top of page

Lymphedema Care 

Current Treatment Options for Lymphedema
Patient & Family Guide

There is no full cure yet, but you can control symptoms and protect your health with the right treatment.
The most effective plan often combines Complete Decongestive Therapy (CDT), compression, safe exercise, skin care, and—in some cases—surgery (International Society of Lymphology [ISL], 2023). 

Complete Decongestive Therapy (CDT):

The gold standard for lymphedema care (ISL, 2023). 
It has four parts:

  • Manual Lymphatic Drainage (MLD): Gentle massage to help fluid move.

  • Compression bandaging/garments: Keeps swelling down after it’s reduced.

  • Exercise: Light movement to support lymph flow.

  • Skin care: Protects skin and reduces infection risk.

 

CDT works best in the early and middle stages, but it’s also important later to stop the condition from worsening (McNeely et al., 2024).

Compression Garments & Devices:

  • Daytime garments/wraps: Meant to maintain—not reduce—swelling.

  • Nighttime compression: Can help maintain or further reduce swelling in some people (McNeely et al., 2016; McNeely et al., 2022; Brunelle & McNeely, 2022).

  • Pneumatic compression pumps: Provide short-term swelling reduction but should be combined with daily garment use (Hou et al., 2024). 

Exercise & Movement
(what if you exercise without compression?):

Good news:

  • Exercise is safe and beneficial for most people with lymphedema. It helps lymph move, supports strength, and does not increase swelling when progressed gradually (Schmitz et al., 2009; McNeely et al., 2024; Cancer Research UK). 

 

With or without compression?

  • Short-term studies show doing remedial exercises without compression did not acutely increase swelling in breast-cancer–related lymphedema (Gülören et al., 2023). PMC

  • In lower-limb lymphedema, a recent randomized crossover trial compared high-intensity cycling with vs. without compression; overall, exercise was feasible, but an occasional adverse event (≥5% limb-volume rise) occurred in the literature, leading to a return to CDT (Wittenkamp et al., 2025). 

 

Takeaway:

  • You can exercise without sleeves for short bouts, but wearing compression during exercise is preferred—especially for heavier or longer sessions—because it helps control fluid shifts and maintain reductions (Lasinski et al., 2012; ISL, 2023). 

 

If you try activity without a sleeve, monitor your limb and put the garment back on promptly if the limb feels “full” or looks larger.

Skin Care – Protecting Your First Line of Defense:

Skin care is just as important as compression or exercise. Lymphedema makes the skin more vulnerable to infection (British Lymphology Society, 2022).Even small cuts or insect bites can let bacteria in, leading to cellulitis, which can worsen swelling and cause serious illness.

 

Key tips backed by guidelines:

  • Keep skin clean and moisturized: Use a pH-balanced, fragrance-free moisturizer daily to prevent dryness and cracking.

  • Check skin daily: Look for redness, heat, swelling, cuts, scratches, or signs of fungal infection (especially between toes).

  • Protect from injury: Wear gloves for gardening or dishwashing, and use insect repellent outdoors.

  • Avoid any blood draws, injections, and blood pressure measurements on the affected side: These can increase the risk of swelling or infection.

  • Treat wounds promptly: Clean cuts right away, apply an antiseptic, and cover until healed.

  • Seek help early for infection: If you notice sudden swelling, redness, pain, or fever, contact your doctor immediately — early antibiotics can prevent serious complications.

  • Prevent fungal infections: Keep skin folds and between toes dry; use antifungal powder if advised by your healthcare provider.

 

Why it matters:
Studies show that people with lymphedema who follow a regular skin care routine have fewer cellulitis episodes, which also helps slow disease progression (British Lymphology Society, 2022; Mortimer et al., 2017).

Surgery:

  • Lymphaticovenous Bypass (LVB/LVA): Creates connections between lymph vessels and veins, best for early-stage lymphedema (Deldar et al., 2023).

  • Vascularized Lymph Node Transfer (VLNT): Moves healthy lymph nodes to the affected area (Winters et al., 2022). 

  • Liposuction for lymphedema: Removes long-standing fatty and protein-rich swelling; requires lifelong compression afterward (ISL, 2023). 

New & Emerging Treatments (research settings):

  • Anti-inflammatory medicines (e.g., ketoprofen) improve skin inflammation and tissue thickening, but don’t reliably shrink limb size (Rockson et al., 2018).

  • Experimental targets (e.g., leukotriene-B4 blockers, topical immunomodulators, gene-directed strategies) are promising but not yet standard care (Brown et al., 2022).

Scientific References:

  • British Lymphology Society & Lymphoedema Support Network. (2022). Guidelines on the management of cellulitis in lymphoedema.

  • Brown, S., et al. (2022). Pharmacological treatment of secondary lymphedema. Frontiers in Pharmacology, 13, 828513. https://doi.org/10.3389/fphar.2022.828513

  • Brunelle, C. L., & McNeely, M. L. (2022). The important role of nighttime compression in BCRL. Cancer, 128(21), 3841–3843.

  • Cancer Research UK. Exercise and lymphedema (patient info).

  • Deldar, R., et al. (2023). Prophylactic lymphovenous bypass during axillary dissection reduces BCRL risk. PRS Global Open, 11, e4954.

  • Dzupina, A., et al. (2025). Predictors of efficacy in decongestive therapy—proper fitting and monitoring. Healthcare, 13(3), 336.

  • Gülören, G., et al. (2023). Remedial exercises with vs. without compression in BCRL. Turkish Journal of Physical Medicine & Rehabilitation, 69(4), 596–604.

  • Hou, S., et al. (2024). Intermittent pneumatic compression as an adjunct to CDT. Breast Care, 19(3), 155–164.

  • International Society of Lymphology. (2023). Consensus document: Diagnosis and treatment of peripheral lymphedema. Lymphology, 56(2), 1–50.

  • Lasinski, B. B., et al. (2012). Evidence for CDT components; adherence to compression + exercise. PM&R, 4(8), 580–601.

  • McNeely, M. L., et al. (2016). Nighttime compression for BCRL. Supportive Care in Cancer, 24(4), 163–171.

  • McNeely, M. L., et al. (2022). Nighttime compression improves self-management. Cancer, 128(21), 3854–3865.

  • McNeely, M. L., et al. (2024). Compression + exercise in BCRL. Cancers, 16(14), 2513.

  • Mortimer, P. S., et al. (2017). The pathophysiology of lymphedema and cellulitis risk. British Journal of Dermatology, 176(2), 279–289.

  • Rockson, S. G., et al. (2018). Ketoprofen improves inflammatory skin changes in lymphedema. JCI Insight, 3(20), e123775.

  • Schmitz, K. H., et al. (2009). Progressive weight training is safe in BCRL. New England Journal of Medicine, 361, 664–673.

  • Winters, H., et al. (2022). VLNT outcomes: Systematic review & meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 75(12), 4323–4335.

  • Wittenkamp, M. C., et al. (2025). Exercise in lower-limb lymphedema; crossover with/without compression. Supportive Care in Cancer, 33, 271.

bottom of page