Tips & Tricks

Springing a leak: understanding and treating lymphorrhea

When your lymphedema limb starts leaking lymph fluid, it can be a little alarming. Here's what's going on and how to treat it.

Back in 2011, I wrote a post on lymphorrhea that briefly explained what it is, why it happens, and what to do if it happens to you. It’s been one of the most viewed posts here on the site, so I thought it’d be a good idea to revisit the topic and take a more thorough look at lymphorrhea and lymph.

“Are you there, God? It’s me, lymphorrhea.”

My first experience with lymphorrhea happened when I was a senior in high school. I was sitting in a quiet auditorium, taking an exam with the rest of my classmates, when I noticed my right ankle felt wet.

I reached down to wipe at it absentmindedly, but a few seconds later it was wet again. Wiped it. Still wet.

To my horror, the fluid just kept coming. It was draining out of seemingly nowhere — I had no cut, no scratch that I could see, just a teeny-tiny pore-sized break that had spontaneously began to leak.

It continued until my shoe was completely soaked through with the unknown fluid, and I was praying it would stop before someone noticed. It felt like a scene out of a Judy Blume novel: what was happening to my body, and why did it have to happen at school?! I sat through the rest of the exam unable to focus, instead feeling utterly mortified and silently freaking out.

“Mortified and freaking out” is, I think, most peoples’ response when they first notice fluid leaking from their body. What is it anyway, and where’s it coming from?

Lymph fluid

The leaking fluid is a substance called lymph, although it goes through a couple transformations before it actually becomes lymph.

The fluid begins its journey as arterial blood plasma, but once it flows into the tissues it’s called extracellular fluid. Within the interstitial spaces in the tissue, the fluid delivers nutrients and oxygen to the cells and removes the debris and waste. After all that’s done, most of the extracellular fluid rejoins circulation as venous blood, and the remaining bit stays behind as lymph.

Watery and usually colorless (although sometimes it has an amber tint to it), lymph is full of waste, pathogens, and undigested proteins removed from cells. The motions of muscles and joints help pump lymph throughout the body, filtering it through lymph nodes as it journeys upward toward the base of the neck. There, the cleansed lymph is drained through the subclavian veins and returned to the circulatory system.

For visual learners, this video from the Khan Academy explains it really well:

Lymphorrhea: what’s going on?

Lymphorrhea is when lymph leaks from the surface of the skin, usually manifesting as a beading or trickling of fluid. Insect bites, abrasions, cuts, wounds, cracks — no matter how small, any break in the skin has the potential to allow lymph to weep through.

According to lymphedema specialist Carmel Phelan, “the pressure of lymph fluid inside the skin tissues is so high that the skin is unable to stretch fast enough to accommodate the fluid”; this makes the skin so tense with excess fluid that the slightest bump or knick can result in lymphorrhea.

Lymphorrhea can affect any area of the body, but it most commonly occurs in the legs and genitals.

Treating the leak

If you spring a leak, don’t worry — there are things you can do to treat it, either by yourself or with the help of a caregiver or lymphedema therapist.

First, you should clean the area where the fluid is leaking to reduce risk of infection. Then, apply a moisturizing lotion to help heal the skin and protect it from further breakdown. Dress the wound with sterile, absorbent, non-sticky bandages, and then wrap your limb with short-stretch compression bandages. With this added pressure, the leaking should stop within one or two days.

Lymphorrhea treatment techniques

Don’t forget to change the bandages often, as the weeping lymph may make them wet and uncomfortable (not to mention it can cause further skin breakdown). When you’re at rest, elevate! Once the leakage has stopped and your skin’s condition has improved, you can don your usual garments again.

As always, double check with your lymphedema therapist or doctor on what they recommend. They may advise differently depending on your symptoms!

Complications and prevention

The earlier you address your lymphorrhea, the better.

