Lymphedema is the accumulation of lymphatic fluid in the body, being most common in the legs or arms, but it can also occur in the genitals, face, neck or chest, leading to the appearance of symptoms such as swelling or a feeling of heaviness in the affected area, redness of the skin, or difficulty moving.

Lymphedema occurs due to injury or blockage of the lymphatic vessels, and is most common after cancer surgery or after removal of lymph nodes. However, it can also occur due to genetic factors or even infections, such as elephantiasis. Learn what elephantiasis is and how to identify it .

Lymphedema is treated by a general practitioner, algologist or vascular surgeon, who may recommend physiotherapy, lymphatic drainage or elastic compression bands to help eliminate excess fluid and facilitate movement of the affected area of ​​the body, or even surgery in more severe cases.

Symptoms of Lipedema

Typical symptoms of lipedema include:

•  Difference in size of feet and legs. If you have lipedema, there’s typically a noticeable difference in size between your feet, which are not affected by the condition, and your lower half and column-like legs. For example, the top half of your body may be a size 8, but the bottom half may be a size 16.

• Pain. Lipedema can be painful, either constantly or only when pressure is applied. , Your skin may also bruise easily.

• Heavy feeling and swelling. You may experience swelling and a heavy feeling in your legs.

• Buildup of fat. As the condition progresses, fat continues to build up, and your lower body grows heavier. Fat can later collect in the arms.

• Loose skin. Lipedema can cause large folds of skin to form.

• Bumps. Bumps inside the fat may make it feel like something is under your skin.

• Fatigue. If you have lipedema, you may feel more tired more often than usual.

  The main symptoms of lymphedema are:

  • Swelling in the legs or arms, including the fingers;
  • Swelling in other areas of the body, such as the breasts, testicles, scrotum, face, neck or abdomen;
  • Sensation of heaviness in the affected area;
  • Difficulty moving the affected limb;
  • Red or darker skin in the affected area;
  • Tougher skin, known as fibrosis;
  • Dry, thicker, scaly skin in the affected area;
  • Skin nodules;
  • Increased temperature in the affected skin;
  • Pain or discomfort in the affected limb or area of ​​the body;
  • Tingling or numbness sensation;
  • Itchy skin or burning sensation;
  • Blisters with fluid on the skin.

  • How to confirm the diagnosis

    The diagnosis of lymphedema is made by a general practitioner, angiology’s or vascular surgeon through an assessment of symptoms, as well as their onset and duration, family history of lymphedema, health history, cancer or surgery history, in addition to a physical examination of the affected region.

  • Furthermore, when there is doubt about the diagnosis, the doctor may request imaging tests, such as ultrasound, magnetic resonance imaging, computed tomography or lymphoscintigraphy, for example.
    

    Possible causes

    Lymphedema is caused by the accumulation of lymphatic fluid, which is a protein-rich fluid, outside the blood and lymphatic circulation, accumulating in the space between cells and fibro-adipose tissue, due to an injury or blockage in the lymphatic vessels.

    Some factors can contribute to the development of lymphedema, such as:

    • Family history of lymphedema;
    • Congenital malformation of the lymphatic system;
    • Cancer surgery, especially when lymph nodes and vessels are removed;
    • Radiotherapy for the treatment of breast, prostate or bowel cancer;
    • Metastasis of cancer from other parts of the body, in the lymphatic system;
    • Trauma to the lymphatic vessels;
    • Overweight or obesity;
    • Rheumatoid arthritis;
    • Psoriatic arthritis;
    • Eczema;
    • Tumors or cancer that affect areas close to the lymphatic vessels;
    • Leukemia;
    • Peripheral vascular surgery;
    • Chronic venous insufficiency in the extremities;
    • Heart disease;
    • Kidney diseases.

    In addition, lymphedema can arise due to infections close to the lymphatic vessels, such as bacterial cellulitis, or that cause scarring in the lymphatic vessels, as in the case of filariasis or elephantiasis.

    Types of lymphedema

    Lymphedema can be classified into different types, according to its cause, the main ones being:

  • 1. Primary lymphedema

    Primary lymphedema, although very rare, occurs due to hereditary or congenital causes, due to changes in the development of the lymphatic system or genetic alterations.

    This type is subdivided into a few categories, which include:

    • Congenital lymphedema: usually present from birth or may develop up to 2 years of age;
    • Early lymphedema: develops during puberty or up to 30 years of age;
    • Late lymphedema: develops after 35 years of age.

    The type of lymphedema is identified by the doctor through diagnostic tests and evaluation of the health history and cases of lymphedema in the family.

    2. Secondary lymphedema

    Secondary lymphedema occurs due to some obstruction or change in the lymphatic system due to infectious disease, cancer treatment or traumatic injury. In these cases there is always inflammation of the tissues involved and a risk of fibrosis.

    Lymphedema is very common after breast cancer, when lymph nodes are removed during surgery to remove the tumor, because lymphatic circulation is impaired, and due to gravity, excess fluid accumulates in the arm.

  • FAQs: Lipedema: symptoms

  • How is the treatment done?

    Lymphedema treatment should be carried out under the guidance of a general practitioner, angiologist or vascular surgeon, with the aim of improving lymphatic circulation, eliminating excess fluid and facilitating movement in the affected area of ​​the body.

    Therefore, the main treatments that can be indicated by the doctor are:

  • Treatment of the disease requires a restrictive and continuous diet, like that of hypertensive or diabetic patients, but focused on foods with anti-inflammatory action, such as fresh fruits and vegetables, and excluding sugars and certain types of fats. It is also necessary to maintain an exercise routine, especially aerobic and low-impact exercises, which improve circulation and reduce fat accumulation in the affected areas. Vascular surgeries and liposuction specifically for lipedema are the treatments that bring the greatest benefit to patients in more advanced stages. Lymphatic drainage procedures and the use of elastic compression devices are also recommended to reduce swelling and stimulate circulation.

  • Lipedema Treatments

    Lipedema doesn’t have a cure, but treatment can help improve symptoms.

    • Exercise and a healthy diet. Lifestyle changes, such as a heart-healthy or anti-inflammatory diet, may help. Certain types of exercise can help increase lymph flow.

    • Compression. Pneumatic compression devices, which are inflatable garments that you put on your legs and that fill with compressed air, and compression stockings may help reduce pain and improve symptoms.

    • Skin moisturizer. This can help prevent your skin from drying out.

    • Medications, supplements, and antioxidant herbal medicines may help manage symptoms. For example, selenium may improve inflammation, and fat-burning supplements may help reduce fat. Amphetamines, diosmin, metformin, phentermine, and resveratrol may help with inflammation, swelling, and other issues.

    • Conclusion: Lipedema: symptoms

      lipedema is a chronic condition that primarily affects women and is characterized by the abnormal accumulation of fat, often leading to significant physical and emotional challenges. Recognizing the symptoms early—such as disproportionate fat distribution, pain, and easy bruising—can lead to better management and treatment options. Awareness and understanding of lipedema are crucial, not just for those affected but also for healthcare professionals, to provide appropriate care and support.

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