How can I tell lipoedema and lymphoedema apart?

The feet are the key clue: lipoedema usually spares the feet, giving a cuff effect at the ankle, while lymphoedema usually involves the foot. Lipoedema is symmetrical, tender and bruises easily, and affects almost only women; lymphoedema is often one-sided and not tender. A clinician can confirm with checks like the Stemmer sign.

Is lipoedema just being overweight?

No. Lipoedema is a specific condition in which fat builds up in a symmetrical pattern, mainly in the legs, and does not respond to dieting the way ordinary fat does. It is a separate condition from obesity, although the two can co-exist, and it almost always affects women.

Can you have both lipoedema and lymphoedema?

Yes. Long-standing lipoedema can, over time, overload the lymphatic system and lead to lymphoedema as well, a combination sometimes called lipo-lymphoedema. In that case treatment addresses both conditions. An accurate diagnosis from a knowledgeable clinician guides the right plan.

What is the Stemmer sign?

It is a simple check where a clinician tries to pinch and lift a fold of skin at the base of the second toe or finger. If the skin cannot be pinched, the sign is positive, which points towards lymphoedema. In lipoedema it is usually negative until lymphoedema also develops.

Lipoedema vs Lymphoedema: Key Differences (Singapore)

Written & reviewed by the BestDoctors.sg editorial team · Last updated 28 Aug 2026 · General information, not medical advice

Quick answer. Lipoedema and lymphoedema are two different conditions that are often confused. Lipoedema is an abnormal, usually symmetrical build-up of fat, almost always in women, affecting the legs and sometimes the arms, that is typically tender and bruises easily and does not respond to dieting. Lymphoedema is a swelling of fluid caused by a lymphatic system that cannot drain properly, and it often affects one limb including the foot or hand. A key clue is the feet: lipoedema usually spares the feet, giving a cuff or bracelet effect at the ankle, while lymphoedema usually involves them.

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Why the two get confused

Both conditions cause the legs to enlarge, so it is easy to mistake one for the other, and both can also be wrongly labelled as simply being overweight. Getting the distinction right matters, because the conditions have different features and their management differs. It is also possible to have both: long-standing lipoedema can, over time, overload the lymphatic system and lead to lymphoedema as well, a combination sometimes called lipo-lymphoedema. A lymphoedema therapist or doctor can usually tell them apart on examination. Because the two can look similar to an untrained eye, it is worth seeing someone familiar with both rather than relying on a general impression or assuming that leg changes are simply down to weight.

What lipoedema is

Lipoedema is a build-up of fat tissue that occurs in a particular, symmetrical pattern, most often affecting both legs and sometimes the arms. It occurs almost exclusively in women and often begins or worsens at times of hormonal change. Lipoedema UK explains that it is not caused by being overweight and that the affected fat does not respond to low-calorie diets or exercise in the way ordinary fat does, which can be distressing and confusing for those affected. The tissue is often tender and bruises easily.

What lymphoedema is

Lymphoedema, by contrast, is a swelling of fluid rather than fat. It develops when the lymphatic system cannot drain fluid from the tissues, whether because it did not form normally or because it was damaged, for example by cancer treatment or infection. It commonly affects one limb, including the foot or hand, and in its early stages the swelling may leave a dent when pressed, known as pitting. Other guides in this series cover its causes and management in detail.

The key differences

Several features help tell them apart. The feet are the clearest clue: lipoedema usually spares the feet, so the enlargement stops at the ankle and leaves a cuff or bracelet appearance, whereas lymphoedema typically involves the foot and toes. Lipoedema is usually symmetrical, affecting both legs equally, while lymphoedema is often one-sided or unequal. Lipoedema tissue is typically tender and bruises easily, whereas lymphoedema is usually not painful to press. Lipoedema affects almost only women; lymphoedema affects either sex.

The Stemmer sign and pitting

Clinicians use a couple of simple bedside checks. The Stemmer sign involves trying to pinch and lift a fold of skin at the base of the second toe or finger: if you cannot pinch the skin, the sign is positive, which points towards lymphoedema. In lipoedema this sign is usually negative, at least until lymphoedema also develops. Early lymphoedema also tends to pit, leaving a temporary dent when pressed, while lipoedema fat generally does not pit. These are guides that a clinician interprets alongside the whole picture.

How management differs

Because the underlying problem differs, so does the emphasis of treatment. Lymphoedema management centres on the four pillars of skin care, compression, movement and lymphatic drainage. Lipoedema is also helped by compression, exercise and looking after general health, and additionally by support for the pain and the emotional impact, with some specialist services offering further options. Where the two co-exist, treatment addresses both. In all cases, an accurate diagnosis from a knowledgeable clinician is the starting point for the right plan.

Getting the right diagnosis

If you have leg changes that you are unsure about, it is worth seeking assessment from a doctor or lymphoedema therapist familiar with both conditions, rather than assuming it is simply weight-related. In Singapore, hospital physiotherapy and lymphoedema services and the Lymphedema Society of Singapore are reasonable starting points, and your own doctor can refer you. Lipoedema is less widely recognised, so it can take persistence to get the right diagnosis; a clear description of your symptoms and their pattern helps.

Living with either condition

Whichever condition you have, or if you have both, the encouraging message is that they are manageable and you are not simply being asked to lose weight. Compression, movement, skin care and support all play a part, and understanding which condition you have helps you focus your efforts. Because both can affect body image and mood, emotional support matters too. If you are struggling to get answers, keep asking, and seek out clinicians experienced in these conditions. Bringing a clear timeline of when your symptoms started and how they have changed, along with any family history, can help a clinician reach the right diagnosis sooner. Remember that needing ongoing management is not a personal failing; these are genuine medical conditions that respond to the right care.

Sources

NHS – Lipoedema: nhs.uk
NHS – Lymphoedema: nhs.uk
Lipoedema UK: lipoedema.co.uk
Lymphoedema Support Network – Lipoedema: lymphoedema.org
Better Health Channel – Lipoedema: betterhealth.vic.gov.au

General information only. This guide supports, but does not replace, the advice of your lymphoedema therapist and doctor. Look after your skin every day and treat even small breaks in the skin promptly. Get medical help the same day if part of the affected or at-risk limb becomes red, hot, swollen and painful, or you feel feverish or generally unwell – this can be cellulitis, a skin infection that needs prompt antibiotics. Call 995 if you become very unwell, confused or breathless. See your team promptly if swelling suddenly increases or a new swelling appears. If you are struggling emotionally, you are not alone: the Samaritans of Singapore (SOS) are on 1767 and mindline.sg on 1771.

Lipoedema & Lymphoedema: What’s the Difference?