Lymphedema vs. Lipedema
This page highlights factors that distinguish lymphedema from lipedema.
Keep in mind that it is possible to have both lymphedema, lipedema, and obesity, see Photos of Lymphedema and Lipedema for examples. Combinations of lipedema or lymphedema with less common adipose tissue disorders, such as Dercum’s disease or multiple symmetric lipomatosis, are also possibilities.
Table 1: Signs by Body Area
| Area | Lymphedema | Lipedema |
|---|---|---|
| Head and Neck | May have swelling, rarely symmetrical | Spared initially; abnormal scalp fat with a spongy feel in Stage 4 |
| Arms | Swelling, then fat, rarely symmetrical | Symmetrical nodular fat on triceps, biceps, forearm |
| Hands | Swelling, then fat | Spared initially; fat at the base of the thumb and between the knuckles in Stage 4 |
| Breasts | Localized edema | Can be edematous if overweight |
| Abdomen | Swelling, fat, panniculus | Swelling, fat below umbilicus initially, later above umbilicus; panniculus if overweight |
| Trunk | Localized edema | Increased fat, localized edema in later stages |
| Genitals | May swell | Swell in later stages |
| Legs | Swelling, then fat, rarely symmetrical | Symmetrical fat initially; fatty extrusions especially around the knees in Stage 2 and 3 |
| Feet and Toes | Swelling, then fat, rarely symmetrical | Spared initially (harem pants), fat in Stage 4 |
Table 2: Lymphedema vs. Lipedema
| Characteristic | Lymphedema | Lipedema |
|---|---|---|
| Fat distribution | Rarely symmetrical | Symmetrical |
| Fat texture | Normal | Small nodules initially, with larger nodules later |
| Abnormal fat locations | Feet and legs, arm, trunk | Legs (hip to ankle) and/or arms, scalp in Stage 4 |
| Onset | Birth, puberty, or later | Puberty, by third decade |
| Sex predominance | Both Sexes | Mostly Female |
| Painful fat | No, may have pain from swelling, tight skin | Yes, touch sensitive, chronic pain |
| Broken blood vessels | Rare | Common, bruises easily |
| Pitting edema | Pitting in early stages; becomes non-pitting later | Minimal pitting |
| Leg swelling progression | Swelling increases from the feet up or trunk down | Stops at ankle and feet are spared initially; feet swell in Stage 4 |
Portions adapted from Lymphedema and Lipedema Nutrition Guide, Lymph Notes 2016 by permission of the publisher.