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Stages of Lymphedema

There are four stages of lymphedema (Stage 0-3; according to the International Society of Lymphology, 2016) that each impact your body in different ways.

Without treatment, lymphedema is a progressive disease. There are four stages of lymphedema 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 categorize the stage of your lymphedema – and together, you will build a treatment plan that is right for you. The earlier you start with the treatment, the better are your chances to prevent the progression and improve the symptoms of your lymphedema.

Stage 0: Latent or Subclinical Stage

In stage 0, the edema 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 swelling. You may notice that the affected area looks puffy. Elevating your limb will help the swelling to go away. The edema is soft and may leave an impression when you push on the skin, called ‘pitting edema’.

Stage 2: Moderate Stage

With stage 2, you will notice that limb elevation alone rarely reduces swelling. Pitting is manifest. Later in stage II 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 more possible. 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 proper management of your symptoms. It prevents your lymphedema from progressing, improves the limb shape and skin condition and reduces the risk of infection. Your condition may also return to a less severe stage.