Can lymphedema cause varicose veins?

September 25, 2025 •

4 min read

According to the National Institutes of Health, phlebolymphedema, a condition where venous and lymphatic issues coexist, is the most common form of secondary lymphedema in the Western world. While lymphedema does not directly cause varicose veins, the two conditions are closely connected and can significantly influence each other's progression.

Quick Summary

Lymphedema does not directly cause varicose veins, but the chronic swelling and inflammation associated with it can increase pressure on the venous system over time, potentially leading to venous damage and the development of varicose veins.

Key Points

Indirect Impact: Lymphedema does not directly cause varicose veins, but the chronic, protein-rich fluid buildup and subsequent inflammation can damage the venous system over time.
Phlebolymphedema Defined: The term phlebolymphedema refers to a condition where both venous and lymphatic systems are insufficient, often occurring together in a vicious cycle.
Venous Insufficiency Link: Conversely, chronic venous insufficiency (the underlying cause of varicose veins) can lead to the development of secondary lymphedema by overwhelming the lymphatic system's drainage capacity.
Overlapping Symptoms: Both conditions can cause leg swelling, heaviness, and skin changes, which can make accurate diagnosis challenging without a specialist's evaluation.
Combined Treatment Approach: Effective management of co-occurring conditions requires a multifaceted approach, including compression therapy, manual lymphatic drainage, exercise, and careful skin care.

Understanding the Distinct Systems

Before exploring the link between lymphedema and varicose veins, it's crucial to understand the distinct roles of the lymphatic and venous systems.

The Lymphatic System's Role

The lymphatic system acts as the body's drainage network, collecting excess protein-rich fluid (lymph) from tissues and returning it to the bloodstream. It is a crucial component of the immune system and maintains fluid balance throughout the body. When this system is damaged or obstructed, as in the case of lymphedema, lymph fluid accumulates, causing swelling.

The Venous System's Role

The venous system, a part of the circulatory system, is responsible for returning de-oxygenated blood to the heart. Veins in the legs contain one-way valves that prevent blood from flowing backward against gravity. When these valves weaken or fail, blood can pool in the veins, leading to chronic venous insufficiency and the formation of varicose veins.

The Intertwined Relationship: Venous and Lymphatic Systems

While they are separate, the lymphatic and venous systems are highly interconnected. Problems in one system can, over time, place stress on the other, creating a progressive, often destructive, cycle. The relationship is so significant that the term "phlebolymphedema" is used to describe the coexistence of chronic venous and lymphatic insufficiency.

Can Lymphedema Affect Your Veins?

Yes, lymphedema can affect your veins. The primary mechanism is through increased pressure and inflammation. Chronic swelling from lymphedema creates a high-pressure environment in the affected tissues. This persistent external pressure can, over time, stress and weaken the venous system, potentially damaging the delicate one-way valves in the veins. This damage can then contribute to the development of varicose veins.

Furthermore, the stagnant, protein-rich lymph fluid in lymphedema causes a state of chronic inflammation in the tissues. This inflammatory process can affect the health of surrounding tissues, including the walls of nearby blood vessels, further compromising venous function.

Can Varicose Veins Affect the Lymphatic System?

The relationship is most often seen in the other direction as well. Varicose veins are a sign of underlying chronic venous insufficiency (CVI). CVI causes increased pressure within the venous system, which leads to fluid leaking out of the blood vessels into the surrounding tissue. Initially, the lymphatic system works hard to drain this excess fluid. However, if CVI persists and worsens, the lymphatic system can become overwhelmed and ultimately fail, leading to secondary lymphedema. This is a key reason why CVI is a leading cause of secondary lymphedema in the Western world.

