Lymphoedema and lipoedema: differences, similarities and the link to varicose veins

Lymphoedema and lipoedema are two common but often misunderstood medical conditions that primarily affect women.
Although they can have similar symptoms, they are different conditions, each with their own causes and treatment approaches.
Many patients do not know exactly what the difference is between these two conditions.
In this article, we at the VenaZiel Vein Competence Center (VKZ) Berlin would like to explain the differences and similarities between lymphoedema and lipoedema and their connection to varicose veins.

What is lymphoedema?

Definition and causes of lymphoedema Lymphoedema is a chronic condition caused by an accumulation of lymph fluid in the tissues.
This occurs when the lymphatic system, which is responsible for removing excess fluid from the tissues, does not function properly.
There are two main types of lymphoedema: Primary lymphoedema: this form of lymphoedema is congenital and can occur due to genetic abnormalities.
Symptoms may become apparent in childhood, adolescence or early adulthood. Secondary lymphoedema: This develops as a result of damage to the lymphatic system, for example due to surgery, radiation, infections or injuries.
Tumors or severe inflammation can also cause secondary lymphoedema. Symptoms of l ymphoedema The typical symptoms of lymphoedema include swelling, usually in the arms or legs, a feeling of heaviness or tightness in the affected areas and restricted mobility.
The skin may appear hardened or thickened, and infection or inflammation may occur.
If left untreated, lymphoedema can lead to a significant reduction in quality of life.

What is lipedema?

Definition and causes of lipoedema Lipoedema is a chronic fat distribution disorder that almost exclusively affects women.
It is a genetic disorder in which there is a symmetrical increase in fatty tissue on the legs, hips and sometimes also on the arms.
In contrast to lymphoedema, lipoedema does not affect the lymphatic system directly, but the subcutaneous fatty tissue. Symptoms of lipoedema The symptoms of lipoedema include a disproportionate distribution of fat, often combined with pain, tenderness and a tendency to bruise.
The affected areas often feel soft and spongy, and in advanced stages there can be a massive enlargement of the extremities, which can severely restrict mobility.
Lipoedema can also cause psychological stress, as those affected often suffer from their altered body image.

Differences between lymphoedema and lipoedema

Although both lymphoedema and lipoedema can lead to swelling of the limbs, there are significant differences:

• Distribution of swelling: Lymphoedema often occurs asymmetrically, whereas lipoedema occurs symmetrically on both legs or arms.
• Nature of the swelling: The swelling in lymphoedema tends to be hard and firm, whereas in lipoedema it is soft and spongy.
• Causes: Lymphoedema is caused by a disorder of the lymphatic system, while lipoedema is a fat distribution disorder.
• Pain: Lipoedema is often painful and sensitive to pressure, whereas lymphoedema does not usually cause pain but can make you feel tight.
• Symptom progression: Lipoedema usually worsens over time, especially without treatment.
  Lymphatic swelling, on the other hand, can occur in episodes or worsen after certain triggers.

Connection between varicose veins, lymphoedema and lipoedema

Varicose veins: Causes and symptoms Varicose veins are enlarged, swollen veins that usually appear on the legs.
They occur when the venous valves no longer close properly and the blood is no longer transported back to the heart effectively.
This leads to blood congestion and increased pressure in the veins.
Symptoms include visible, twisted veins, swelling, pain, a feeling of heaviness in the legs and sometimes skin changes or ulcers. Varicose veins and lymphoedema There is a close link between varicose veins and lymphoedema.
If the venous blood circulation is impaired, this can lead to additional strain on the lymphatic system.
This can promote the development or worsening of lymphoedema.
Poor venous function can also cause fluid to leak into the surrounding tissue, further exacerbating the swelling.
It is therefore important to consider the lymphatic system when diagnosing and treating varicose veins. Varicose veins and lip oedema Even though varicose veins and lipoedema have different causes, they often occur together.
In lipoedema, the extra fatty tissue can impair venous return, which can lead to the development of varicose veins.
Conversely, varicose veins can increase the pressure and symptoms of lipoedema.
Holistic treatment should therefore take both aspects into account in order to achieve optimum symptom relief.

Diagnostics and treatment

Diagnosis The diagnosis of lymphoedema, lipoedema and varicose veins requires a thorough clinical examination and often also imaging procedures such as ultrasound or lymphoscintigraphy.
An experienced specialist can make the correct diagnosis based on the symptoms and examination results.
A comprehensive medical history is also important in order to take into account the patient’s individual risk factors and medical history. Treatment of lymphoedema The treatment of lymphoedema usually includes

• Manual lymphatic drainage: A special massage technique to promote lymphatic drainage.
• Compression therapy: Use of compression bandages or stockings to reduce swelling.
• Exercise therapy: Special exercises that stimulate the lymph flow.
• Skin care: Avoid injuries and infections through careful skin care.

In addition, it is often necessary to treat existing varicose veins in order to eliminate the venous reflux disorder and reduce the strain on the lymphatic system.
Various minimally invasive methods are available for this purpose. Treatment of lipoedema The treatment of lipoedema focuses on reducing symptoms and improving quality of life.
The treatment options include

• Compression therapy: Use of compression stockings or pants to reduce swelling and improve circulation.
• Manual lymphatic drainage: To reduce swelling and alleviate discomfort.
• Exercise therapy: Regular, gentle exercise such as swimming or cycling to relieve symptoms.
• Dietary changes: A healthy diet can help to slow down the progression of lipoedema.
• Liposuction (liposuction): In advanced cases, liposuction may be considered to remove the excess fatty tissue and alleviate symptoms.
  This method has proven to be effective in reducing symptoms and improving quality of life.

Treatment of varicose v eins The treatment of varicose veins ranges from conservative measures to minimally invasive procedures:

• VenaSeal (vein glue): A modern, minimally invasive method in which a special medical adhesive is used to seal the affected veins.
  This method is particularly gentle and does not require surgery.
• Endovenous radiofrequency therapy (ClosureFast or Venclose): Another minimally invasive method in which radio waves are used to close the affected veins.
  This method is also very effective and gentle.
• Endovenous laser therapy: A minimally invasive procedure to close the affected veins using laser energy.
• Sclerotherapy: A method in which a sclerosing agent is injected into the affected veins to close them.

The choice of treatment depends on the severity of the varicose veins and the individual needs of the patient.
Timely treatment can alleviate the symptoms and prevent complications.

Conclusion

Lymphoedema and lipoedema are two different but serious conditions, but they have similar symptoms and are often associated with varicose veins.
A correct diagnosis and a comprehensive treatment plan are crucial for improving the quality of life of those affected.
The VenaZiel Vein Competence Center (VKZ) Berlin is here to help you with its expertise and modern treatment methods to alleviate your symptoms and improve your health.
If you have any questions or concerns about your symptoms, please do not hesitate to contact us and arrange a consultation.