Four Stages Of Lymphedema

Think of it as the four horsemen. There are four stages of lymphedema.

(Sometimes they are referred to as a “pre-stage” or stage 0 and three additional stages. But regardless there are four stages that happen.)

Stage 0: There are no signs or symptoms of lymphedema but underneath the surface, there’s abnormal lymphatic flow happening. This can happen for months or even years without detection.

Stage 1: Fluid begins to accumulate and swelling starts. Body parts might look “puffy.” This is when some doctors mistakenly prescribe diuretics. (A big don’t.) Watch this video to learn more. Swelling may increase and decrease but it is always present.

When the skin is touched (like putting a thumb on top of a swollen foot) it will leave an imprint that doesn’t go away. This is called pitting.

Stage 2: Swelling doesn’t ever go away. Skin begins to thicken at the end of Stage 2. It gets harder, like a dried-out orange peel. Fat pockets can form and create fibrosis—the thickening, hardening of skin and tissue. Therapists may use foam covered with bandages to “chip” away at the pockets of tissue that are beginning to harden.

Stage 3: Limbs are massively swollen with elephantiasis. The skin has thickened severely becoming tough like leather and now folds over with fat deposits covered in wart-like growths that can “weep” leaking lymphatic fluid.