Conditions
Lymphoedema and the Lymphatic System
The Lymphatic System
The lymphatic system plays an essential role in keeping your body healthy. Its two main functions are supporting your immune system, helping to protect you from infection and disease, and managing fluid balance within the body.
It works by moving fluid, vitamins, and hormones around the body, keeping tissues balanced. Most of this fluid is filtered and reused by the body, while waste products are safely removed through the urinary system.
What Happens When the Lymphatic System Isn’t Working Properly?
When the lymphatic system is unable to work efficiently, protein-rich fluid and waste products can begin to build up in the body’s tissues. This causes swelling and increases the risk of infection and skin changes.
Swelling is most commonly seen in one or both arms or legs, but it can also affect other areas, including the breast, head and neck, abdomen, and genitals.
If this build-up of lymphatic fluid continues over time, changes may occur in the skin and underlying tissues, such as:
- Thickening of the skin
- Skin feeling firmer to touch
- Dry or cracked skin
- Small, benign wart-like growths (papillomatosis)
Lymphoedema
Lymphoedema is a chronic, progressive condition that occurs when the lymphatic system is unable to move fluid effectively, leading to ongoing swelling.
Early symptoms may include:
- A feeling of tightness or heaviness in the affected area
- Clothing, shoes, or jewellery feeling tighter than usual
- Indentations in the skin from socks, rings, or clothing
- Recurrent episodes of infection (cellulitis) requiring antibiotics
Types of Lymphoedema
Primary lymphoedema
This occurs due to an underlying developmental issue with the lymphatic system, often genetic. Although present from birth, symptoms may not appear until later in life, sometimes triggered by additional strain or damage to the lymphatic system.
Secondary lymphoedema
This develops following damage to a previously healthy lymphatic system. Contributing factors may include:
- Cellulitis or repeated infections
- Inactivity or reduced mobility
- Chronic inflammatory conditions
- Obesity
- Venous disease
- Heart failure
- Lipoedema or lipolymphoedema
- Deep vein thrombosis (DVT)
- Certain medications, including some blood pressure tablets (such as amlodipine), steroids, non-steroidal anti-inflammatory drugs, and sex hormones
- Surgery
- Cancer +/- its treatments
Management and Treatment
While lymphoedema cannot currently be cured, it is highly manageable, particularly when identified and treated early. Even long-standing lymphoedema can be effectively managed, although improvement may take longer and require a more structured approach.
Early assessment and personalised management can help reduce symptoms, protect skin health, and improve comfort and quality of life.
Lipoedema (also known as Lipalgia)
Lipoedema is a chronic condition characterised by the excessive and symmetrical laying down of fat cells, most commonly in the legs and thighs, tho it can affect the arms too. A key features of Lipoedema is that the feet and hands remain unaffected, creating a distinctive ‘cuffing’ appearance around the ankles (and wrists).
People with Lipoedema often experience heightened sensitivity in the affected areas, which may also bruise easily. On palpation, the tissues can feel lumpy, nodular or dimpled. Un like typical weight gain, the fatty tissue linked to Lipoedema does not respond to conventional diet or exercise, leading to a disproportional body shape, despite efforts to reduce weight. Lipoedema primarily affects women, however in rare cases it can affect men also. Although the precise cause of lipoedema remains unknown, it often develops around times of hormonal change- such as puberty, pregnancy, or (peri) menopause, suggesting a potential hormaone influence.
Diagnosis can be challenging due to similarities with conditions such as lymphoedema, obesity and Dercums disease. However with a specialist assessment by a trained Lipoedema Practitioner, an accurate diagnosis can be made and an individualised management plan can be developed.
Heart Failure:
Heart Failure and Swelling
Heart failure occurs when the heart is unable to pump blood as effectively as it should. This can lead to a build-up of fluid in the body, most commonly affecting the legs, ankles, feet, and sometimes the abdomen. Swelling may be more noticeable in the evening or after increased activity.
Common symptoms include:
- Swollen legs, ankles, feet, or abdomen
- Skin that appears shiny or stretched
- Pitting oedema (when pressing the skin leaves an indent)
Management of heart failure–related swelling may include diuretic medication (water tablets), compression hosiery used with caution, and dietary or lifestyle adjustments. These treatments should always be guided and monitored by your medical team, such as your GP, cardiac consultant, or specialist nurse.
If you notice sudden weight gain, worsening or persistent swelling, increasing breathlessness, or unusual fatigue, please seek medical advice promptly, as these may indicate a change in your heart condition.
Post-Procedure Swelling
Swelling after a procedure such as surgery or liposuction is a normal part of the healing process. It is usually most noticeable in the first few days and can last for up to three months, gradually improving over time.
Swelling typically settles with measures such as:
- Gentle movement
- Elevation
- Compression (if advised)
- Ice in the early stages
If swelling is worsening or has not improved after three months, further review is recommended.
Once the skin has fully healed, post-procedure Manual Lymphatic Drainage (MLD) can be very helpful. MLD may reduce inflammation, swelling, bruising, and tissue firmness, and can support a smoother, more comfortable recovery.
When to Seek Medical Advice
Please contact your doctor promptly if you experience:
- New or significant swelling and pain in one limb compared to the other
- A high temperature or fever
- Redness, warmth, or increasing pain in the area
- Malodorous or unusual discharge from wounds
These symptoms may indicate infection or another complication requiring medical review.
Scars, Adhesions, Fibrosis, and Swelling
When the body heals after surgery, injury, or trauma, scar tissue forms as part of the natural repair process. While this is normal, scars do not behave like healthy skin and tissue.
Adhesions occur when scar tissue binds layers of tissue together that would normally move freely.
Fibrosis refers to an abnormal thickening or hardening of tissue caused by excess collagen during healing.
Scars, adhesions, and fibrosis can:
- Restrict movement of the skin and underlying tissues
- Alter normal fluid flow
- Place strain on the lymphatic system
When tissues cannot move and drain fluid effectively, this can contribute to persistent swelling, discomfort, and a feeling of tightness in the affected area or surrounding regions.
Targeted Restore scar therapy and lymphatic techniques can help reduce pain, soften tissue, improve mobility, and support healthy fluid movement, even in scars that are many years old.