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?

15 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! :)

  5. Pingback: Lymphorrhea: the leakage of lymph – The Lymphie Life

  6. HI,
    You cannot believe how glad I am to have found this. About 7yrs ago, I was diagnosed with Bone Cancer, that led to a Hemi-pelvictomy and a hip implant. Since the first surgery, I have had 6 wound washes, to drain out the fluid that seems to accumulate at the surgical site. The first couple of times it happened, I was put on heavy IV antibiotics and then they found a fungal infection and I was on anti-fungal for 2 yrs… all because I refused to get my implant removed (that was the only solution docs seemed to have for the fluid accumulation). After 2 yrs of anti-fungal, I seemed to be fine … for about 8 months and again there was fluid accumulation and another wound-wash surgery. This time the surgeon decided to leave the VAC in for as long as needed, which ended up being 2 weeks. A month later I was leaking through a pin-hole in my leg-groin joint. Fortunately my surgeon was out of country and he advised me to manage with dressing it and keeping the area clean and dry until he got back. Once he got back and I spoke to him, his only solution was another surgery and that I would eventually need to have my implant removed. But i disagreed and he sent the fluid for testing and that is when we realized it was lymphatic drainage and he had no idea when it would stop leaking. So i refused the surgery and said I will get the leaking luid tested regularly to ensure that my implant does not get infected… and will continue to manage with dressing the area etc. I have been doing this for 2 whole years now… Is there any way to get it stop?

    • Clare Landy

      Hi Preeti – that’s a tricky question. Lymphedema/swelling in arms and legs is usually best managed by wearing compression garments. If your fluid is accumulating because of a deeper leakage in your pelvis region, compression may help. If you can find a therapist who knows how to do lymphatic drainage massage, they may be able to help you. Find a therapist, or a doctor who understands lymphedema better.

  7. Clare Landy

    Thanks Alexa for a detailed explanation of lymphorrhea and how to manage it. This information is so important and useful for all people with lymphedema/lymphorrhea. Cheers!

  8. this is currently happening to me right now. I had testicular cancer and got radiation and surgery to fix it. now that I’m all healed from the cancer, seems as tho I’m having long term side effects. I hate that I conceded to get radiation therapy.. it ruined my body.

  9. I’ve had lymphedema in my legs for 18 years now after surviving a massive bout of cellulitis which put me in hospital for weeks. Leakage comes and goes, my current run is at 3 months.

    I hate leakage, it raises my potential for getting infections massively. In 18 years I have had 9 bouts of septisimia, 7 bouts of pneumonia, 7 bouts of cellulitis and 5 of blood clots on my lungs. Each requiring at least a week in hospital.

    My leakage goes straight through absorbent pads, bandaids, bandages, compression stockings and my clothes.

    I’ve done the nappy thing when in hospital, the nurse told me there was no way I’d fill it, it holds 2 liters (about half a gallon). I filled it in less than 3 hours. Also soaked every towel on the ward, they were not happy.

    I’m at my wits end at the moment but have a few things that have worked in the past for me:

    – bandage strips which come in 1 meter to 5 meter lengths, makes it easier to wrap around an
    affected area because you cut the bandaid to fit, then stick it on (found on ebay under first aid dressing strip plaster)

    – towels, using one then washing it and using another, rotating them. Absorbing as much of the fluid and removing it allows you to cut down on smell and avoid damage to the rest of the skin, the lymph fluid is slightly acidic and will cause irritation to the area.

    I had a huge problem elevating my leg, it was so big and heavy, about 3 times bigger than my normal leg.
    – I got an armchair which reclines using an electric motor, my legs are held up by the feet part, allowing hours and hours of comfortable elevation, obviously lying down is better but for extended periods a chair is excellent. You can actually do something and elevate the leg at the same time. Also cut down on problems of having to get back up. I found a recliner which I had to pull back didn’t work, but less overweight people may find they work for them.

