Lymphoedema Diagnosis and Treatment in London

Understanding Lymphoedema

Lymphoedema is a condition that occurs when the lymphatic system—responsible for draining fluid and filtering waste—does not work effectively. This results in fluid accumulation, leading to chronic swelling. It can be primary (due to developmental abnormalities of lymphatic vessels) or secondary (caused by surgery, radiotherapy, trauma, or infection). Unlike temporary swelling, lymphoedema is long-term and requires ongoing care.

Causes of Lymphoedema

The lymphatic system is made up of a network of vessels and nodes that help return fluid to the bloodstream and fight infections. Lymphoedema occurs when this system is blocked or damaged.

• Primary lymphoedema: Caused by congenital or genetic problems affecting lymphatic vessels. May present at birth, during adolescence, or adulthood.
• Secondary lymphoedema: Far more common. Causes include:
  • Cancer treatments such as radiotherapy or lymph node removal
  • Infections such as cellulitis or filariasis (tropical regions)
  • Trauma or surgery damaging lymph vessels
  • Venous disease increasing pressure on lymphatic circulation

Symptoms of Lymphoedema

The presentation of lymphoedema varies depending on severity and location. Common symptoms include:

• Persistent swelling in one or more limbs
• Sensation of heaviness or tightness
• Skin changes such as thickening, fibrosis, or warty texture
• Reduced flexibility and mobility
• Recurrent skin infections (cellulitis)
• Pain or aching discomfort

Lymphoedema Diagnosis

Diagnosis is usually clinical, based on history and examination. Investigations may include:

• Limb measurements to track swelling progression
• Ultrasound to rule out deep vein thrombosis
• Lymphoscintigraphy to visualise lymphatic drainage
• MRI or CT scans in complex cases to rule out tumour obstruction

Lymphoedema Treatment and Management

While lymphoedema cannot be completely cured, treatments aim to control symptoms, reduce swelling, and prevent complications:

• Compression therapy: Custom-fitted garments or bandages help reduce swelling and improve lymph flow.
• Manual lymphatic drainage: Specialised massage technique to encourage lymph drainage.
• Exercise: Regular activity promotes circulation and fluid movement.
• Skincare: Keeping skin healthy reduces risk of infection.
• Specialist physiotherapy: Intensive treatment programmes may be prescribed.
• Surgical options: In selected cases, procedures such as lymph node transfer or liposuction may help.

Living with Lymphoedema

Lymphoedema requires long-term self-care. Patients are encouraged to maintain a healthy weight, follow skincare routines, wear compression garments consistently, and seek prompt medical advice for signs of infection. Support groups and psychological support may also help patients cope with the challenges of a chronic condition.

Your first visit — what to expect

1. History: Review of symptoms, onset, and risk factors such as cancer treatment or infections.
2. Examination: Limb swelling, skin changes, and mobility assessed.
3. Investigations: Tests arranged if secondary causes are suspected.
4. Management plan: Personalised advice on compression, skincare, and lifestyle changes.
5. Referral: Where needed, referral to specialist lymphoedema services or physiotherapists.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 21 August 2025