lymphedema levels - excerpt from a lymphedema care website

Grades of Lymphedema

The International Society of Lymphology has graded lymphedma into categories:

Grade 1 - when the skin is pressed the pressure will leave a pit that takes some time to fill back in. This is referred to as pitting edema. Sometimes the swelling can be reduced by elevating the limb for a few hours. There is little or no fibrosis (hardening) at this state, so it is usually reversible.

Grade 2 - when the swollen area is pressed, it does not pit, and the swelling is not reduced very much by elevation. If left untreated, the tissue in the limb gradually hardens and becomes fibrotic.

Grade 3 - the lymphedema is often called elephantiasis. It occurs almost exclusively in the legs after progressive, long term, and untreated lymphedema. At this stage there may be gross changes to the skin and it may protrude and bulge. There may be some leakage of fluid through the tissue in the affected area, especially if there is a cut or sore. While lymphedema will respond to treatment at this state, it is rarely reversible.


* This was taken from "Grades of Lymphoedema" in Information About Lymphoedema for Patients, 6th ed. (Malvern, Australia: Lymphoedema Association of Australia,1997) Judith R. Casley-Smith M.D.