    – Wearing clothes that don’t cover the area, if its at the bottom of your leg, consider a skirt (for us ladies), shorts or culottes, which sit higher than the point of leakage, this avoids the yucky smelly clothes issue.

    I love this blog, it is simple, straightforward and honest. In dealing with lymphodema I find honesty from medical professionals severely lacking. They don’t know what to do and they don’t care. I once had a woman chase me down on a public street because she needed information and no one had helped her. She was so desperate, she didn’t know how to help her daughter. I sat with her for half an hour giving her every piece of info on hospitals, physio and occupational therapists that I could think of, anything that could help. I was late to classes that day but I’ve never forgotten her crying and thanking me over and over for basic info she should have been able to get from a doctor or the hospital.

    So I’m here in Australia, having a really bad run at the moment and today this blog shows me I’m not alone, I’m not the only one having these problems. Thankyou for the article, I hope my points, (which are rather simple) help someone else as much as the article you put up has helped me.

    • Jeffrey Gan

      Hi Alex, do you know any pediatric lymphedema specialist in australia? My newborn has secondary lymphedema at both of his feet due to ABS (amniotic band syndrome). The constriction bands had been removed but we don’t know how to manage his lymphedema. Could you advise?

  10. I also have lymphedema. I have had the fluid leaking out, but not in years and not in the amount it is now. For me, it is more of a nuisance than anything. It is a bit scary, but reading similar stories makes me feel somewhat better.
    I have been elevating my leg and my sister helped me to put gauze and wrap it. The challenge for me is that my leg is so large that the compression wrap moves. This is my first day with the wrap. I am thinking to see a doctor but I do not know that they will be able to do anything.

  11. Thank you for a great article on Lymphorrea!! This is the best collection of information on this aggravating leakage many of us with lymphedema have.

    Both of my legs are affected by lymphedema and lymphorrea has been a problem since the beginning. For me, it doesnt go away in a couple of days; it takes weeks, months, or even years (what I am experiencing now). My legs have been perfectly fine, and midday at work, I have suddenly realized the front of my pants leg is wet and my socks are soaked. I have even found myself in a puddle on the floor and not noticed it happening.

    There is a lot of shame (people notice the wet stains and complain about odor), but you cannot just stop your drainage from happening by willing it. What you can do is reduce the size of the affected limb through compression, thorough washing, a 40% zinc protection cream (like Desitin or Boudreaux’s Butt Paste), and dry pads applied often to absorb the drainage. (I recommend feminine pads because they are cheaper than expensive medical pads.) And, elevate as much as you can.

    My skin gets macerated fast if my socks get wet and then wounds develop. My skin is torn up by the draining lymph. It is a slow healing process for me, even with weekly visits to wound care.

    Recognize that we each heal at different rates, and lymphedema affects each of us in unique ways. Don’t let people’s judgments of you (and they DO judge) discourage you. They have no idea how this affects your mind (frustration, anger, helplessness), body (pain, infections, sudden changes), or spirit (self-loathing, shame, embarrassment, loneliness). Keep on going despite what is happening. Do your very best one day at a time. You are not alone!!

    • Arlene Slobecheski

      Thank you soo much for writing this. I have been told that I have and that I don’t have lymphedema. My calves swell greatly everyday but my ankle area is normal but that is where the leaks come from. In fact when the leaks first started in 2017 I wound up with an infection that turned into septic arthritis in an artificial knee. I had been wearing a feminine pad as you say but none of my doctors seem to care about what was happening. I spent 2 weeks in Intensive Care and completely unaware and then 6 weeks in rehab to relearn myself after almost dying. After that much time off my feet my legs had lost all of the fluid. I then went to a physical therapist to learn how to wrap my leg and she told me she didn’t think I had lymphedema. I can’t understand why this isn’t taken more seriously. My calves have once again doubled in size and started leaking. Everyday I make sure to do a thorough cleaning and dressing of the area. I purchased cheap compression stockings but they don’t help.
      It’s just nice to know there is someone out there going through the same issue. Thanks again and much love and blessing are being sent your way.

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