What is a lipoedema?
A lipoedema is a chronic disease. It’s a fat distribution disorder – especially on the upper and lower legs and in the hip area. Sometimes the arms are also affected. Lipoedema are generally not curable. However, the symptoms can be treated and reduced through consistent therapy. It’s essential that patients accept the disease and manage it responsibly.
Causes and risk factors: How does a lipoedema develop?
Lipoedema almost exclusively affects women and girls. Men, in contrast, rarely suffer from lipoedema. The specific causes of lipoedema have not yet been sufficiently researched. The timing of hormonal changes is often associated with the onset of lipoedema.
Are hormones a cause of lipoedema?
Experts suspect the influence of hormones as a cause, because symptoms often manifest or worsen during phases of hormonal changes. In addition, the tendency to lipoedema seems to be genetically determined, as a familial disposition has been observed. Lipoedema usually appear
- towards the end of puberty,
- during pregnancy or
- during the menopause.
Strong patients and their very individual stories
The symptoms of a lipoedema: Are you overweight or do you have a fat distribution disorder?
It requires close observation to detect a lipoedema and to distinguish it from being “normally” overweight or obese.
Lipoedema should not be confused with obesity. In contrast to obesity (a generalised increase of fat tissue of the entire body), diets or more exercise do not lead to a reduction of the pathological fat tissue in lipoedema patients.
The nature of the symptoms is very individual. Typical symptoms, especially of a lipoedema of the legs, are:
- unequal proportions from the torso to legs: rather slim upper body with thicker legs (often a difference of several clothing sizes)
- blue spots occur quickly and easily (bruising, haematomas)
- tenderness on palpation and touch
- orange-peel or wavy skin with nodules under the skin
- tenderness on palpation and touch
- a symmetrical, relatively spontaneous “unexplained” increase in volume on both legs. This leads to “columnar” changes, and over time, to deformations of the legs
- further progression: bead formations mainly on the inner thigh
Saddle bags: Diet-resistant fat deposits
The fat pads on the buttocks, hips and the inside of the knees are commonly called saddle bags. If the fat pads resist any diet and sporting activity, the so-called saddle bags can be an indication of a lipoedema.
Test: Detect lipoedema yourself
If you suspect that you’re suffering from a lipoedema, this self-test can give you initial pointers. This test does not replace a professional diagnosis. Please consult your general practitioner or a specialist in lymphology.
Stages and pictures of lipoedema
Stage 1 – Orange-peel skin
orange-peel skin: smooth skin surface with evenly thickened subcutis (not to be confused with cellulite)
- saddle bag
Stage 2 – Mattress skin
- uneven, mostly wavy skin surface
- knot-like structures in thickened subcutaneous skin
Stage 3 – Dewlap formation
- coarse nodular skin with larger dimples
- pronounced size increase with overhanging, roughly distorted tissue parts (dewlap formation)
Mixed forms of lipoedema treatment
Lipoedema are different from lymphoedema (accumulations of lymphatic fluid in the tissue due to a flow disorder in the lymphatic vessel system).
More information on diagnosis and lymphoedema therapy.
Lipo-lymphoedema: When a lymphoedema develops in addition to a lipoedema
Depending on its severity, a lipoedema puts a strain on the lymphatic system: the transport capacity of the lymphatic vessels can be limited to such an extent that fluid accumulates in the tissue. Consequently, a lipoedema can cause a secondary lymphoedema. This symptom is called lipo-lymphoedema.
Lipoedema with accompanying obesity
This mixed form displays the symptoms of a lipoedema plus a generalised increase in fat throughout the whole body.
Differences between lipoedema and lymphoedema
Lipoedema and lymphoedema can be clearly distinguished with the help of these three main characteristics:
- Lipoedema always occur symmetrically, i.e. both legs are affected.
- Backs of hands and feet are unaffected.
- Lipoedema are tender to pressure and touch.
- Lymphoedema usually occur unilaterally or asymmetrically.
- The back of the hands and feet are also affected.