If left untreated, it can lead to serious complications for lymphies: the protein-rich lymph fluid is considered a natural food source for bacteria, meaning the draining break in the skin provides an entry point for bacteria to enter your body. This can cause infection, such as cellulitis, lymphangitis, or erysipelas. Lymphorrhea is also highly caustic to skin tissue and can develop into a large, gaping wound. (If any of these complications occur, immediately seek medical attention.)

A good prevention tip is to be compliant in wearing your compression so your lymphedema-affected area isn’t overloaded with stagnant fluid. One of the best thing you can do to avoid lymphorrhea, though, is to take care of your skin by keeping it clean and moisturized. Also avoid cuts, bites, and scrapes on your affected area if you can — I know that’s often easier said than done, but if you’re careful, your chances of lymphorrhea will be that much less!

Have you had lymphorrhea? What was your experience like?

4 comments on “Springing a leak: understanding and treating lymphorrhea

  1. Arlene Slobecheski

    I had lymphorrhea for on and off for several weeks. On Cinco de Mayo, when I was planning our celebration, I suddenly felt very ill and severely cold. A bone shattering cold. I went to bed and awoke the next morning with severe pain in my left artificial knee. The 3rd day I was unable to walk and had a high fever. I was taken to the hospital and Dx with Sepsis and went into an altered mental state for over 1 week. During this time I had many tests and surgery to thoroughly clean my knee of all infection. I spent 2 weeks in ICU and then 3 weeks in Rehab/skilled nursing in recovery. On my last day in rehab I sprang a leak in my right leg. Please do not ignore “springing a leak”. It could be a matter of life and death. Thankfully I had an infectious disease doctor that knew sepsis and saved my life.

  2. Thanks so much for sharing about lymphorrhea. Good overview of an embarassing side effect of lymphedema.

  3. Donna Miller

    When I had leaking, I didn’t know I had Lymphedema. The doctors thought the swelling was from
    vein problems. They operated for the vein problem and the swelling got worse. The leaking
    was terrible. Using the process of elimination, they decided I might have Lymphedema. When I
    went to therapy, the swelling got better right away.

  4. Cheree Bailey

    Until this very moment, I had no idea that what happened to me had a name! I have lipo-lymphedema in both legs; my left leg is much larger than my right and I have huge lobes that began inside my knees and are now mid-calf on my left leg and just descending on my right. In 2013, my ”swelling’ (what we called it at the time) in my legs was so severe by days end that I could no longer comfortably sleep in a standard bed, and had moved to our recliner instead. My husband propped 2 layers of pillows under my legs each night to help them feel better by morning. One morning he was removing the pillows when to my horror, the pillows under my upper thighs and knees were soaked through the top layer of pillows! It had left a yellowish stain, so I automatically assumed that I had experienced bladder incontinence (I also have secondary progressive multiple sclerosis). I had never had an episode that severe, so of course I was embarrassed! But my husband looked at my backside and said it hadn’t come from my bladder…the wetness was all around my knees. I couldn’t find any area with cuts and my internist (who knew nothing really about lymphedema and had initially diagnosed it only after I googled it – small town country doctor) couldn’t figure out what it could be! I fought for PT and got no help except the suggestion to buy 6″ wide ace wrap bandages and wrap my legs myself…no instruction at all! So, I googled quite a bit more and rea about lymph leakage but this is the first time I’ve heard the term for it. I also discovered the Lymphapress compression sleeves and fought for Blue Cross Medicare to cover them and was successful! I only had to pay my 20% DME co-pay, which I gladly did! Now, I’ve moved to a CA where there is more knowledgable healthcare and hope to meet with a physiatrist or lymph specialist. I have 2 different blood clotting disorders as well, so I will be seeing a vascular doctor as well. I’m also suspicious now of having it in my arms as well, as my mosquito bites will weep fluid non-stop, leaving streams of sticky lines down my arms each morning. Wow…this has literally got me weepy with joy! ANSWERS! What an incredible blessing! Thank you so much for having this page here for others! :)

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