When temperatures rise, the circumference of legs and ankles increases. Swelling, heaviness, and in some cases, an annoying tingling sensation that affects one in two women in the summer, triple the rate of occurrence in winter. Men are not immune either, though they tend to ignore and underestimate the problem much more than women.

Corrado Campisi, President of the World Congress of Lymphology to be held in Genoa in September, and a professor of Plastic Surgery at the University of Catania, warns of the risk of lymphedema during this period of intense heat. At that time, doctors, surgeons, nurses, physiotherapists, podiatrists, and other specialists from around the world will discuss updates in the treatment of lymphatic pathologies. 

Too Much Heat:

Professor Campisi, why do legs swell? 

“When we talk about swollen legs and circulation, the thought goes directly to blood, which flows through the arteries and veins. However, in addition to the major ‘highways’ of the blood circulatory system, there’s also the intricate network of the lymphatic system that transports proteins, liquids, and lipids, consisting of lymphatic vessels and nodes, which allows lymph to be drained into tissues at every point of our body before flowing into the blood circulatory stream. A malfunction of this network can lead to abnormal swelling of hands, arms, or legs, sometimes so extensive they seem like ‘elephant’ limbs.” 

How widespread is the problem? 

“It is estimated that there are 350 million people with lymphedema worldwide, 2 million in Italy. These numbers are growing strongly, with about 40,000 more cases per year in our country.” 

Let’s remember, it’s not just a cosmetic issue. 

“No, even though in summer it can be hard to walk or even 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.” 

How can we reduce the risks? 

“There are various levels of treatment depending on the severity of lymphedema: from simple lifestyle changes like avoiding smoking or standing still for long periods, to the use of elastic stockings. Then there are drugs, physiotherapy, or even minimally invasive surgery. Making a difference is the timely diagnosis, identifying the first warning signs.” 

And what are they? 

“Initially, symptoms can be difficult to understand in summer: the most common are heavy legs and swollen ankles, often considered ‘normal’ and therefore negligible. What should not be ignored is the difficulty with which the legs deflate: if you don’t feel better by raising them and refreshing them with jets of cold water, it’s best to consult a specialist. Initially, a doctor needs just one finger to verify that there’s a problem.” 

How so? 

“With the pressure exerted by the finger on an ankle or leg, you can verify that, for a few seconds, a kind of dimple forms, a clear sign of lymphatic dysfunction. Then you should also have an EcoColorDoppler to study the venous circle and a lymphoscintigraphy to check for lymphatic congestion.” 

New Technique: Sound Waves that Dissolve Lymphatic Congestion 

The fluids that cannot be drained can become so dense as to compromise the proper oxygenation of tissues, predisposing them to redness, eczema, dermatitis, ulcers, and infections. Professor Corrado Campisi (in the photo) is also the inventor of a new technique of “ultrasound liposuction,” which uses sound waves to “dissolve” lymphatic congestion and facilitate the surgical procedure. 

In the city, at the beach, traveling, or in the office: Ten Moves to Follow Given the intense heat, here’s the experts’ decalogue, developed to “lighten” swollen legs in summer. 

1 – Engage in regular moderate physical activity. Better a gradual workout, without intense efforts to not overtax the limbs. 

2 – Perform exercises preferably in the morning when the limb is not yet tired from the daily routine. 

3 – Wear comfortable shoes with 2-2.5 centimeters heels. 

4 – Avoid walking barefoot, even though it seems to give immediate relief. 

5 – Take walks at the sea, with water up to the waist. 

6 – Do not expose yourself to the sun during hot hours. Sunburn can cause inflammation of the lymphatic capillaries. 

7 – Change position often when sitting or standing for long periods. 

8 – Sleep with legs slightly elevated, placing a pillow under the mattress. 

9 – Do not cross your legs when sitting. 

10 – In case of too long trips by plane or car, wear the elastic sheath and try to move the legs by making short breaks from the sitting position. 

When all this is not enough, pharmacological therapy is needed with, for example, benzopyrones, antibiotics, antifungals.

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