- Lymphoedema do not usually cause pain.
Treating lipoedema: Diagnosis and therapy
Until lipoedema is clearly diagnosed, many people affected have a long history of suffering, often accompanied by severe mental stress. The right therapy can do a lot to alleviate the symptoms. People affected usually seek medical advice only when sport, exercise and diets fail to bring success, pain is an added factor and the mental stress becomes too great.
There are two main aims in lipoedema therapy:
- Eliminating or improving the findings and symptoms (especially pain, oedema and disproportion).
- Preventing complications. As the severity of the findings progresses with an increase (especially) in leg volumes, the risk of dermatological (e.g. infections such as erysipelases), lymphatic (e.g. lymphoedema) and orthopaedic (gait abnormalities or impairments, axillary malformations) complications increases.
Various therapeutic approaches are available for this.
Complex decongestive therapy (CDT)
Complex decongestive therapy (CDT) is a comprehensive therapy that consists of the following pillars:
- Manual lymph drainage
Depending on the diagnosis, the tissue must be decongested by manual lymph drainage: The lymph drainage is activated by certain physiotherapeutic approaches.
- Compression therapy with medical compression stockings
Basic therapy for lipoedema is wearing medical compression stockings daily. Different products are used depending on the stage: In stage 1 seamless, round knit medical compression stockings can often still be used. In most cases and in more advanced stages II and III, experts recommend flat knit compression treatment.
How do I get a supply of medical compression stockings?
Medical compression stockings are usually prescribed by a doctor and are available as medical aids – unlike support stockings – from specialist medical retailers.
How do medical compression stockings work?
Medical compression stockings work through the precisely defined pressure distribution on the leg: the compression is strongest at the ankle. towards the top, it decreases continuously. Learn more here.
- Nutrition and gentle endurance sports for lipoedema
Lipoedema are not fat pads that result from incorrect nutrition alone. It’s therefore unlikely that the patient can prevent a lipoedema from developing. However, he/she can do a lot to help the lipoedema progress more slowly or not to develop at all: For example, exercise and a healthy diet can help in the preliminary stages of lipoedema.
If the patient is overweight, weight reduction in combination with gentle endurance sports (with medical compression stockings) has a positive effect. In any case, avoid gaining weight. If you have a lipoedema and are overweight, try to slim down to normal weight. A Body Mass Index (BMI) between 19 and 25 would be ideal.
- Skin care and self-management
In addition to the medical treatment, your personal behaviour also determines how you live your life with lipoedema. Hygiene is particularly important for oedema patients. Always clean and cream your skin with pH-neutral care products. Yoga can also help you to think positively and accept the disease.
Liposuction: Fat removal via an operation
Another therapy option is liposuction (fat removal). In this procedure, the pathologically increased fat cells are sucked out from under the skin by using cannulas. The operation is usually performed under anaesthesia. Experts recommend wearing compression stockings in order to preserve the results of the operation.
Lipoedema patients often suffer from a low level of self-esteem, depression and eating disorders. Psychotherapy that supports patients in dealing with the condition can usefully supplement the treatment.
Blog for lipoedema patients
Caroline Sprott, herself a lipoedema patient, collects a lot of helpful information in her blog at www.lipoedemmode.de/en, for example about fashion and liposuction.
Which doctor treats lipoedema?
Do you suspect that you’re suffering from lipoedema? Please discuss your observations with your general practitioner. If necessary, he/she will refer you to a specialist, such as a phlebologist (vein specialist), vascular specialist or lymphologist.
Products from medi for treating a lipoedema
Medical compression stockings from medi can support you during lipoedema therapy, for example
- mediven cosy, mediven 550, mediven mondi (flat knit medical compression stockings (from stage 1 to 3)
Benefit from the wide variety of colours and patterns, especially with our flat knit products.
Nutrition for lipoedema and lymphoedema: 7 tips for wellbeing
The ideal compression garment for treating oedema
Caroline Sprott: story of a patient with lipoedema
Health personnel will make the diagnosis and can prescribe compression stockings, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.