Quick Answers
Lymphedema is a condition characterized by swelling due to a buildup of lymph fluid. The main fluid that leaks from lymphedema is lymph fluid. Other fluids like blood or clear fluid from blisters may also leak.
Lymphedema is swelling that occurs when lymph fluid accumulates in the tissues. It usually affects an arm or leg, but can occur in other parts of the body. Lymphedema is caused by damage to or problems with the lymphatic system. The lymphatic system is a network of lymph nodes, vessels, and organs that carry lymph fluid throughout the body. Lymph fluid contains white blood cells that help fight infection. It also absorbs fats and proteins from tissues. Normally, lymph fluid circulates through the lymphatic system, getting filtered and drained. But when the lymphatic system is damaged, lymph fluid can’t drain properly. This causes swelling or lymphedema in the affected area. There are two main types of lymphedema:
- Primary lymphedema – caused by abnormalities in the development of lymph nodes or vessels.
- Secondary lymphedema – caused by damage to the lymphatic system from surgery, radiation, infection, or trauma.
Common causes of secondary lymphedema include:
- Cancer surgery/treatment – Removing lymph nodes and radiation therapy can damage the lymphatic system.
- Infection – Infections like cellulitis can scar and block lymph vessels.
- Injury – Trauma from burns, blunt force, etc. can obstruct lymph drainage.
- Obesity – Excess weight strains the lymphatic system.
People with lymphedema experience swelling, a feeling of heaviness, aching, and discomfort in the affected limb. As lymphedema progresses, the swelling becomes more severe and the limb may take on a swollen appearance described as resembling an elephant’s leg. Additional symptoms may include:
- Tight, shiny skin
- Restricted mobility in the limb
- Thickened, hardened skin
- Recurring infections
- Leakage of clear fluid through the skin
What Fluid Leaks from Lymphedema?
The primary fluid that leaks from lymphedema is lymph fluid itself. As pressure builds up from the accumulation of lymph fluid in the tissues, some of the fluid can leak through the skin. This commonly occurs through tiny breaks in the skin or pores. The leaking lymph fluid has a clear or watery appearance. Other names for this include lymphorrhea or lymphatic fluid discharge.
Besides lymph fluid, other types of fluids associated with lymphedema may also leak from the skin in some cases. These include:
Blood
Lymphedema skin can become prone to injury and bleeding because it is stretched thin and fragile. Even minor scrapes or bumps can lead to blood leaking from damaged vessels under the skin. The blood may mix with lymph fluid seeping from the pores.
Clear fluid from blisters
The constant irritation and swelling in lymphedema can cause blisters to form on the skin. When blisters pop, they release a clear or pale yellow fluid. This fluid discharge contains plasma from inside the blister.
Pus
Due to problems fighting infections, people with lymphedema get frequent skin infections. When lymph is blocked and swelling develops, immune cells have a harder time reaching and attacking infections. Bacterial infections like cellulitis can occur and may leak pus through openings in the skin. Pus is a white or yellow fluid that contains dead cells, bacteria, and proteins.
Why Does Fluid Leak?
There are a few reasons why lymphedema leads to fluid leaking from the skin:
Increased pressure in the tissues
As excess lymph fluid accumulates, it increases pressure in the tissue spaces under the skin. The tissue has a harder time containing this fluid and some begins to leak out. Pressure puts strain on the connections between lymph vessels, forcing fluid out.
Damaged or overwhelmed lymphatic system
Lymphedema develops when the lymphatic system is damaged or overloaded. Lymph vessels struggle to drain all the lymph fluid, so it builds up. Openings in the vessels and lymph nodes allow fluid to seep into the surrounding tissue. Leaky valves in lymph vessels also contribute to backflow.
Changes in skin integrity
The skin often becomes thinned and compromised as lymphedema progresses. Swelling stretches the tissues, impairing their protective barrier function. The overloaded lymph system also fails to transport immune cells to the skin surface efficiently. This makes the skin more prone to infections and injury, creating ports for fluid to escape.
Where Does the Fluid Leak Out?
The spots where lymph fluid and other liquids seep out depend on the location of the lymphedema:
Arm lymphedema
For arm swelling, fluid tends to leak from the hand and fingers, as well as the inner elbow. These areas have many lymph nodes and vessels close under the skin. Thin skin on the hand allows fluid to seep through pores.
Leg lymphedema
In leg lymphedema, leaks often occur on the lower calf and dorsum of the foot. The outer ankle is also a common site. These areas have clusters of lymph vessels and nodes that get overloaded.
Facial lymphedema
Facial swelling creates leaks around the eyes, cheeks, lips, and neck. The head and neck contain hundreds of lymph nodes, many just under the surface.
Genital lymphedema
Genital or groin lymphedema arises from obstruction of vessels that drain the lower limbs and pelvis. Leakage occurs in the genital area.
Midline/truncal lymphedema
Swelling in the midsection or trunk causes fluid discharge near the abdomen, chest, back, and flanks. These regions contain lymph nodes serving organs and tissues.
In general, thin skinned areas with many superficial lymph vessels are most prone to leaking. Lymph fluid takes the path of least resistance to escape the congested system.
What Does Lymph Fluid Leaking from Lymphedema Look Like?
The appearance of lymph fluid leaking from the skin varies somewhat based on the stage of lymphedema:
Early stage
In milder cases, small amounts of thin, watery fluid may seep from intact pores. The discharge is clear and mainly consists of excess lymph fluid. It may crust or dry on the skin, appearing like flaky or peeling skin. The leaking fluid is easier to overlook in early lymphedema.
