An Introduction to Lipoedema
Published: 14 March 2022
Published: 14 March 2022
Lipoedema is an almost-exclusively female condition estimated to affect up to 11% of adult women (Oakley et al. 2020; Vyas & Adnan 2022).
In addition to significantly affecting a person’s physical appearance, lipoedema can also cause pain and discomfort that interferes with their daily activities.
Lipoedema is a chronic progressive condition characterised by an unusual build-up of adipose tissue (fat) under the skin. It predominantly affects women, possibly due to being associated with female hormone changes (Better Health Channel 2017).
In lipoedema, there is an uneven distribution of adipose tissue in the body, causing the lower extremities to have a disproportionately high amount compared to the upper body (Better Health Channel 2017; Vyas & Adnan 2022).
This causes a symmetrical accumulation of fat that typically affects the buttocks, thighs, calves, and sometimes the upper arms. The hands and feet do not display swelling (Oakley et al. 2020; Cleveland Clinic 2019).
The condition is often painful, with the affected area being tender, swollen and more likely to bruise (Better Health Channel 2017).
Lipoedema is believed to be genetic, potentially with an autosomal dominant inheritance pattern, as those affected tend to have a family history of the condition. However, this has not been confirmed (Oakley et al. 2020; Better Health Channel 2017).
It’s also thought that the female hormone oestrogen is a contributing factor, as the onset of lipoedema tends to occur during periods of hormonal shift: puberty, pregnancy and menopause (Oakley et al. 2020; Better Health Channel 2017). Further supporting this theory is the fact that the few men who develop lipoedema often have liver disease or low testosterone - both of which are associated with high levels of oestrogen (Vyas & Adnan 2022).
Lipoedema is not related to obesity or weight gain and can affect people of all body types (Better Health Channel 2017).
Despite the similarities in name, lipoedema and lymphoedema are separate conditions.
Both conditions can result in a similar body appearance, however, while lipoedema is an excessive accumulation of fat, lymphoedema is an excessive build-up of fluid caused by a blockage in the lymphatic system (Vein Health 2019).
Lymphoedema can be primary or secondary, and in some cases may actually be secondary to lipoedema if the excessive adipose tissue compresses the lymphatic tracts/vessels and causes an obstruction (Vein Health 2019).
Key differences between lipoedema and lymphoedema include the following:
(Better Health Channel 2017)
Those with lipoedema might experience:
(Better Health Channel 2017; NHS 2020)
As lipoedema is a progressive condition, the accumulation of adipose tissue usually increases over time (GARD 2021).
Lipoedema can be categorised into one of four stages depending on how much the condition has progressed. However, note that these stages are based solely on the appearance of the skin and do not take into account the patient’s symptoms, pain, functional capacity and quality of life (Lipedema Foundation 2019; Oakley et al. 2020).
Stage 1 | Skin is smooth and appears normal, but small nodules of adipose tissue can be palpated. |
Stage 2 | Skin surface is uneven, and larger nodules of adipose tissue can be seen and palpated. |
Stage 3 | Nodules of adipose tissue become large and disfiguring, particularly around the knees and thighs. The legs may appear column-like with large folds of skin and fat. Joints, mobility and balance may be impaired. |
Stage 4 | Development of lipo-lymphoedema (presence of both lipoedema and lymphoedema) and large overhangs of tissue on the legs and arms.. |
(Lipedema Foundation 2019; Oakley et al. 2020; Vyas & Adnan 2022; Lipedema Medical Solutions 2022)
Lipoedema may be diagnosed through a combination of the following:
(Better Health Channel 2017; Oakley et al. 2020)
There are a variety of differential diagnoses that may need to be excluded, including:
(Oakley et al. 2020)
Treatment and management strategies for lipoedema include:
(Better Health Channel 2017; medi Australia 2015)
Question 1 of 3
True or false: Lipoedema affects the hands and feet.