Stages of Lymphoedema

Without treatment, lymphoedema is a progressive condition. There are four stages of lymphoedema that are graded according to their severity and run from not visible (stage 0) to severe (stage 3).

Your healthcare professional will assess, diagnose and probably categorise the stage your lymphoedema is at – and together, you will build a treatment plan that is right for you. The earlier you start with the treatment, the more likely you are able to prevent the progression and improve the symptoms of your lymphoedema.

Stage 0: Latent or Subclinical Stage

In stage 0, the oedema is not visible or even evident using limb measurements despite impaired lymph transport. This stage may exist for months or years before you notice any swelling. Therefore, it is important to keep an eye on the at-risk area. As soon as you notice any changes, treatment should be started.

Stage 1: Mild Stage

In stage 1, fluid starts to collect in the affected area and causes a swelling. You may notice that the affected area looks puffy. Elevating your limb will help the swelling reduce. The oedema is soft and may leave an impression when you push on the skin, called ‘pitting oedema’.

Stage 2: Moderate Stage

With stage 2, you will notice that limb elevation alone rarely reduces swelling. In early stage 2 pitting is present. Later in stage 2 the limb may not pit as excess subcutaneous fat forms and tissue fibrosis (hardening of the skin) develops. Swelling increases.

Stage 3: Severe stage

In stage 3, there is extensive swelling present. The tissue is fibrotic (hard) and pitting is no longer present. Skin changes, such as thickening, hyperpigmentation (change of color), increased skin folds, fat deposits, and wart-like growths, can develop. The skin becomes susceptible to deep, poorly healing wounds and is in danger of infection.

Early treatment can support the management of your symptoms. It may prevent your lymphoedema from progressing, improve the limb shape and skin condition and reduces the risk of infection. Your condition may also return to an earlier stage.

Learn more about treatment for lymphoedema