Is Lipedema/ Lymphedema Fatal?

Lipedema and lymphedema may impact your quality of life, but they are not likely to kill you. However, these conditions can increase other risks that you should know about:

  • Lightheadedness or fainting when standing up or changing positions increases the risk of falls and other accidents. Lightheadedness on standing can be caused by an abnormal increase in heart rate (postural orthostatic tachycardia or POTS) linked to hypermobility and other conditions associated with lipedema or lymphedema. 

  • Difficulty moving or walking (abnormal gait and dysmobility) because of lipedema- or lymphedema-related body changes—including heaviness, joint pain, or back pain—can also increase the risk of falls and other accidents. 

  • Mental health issues—including depression, suicide, self-harm, eating disorders, body image issues, social anxiety, etc.—are experienced by people with lipedema or lymphedema. The risks of mental health challenges are higher in those who have not been diagnosed and provided with supportive care.

  • Skin infections such as cellulitis or lymphangitis, are much more common in areas affected by lymphedema swelling than in normal skin. In addition to damaging the skin, any infection that is not treated quickly can develop into a life-threatening systemic infection or sepsis, see Treating Skin Infections below. 

  • Rare forms of cancer, such as lymphangiosarcoma or Stewart-Treves Syndrome (STS), may develop in areas of long-term lymphedema swelling and are frequently fatal. Any purple discoloration or tender nodules that develop on areas affected by lymphedema should be evaluated promptly by a medical professional. 

Treating Skin Infections

Skin or lymph vessel infections may occur in areas of the skin affected by lymphedema. Infection can start from a wound, insect bite, fungal infection (such as athlete’s foot), or without any identifiable cause. 

A skin infection may be the first sign of lymphedema in someone who has not previously been diagnosed with lymphedema. This happens most frequently in those who have an increased risk of lymphedema from cancer treatment or other factors.

Infected areas of skin typically turn bright red or “angry”, feel hot, swollen, itchy, and will be painful when touched. Within hours, an infection may worsen with redness spreading over a larger area. 

Cellulitis and lymphangitis can spread to the rest of the body and become a systemic infection characterized by aching joints, flu-like symptoms, fever, and chills. 

Severe headache or vomiting can accompany a systemic infection or may occur up to 24 hours before any skin redness develops. Systemic infections often require hospitalization and can be life threatening, especially if not treated aggressively.

The Figures below show lymphedema patients with redness from infection in the arm, leg and trunk. 

Figure 1: Arm Infection

Figure 2: Leg Infection

Figure 3: Trunk Infection

When a skin infection is suspected:

  • Seek medical attention immediately by going to an emergency department or contacting the patient’s primary care provider. Systemic infections can spread quickly—do not wait to see if the patient gets better.

  • Start taking antibiotics as directed without delay, if antibiotics are prescribed have the prescription filled as soon as possible. If standby antibiotics have been prescribed for the patient (see below) start them at the first signs of an infection. 

  • Stop lymph drainage massage and compression since this may spread the infection further. Do not resume these treatments until advised to do so by the patient’s physician or lymphedema therapist.

  • Inspect between the toes and under skin folds for signs of fungal infection because cracked or damaged skin from athlete’s foot or other fungal infections can lead to bacterial infections. Seek treatment for the fungal infection as well as the bacterial infection. 

If someone has a history of lymphatic infections, their health care provider may prescribe:

  • Standby antibiotics to keep on hand so the patient can start taking them at the first sign of infection. Any time standby antibiotics are used, be sure to request a replacement and have the prescription filled promptly.

  • Low dose antibiotics, also known as prophylactic antibiotics, to be taken routinely to reduce the risk of recurrent infections in patients who have experienced frequent infections. Low dose antibiotics may be discontinued if the patient starts taking standby antibiotics or other antibiotic therapy, according to the health care provider’s instructions.


Portions adapted from Lymphedema Caregivers Guide, Lymph Notes 2009 by permission of the publisher. 

Author: Chuck Ehrlich 

Reviewers: Steven Dean, DO, Marti Klein, Jacqueline Larson, MS, RDN, Camille Morrison, PT, CLT, Nicholas Pennings, DO, Jaime Schwartz, MD, Thomas Wright, MD, Linda-Anne Kahn, CMT CLT-LANA CHNC, Nadiv Shapira, MD.

Review dates: 2022-05-30, 2022-09, 2022-11