Stages of Lymphedema

There are four primary stages of lymphedema that each impact the body in different ways. They are categorized according to severity and run from subclinical to severe. Work with your physician and/or therapist to determine your stage of lymphedema. Together, you will build a plan that is right for you.

Stage 0 - Latency or subclinical stage

Stage 0 is a subclinical stage where swelling is not visible to the eye or even measurements. Protein will start to accumulate and cause small changes. You may sometimes feel a sense of heaviness in the area. This stage may exist for months or years before edema becomes evident. It is important to monitor the at-risk area so that you can start treatment as soon as possible if you notice any changes. Early treatment can make the management of your symptoms easier.

Stage 1- mild stage

With Stage 1 there is an early collection of high protein fluid. You may notice that your hands or feet look puffy and that elevating your limb will help the swelling go away. The edema may leave an impression when you push on the skin, which is called pitting edema. You can see an example of this in the photo.

Stage 2 - moderate stage

With Stage 2, you will notice that limb elevation alone rarely reduces swelling. Pitting may or may not occur as tissue fibrosis develops.

Stage 3 - lymphostatic elephantiasis (severe stage)

At Stage 3, there is extensive swelling present. Tissue is hard (fibrotic) and pitting is absent. Skin changes, such as thickening, hyperpigmentation (change of color), increased skin folds, fat deposits, and warty overgrowths can develop.