Raise your hand if, in summer, you don’t suffer from swelling and heaviness in your legs. Even putting on shoes sometimes becomes difficult. Swollen legs, including ankles, when the heat arrives, is a problem that affects 1 in 2 women, three times as much as in winter. 

Is it only a female problem? Absolutely not. But men often tend to ignore and underestimate the problem much more than women do. 


Therefore, the problem of lymphedema, especially on the eve of what promises to be the hottest summer ever, should not be minimized. 

“When talking about swollen legs and circulation, thoughts immediately turn to blood, which flows through our body’s arteries and veins propelled by the heart. However, beyond the main ‘highways’ of the blood circulatory system of arteries, veins, and capillaries, there is also a complex network represented by the lymphatic system that transports proteins, fluids, and lipids. This system, consisting of lymphatic vessels and lymph nodes, allows lymph to be drained in bodily tissues throughout our organism, before flowing back into the blood circulation.

Dysfunction in this network can lead to abnormal swelling of the hands, arms, or legs, sometimes so extensive that they appear ‘elephant-like’,” explains Corrado Campisi, a professor of Plastic Surgery at the University of Catania. He is considered one of the leading experts in Surgery and Microsurgery of the Lymphatic System and co-founder of the Campisi Clinic. 

Lymphedema affects 2 million Italians 

There are two main forms of lymphedema. The “primary” ones, due to congenital malformations of the vessels of the lymphatic system, and the “secondary” ones, due to external adverse events that alter the normal function of the lymphatic system, such as lymph node removal and radiotherapy, both involved in oncological treatments. It is estimated that there are 350 million people with lymphedema worldwide, 2 million in Italy alone. These numbers are on the rise, with about 40,000 more each year in our country. 

“When the lymphatic circulation of our legs has anomalies, a buildup of fluids occurs in the tissues, and when this state, as often happens, is associated with venous insufficiency of the limbs, the situation complicates. It is not just an aesthetic issue, considering that in summer, it can be difficult to walk or even to wear shoes. The fluids that cannot be drained can become so dense, due to the high protein content, that they can compromise the proper oxygenation of the tissues, predisposing them to redness, eczema, dermatitis, ulcers, and infections,” adds Campisi. 

Pay attention to the warning signs “The difference is made by the timely diagnosis of the problem, which can only happen by identifying the first warning signs. Initially, the symptoms can be subtle and hard to detect in summer: the most common are heaviness in the legs and swollen ankles, which are often considered ‘normal’ and therefore negligible.

What should not be ignored, however, is the difficulty with which the legs deflate: if benefits are not achieved by lifting them and refreshing them with jets of cold water, it is wise to consult a specialist. Initially, a doctor needs only one finger to verify that there is a problem. The depression formed by the finger’s pressure on the ankle or leg for a few seconds is a clear sign of lymphatic dysfunction. To clinical observation, an EcoColorDoppler should also be associated for the study of the venous circulation and a lymphoscintigraphy to check for lymphatic congestion,” concludes Campisi. 

Here is the ten-point plan to ‘lighten’ swollen legs 

Corrado Campisi will be the president of the World Congress on Lymphology to be held in Genoa from September 11 to 15. The event, which will bring together doctors, surgeons, nurses, physiotherapists, podiatrists, and many other specialists from around the world, represents an opportunity for updating in the treatment of lymphatic pathologies and for discussing the latest technological innovations. 


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