Both types of lymphedema have the fluid accumulation that is actually outside of lymphatic vessels and superficially or right underneath the skin. That is why more progressed stages causes skin changes like redness, blisters, hardening, and weeping wounds.  These present as a huge risk of infection. There are stages to lymphedema that can be defined clinically:

Stage 0: (Latency) subclinical presentation with a sense of fullness, heaviness, or diffuse tingling of the limb without external edema or swelling or skin changes. *Communicating these symptoms to your provider and being assessed by a certified lymphedema therapist (CLT) can assist to prevent any further progression.

Stage 1: (Spontaneously Reversible) edema or swelling that is intermittent or come and go.  Elevation of the limb helps with reduction.*This is a great time to seek an assessment and treatment for self-management tools that can help prevent any further exacerbation as this stage can quickly progress to stage 2.

Stage 2: (Spontaneously Irreversible) Edema is more prevalent and obvious with signs of skin changes with less pitting and firmer tissue that forms into fibrotic tissue from the stagnant lymph fluid. *Seeking treatment from a CLT is imperative in this stage to reduce limb volume and improve tissue integrity and will require more intensive or frequent treatment and being more vigilance for follow-up.

Stage 3: (Lymphostatic Elephantiasis) often what people think of first with lymphedema. Here is where the skin becomes very hard, fibrotic, can develop into breakdown with weeping sores and could cause irreversible damage if left untreated.  There is also significant risk of infection that could spread systemically. *This absolutely requires collaboration with a CLT to resolve skin issues and limb volume and requires an intensive phase of treatment with maintenance program and periodic follow-up.