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Stages of Lymphedema

Stages of Lymphedema

There are 4 stages of Lymphedema (Stages 0-3) according to the International Society of Lymphology.

Stage 0: Latent Stage

In stage 0, the swelling/edema is not yet visible, however there is an impairment in the lymphatic fluid transport in the body. It may take several months to years before noticing any swelling. It is therefore important to know if you are at risk of developing Lymphedema, especially after cancer treatments or surgery, so that lymphedema treatment can start immediately you notice any changes.


Stage 1: Mild Stage

In stage 1, the lymph collects in the affected area(s) and causes swelling. The areas affected may look puffy and the swelling goes away when you elevate the affected limb. This stage is mostly reversible, when it is early detected and managed appropriately.


Stage 2: Moderate Stage

In stage 2, the swelling becomes more obvious and elevating the limb alone doesn’t reduce the swelling. Pitting edema is present, where the skin leaves an indentation when you push on the skin. This stage can progress from pitting edema to non-pitting edema as excess fat and hardening of the skin develops. A lot of people ignore the previous stages and start seeking help at this stage. Stage 2 is not reversible most of the time.


Stage 3: Severe Stage

In stage 3, the swelling is more extensive, and the skin becomes hard (fibrotic). When you push on your skin, it doesn’t leave an indentation (non-pitting edema). Skin changes occur such as thickening, discoloration, skin folds, fat deposits, wart-like growths and recurrent infections such as cellulitis. The affected limb may also form different shapes because of the extra skin folds and swelling that causes lobules.


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