Late stage
In advanced lymphedema with more damage to vessels and skin, the leaking fluid takes on a thicker, yellowish or milky color. The amount of secretion increases as tissues become engorged with lymph. Due to injuries, bleeding may cause some discharge to appear pink or blood-tinged. Leaking blister fluid or pus from infections also influences the appearance.
Fungal infections
A common complication of lymphedema is fungal skin infections. Fungal infections can cause peeling, cracked, or scaly skin that weeps fluid. The discharge in these cases contains lymph, serum, and microbes from the infection.
Is Fluid Leaking Dangerous?
Some risks and dangers associated with fluid leaking from lymphedema include:
Risk of infection
Open drainage can allow bacteria entry to the body, increasing infection risk. Infections like cellulitis are common with lymphedema and can spread rapidly when the skin barrier is compromised.
Dehydration
Large amounts of fluid loss through constant leakage can potentially lead to dehydration. Drink plenty of fluids to replace what is lost.
Skin damage
The leaking fluid contains enzymes that can digest proteins in the skin. This can damage tissues and worsen leakage over time.
Embarrassment/discomfort
Fluid leaking from the limbs or genitals can be uncomfortable, embarrassing, and distressing for patients. It may cause anxiety and reduce quality of life.
However, small amounts of seepage from lymphedema are often harmless. Wearing absorbent bandages and frequent cleaning helps manage this symptom. Seek medical advice if the amount or appearance of leaking fluid changes or worsens.
Treatments to Reduce Leaking
While fluid discharge is difficult to control completely in lymphedema, certain treatments can help reduce leaking:
Compression
Compression stockings, bandages, or garments provide external pressure to improve fluid drainage and containment. Gradient compression works best.
Lymphatic drainage massage
Special massage techniques encourage remaining lymph vessels to drain excess fluid from congested areas.
Exercises
Certain exercises and stretches improve activity of muscle pumps that propel lymph flow. This enhances fluid transport and drainage.
Wound care
Properly cleaning and protecting leakage sites allows quicker healing. Apply antibiotic cream to prevent infection in open wounds. Keep the affected area dry.
Elevation
Keeping the swollen limb elevated above heart level uses gravity to improve lymph and fluid return. This reduces pressure and pooling of lymph in the tissues.
Skin care
Moisturizing improves skin integrity to act as a better fluid barrier. Avoid harsh soaps that strip protective oils. Inspect the skin daily and treat any infections.
Medications
Certain drugs help reduce swelling and susceptibility to infections that worsen leakage. These include antibiotics, diuretics, and drugs to optimize lymph vessel function.
Surgery
Surgical procedures like lymphovenous bypass can reroute fluid flow from blocked lymph vessels into blood vessels. This improves drainage and reduces leakage risk.
When to See a Doctor
Consult a doctor promptly if you notice any of the following:
- Sudden increase in amount of drainage
- Changes in the color or smell of the discharge
- Signs the fluid is pus from an infection
- Severe pain, redness, warmth at leakage site
- Fever or flu-like illness, which may indicate infection
- No improvement despite self-care and compression
With early diagnosis and management, complications of leaking fluid can often be avoided. Doctors can provide medications, compression supplies, therapies, and guidance on self-care strategies. They may refer patients with very severe, chronic lymphedema to a lymphedema specialist. Plastic surgeons can also evaluate someone for reconstructive operations to reduce leaking.
Coping with Leaking Lymph Fluid
Having body fluids constantly seeping from your skin can be upsetting and negatively impact quality of life. Some tips that may help patients cope emotionally with lymphedema leakage:
- Use absorbent dressings, pads, or bandages to help contain drainage.
- Try collecting leakage with a handkerchief or gauze in your pocket or bag.
- Apply essential oils like tea tree, lavender, or mint to drainage sites to control odor.
- Keep your affected limb elevated when possible to reduce pooling of fluid.
- Find an empathetic lymphedema therapist you can share concerns and frustrations with.
- Join a support group to realize you are not alone in dealing with leaks.
- Stick to treatment to prevent infections that could increase drainage.
- Focus on self-care practices that improve your emotional wellbeing.
- Remind yourself that leakage does not define you or make you any less worthy.
When to Seek Emergency Care
Seek prompt emergency medical care if you experience:
- Sudden, severe swelling in the affected limb
- Difficulty breathing
- Drainage that appears bloody or purulent
- High fever, chills, weakness, or severe pain
- Red streaking from the leakage site
These signs may indicate a limb- or life-threatening infection, blood clot, or other complication requiring urgent treatment. Call 911 or have someone drive you to an emergency room for evaluation if you experience such symptoms.
Conclusion
Lymphedema is a common condition involving localized fluid retention and swelling. Damaged or overloaded lymph vessels cause lymph fluid to accumulate in tissues. This pooled lymph can leak out through pores and other openings in the skin. In advanced lymphedema with severe swelling, the discharge may contain other fluids like blood, blister fluid, and pus from skin infections. While leakage can increase risk of infection and skin damage, proper treatments help reduce and manage drainage. Supportive self-care and therapy can also improve emotional wellbeing for those coping with embarrassing leaks. But sudden increases in drainage or other signs of infection should prompt urgent medical evaluation to prevent serious complications of lymphedema.