description
Gehwol Fluid is designed to treat problem areas around nails, restore healthy skin and treat ingrown nails. Essential oil of the clove tree, which is part of the Gevol remedy for ingrown nails, perfectly heals and eliminates pustular and infectious lesions around the nails.The drug relieves pain during inflammation, relieves burning and itching. Thyme essential oil (thymol) has a disinfecting, anti-inflammatory and bactericidal effect, it is excellent for the treatment of ulcers, abscesses and small wounds. Also, thyme oil saturates the skin and nail plate with tannins and minerals, vitamins (including vitamin K, which is not produced by the body, but is necessary to ensure good blood clotting). The drug improves skin elasticity and strengthens the walls of superficial vessels, reducing the likelihood of injury during the pedicure procedure.Application
When treating, use Gehwol Fluid daily 1-2 times a day. Apply 1-2 drops of the drug to problem areas of the skin and leave until completely absorbed. The product is suitable for softening the skin around an ingrown toenail and relieving soreness.
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10901

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