Comparison: Lymphedema vs. Varicose Veins


Feature	Lymphedema	Varicose Veins
Underlying Cause	Impaired lymphatic system function, leading to a buildup of protein-rich lymph fluid.	Malfunctioning one-way valves in veins, causing blood to pool.
Primary Fluid Involved	Lymph fluid	De-oxygenated blood
Appearance	Often causes generalized swelling of a limb (arms or legs); skin may thicken and feel tight. A positive Stemmer's sign may be present.	Bulging, twisted, and discolored (blue or purple) veins visible on the skin's surface.
Sensation	Feeling of heaviness, tightness, or fullness in the affected limb.	Aching, throbbing, or burning sensation in the legs.
Progression	Chronic and progressive; swelling can worsen over time without treatment.	Progressive; underlying venous insufficiency can worsen over time.
Skin Changes	Thickening, hardening, and potential for skin infections (cellulitis).	Skin discoloration (brownish), eczema-like rashes, and in severe cases, venous ulcers.

The Vicious Cycle of Combined Conditions

When an individual has both conditions, a self-perpetuating cycle can emerge. CVI leads to swelling and increased tissue pressure, which overloads the lymphatic system and contributes to lymphedema. In turn, the chronic fluid accumulation and inflammation from lymphedema can exert external pressure on the venous vessels, further compromising venous return and worsening CVI. This dynamic makes accurate diagnosis and targeted, comprehensive treatment from a vascular specialist critical.

Diagnostic and Treatment Approaches

Diagnosing these conditions requires a thorough evaluation, often involving a physical exam, patient history, and diagnostic tests like a vascular ultrasound. Differentiation between the two is important for effective treatment, though treatment plans for co-occurring conditions often overlap.

Treatment for Both Conditions

Compression Therapy: Compression garments are a cornerstone of treatment for both conditions, helping to improve circulation and reduce swelling.
Elevation: Elevating the affected limbs can help reduce swelling and assist with fluid flow.
Manual Lymphatic Drainage (MLD): A specific massage technique performed by a certified therapist to encourage the flow of lymph fluid.
Exercise: Gentle, regular exercise helps to activate the calf muscle pump, which assists both venous and lymphatic circulation.
Skin Care: Proper skin hygiene is essential to prevent infections, which can be a significant complication, especially with lymphedema.
Venous Procedures: For severe varicose veins, procedures such as sclerotherapy or laser ablation can be used to close off damaged veins.

For more detailed information on lymphatic function and disorders, an authoritative resource is the Lymphatic Education & Research Network.

Conclusion

While lymphedema does not directly cause varicose veins in a traditional sense, the chronic swelling and tissue inflammation it creates can certainly damage the venous system over time, contributing to venous insufficiency and the development of varicose veins. The two conditions are deeply intertwined, with chronic venous insufficiency being a significant risk factor for secondary lymphedema. Recognizing this complex relationship is the first step toward effective diagnosis and management. A comprehensive approach that addresses both lymphatic and venous health is essential for managing symptoms and improving long-term quality of life.

Frequently Asked Questions

Yes, swelling from both lymphedema and varicose veins can appear similar, especially in the early stages. A key difference is the consistency of the swelling; lymphedema swelling is often firmer and may not pit when pressed, though this can vary. A vascular specialist or lymphedema therapist can help differentiate the cause.

Phlebolymphedema is a specific type of swelling that occurs when a person has both chronic venous insufficiency and lymphedema. It is often the result of the venous system overwhelming the lymphatic system's capacity to drain excess fluid and protein.

Yes, compression therapy is a cornerstone of treatment for both conditions. Compression stockings or wraps help reduce swelling, improve circulation, and support the affected vessels, which benefits both venous return and lymphatic drainage.

Yes, chronic lymphedema can lead to significant skin changes. These can include thickening and hardening of the skin (fibrosis), a sandpaper-like texture (hyperkeratosis), and an increased risk of infections like cellulitis due to compromised immune function in the affected tissue.

A doctor can perform diagnostic tests, most commonly a vascular ultrasound, to evaluate the function of your veins. If signs of chronic venous insufficiency are present alongside lymphedema symptoms, it indicates that venous issues may be contributing to or worsening the lymphatic condition.

Yes, chronic venous insufficiency, the underlying cause of varicose veins, is a significant risk factor for developing secondary lymphedema. The sustained high pressure from pooling blood can overload and damage the lymphatic system.

Yes. Lymphedema can be caused by other factors, such as surgery, radiation, trauma, or genetic conditions, which may not involve the venous system at all. However, the co-occurrence of both conditions is common.