Resources

ALA Position Paper – August 2026

This evidence-informed position paper from the Australasian Lymphology Association gives clear, practical guidance for health professionals on assessing, treating and preventing cellulitis in people living with lymphoedema or chronic oedema.

It covers: • Accurate diagnosis and common misdiagnoses • Risk stratification and treatment settings • Antibiotic recommendations (including dosing) • Safe use of compression during acute episodes • Prevention strategies to reduce recurrence.

*More information in the PDF

Cellulitis and Lymphoedema: What You Need to Know

If you live with lymphoedema or chronic swelling, you’ve probably heard the word “cellulitis” mentioned by your care team — and for good reason. New guidance from the Australasian Lymphology Association highlights just how closely these two conditions are linked, and what you can do to protect yourself.

Why swelling increases your risk

Chronic swelling (present for more than three months) means your lymphatic system isn’t clearing fluid the way it should. That’s more than just uncomfortable — it can weaken your skin’s natural defences and make it easier for bacteria to get in and take hold. That’s why people with lymphoedema are more prone to cellulitis, a bacterial infection of the skin and the tissue underneath it.

What to look out for

Cellulitis usually shows up as:

Redness, warmth and swelling in one area (it’s rarely on both sides — if both legs flare up at once, it’s more likely something else)
Pain or tenderness
Sometimes fever or feeling generally unwell

If you notice these signs, it’s important to see a doctor promptly rather than wait it out. Most people start feeling better within 24–48 hours of starting the right antibiotic.

A word of caution: it’s not always cellulitis

Interestingly, around 3 in 10 presumed cellulitis cases turn out to be something else entirely — like dermatitis or a skin reaction related to the swelling itself. That’s worth knowing, because it means not every red, warm patch needs antibiotics. Your doctor may use a structured checklist to help tell the difference.

The good news: you can lower your risk

The strongest evidence for preventing cellulitis if you have lymphoedema comes down to three things:

Wearing your compression garments — consistent, well-fitted compression significantly cuts your risk of recurrent infections.
Looking after your skin — daily moisturising, and treating any cracks, cuts, athlete’s foot or fungal nail infections quickly, closes off the entry points bacteria use.
Managing your weight, where relevant — this is a genuine risk factor for both chronic swelling and cellulitis.

If you’ve had cellulitis before, it’s worth having a chat with your doctor about a personal management plan — including whether a stand-by prescription makes sense for you, especially if you travel.

This information is general guidance based on the ALA’s 2026 position paper and isn’t a substitute for advice from your own doctor or lymphoedema therapist.

*More information in the PDF

Exercise and Your Immune System

Most people with lymphatic conditions would understand the importance of exercise to encourage lymphatic movement. Do you also understand that your lymphatic system drives your immune system and that exercise can benefit your immune response as well?

“Immune cells physical activity promotes the movement of the immune system (lymphatic system) via white blood cells to more locations where viruses and bacteria can be identified.
Not only does exercise get the immune cells moving throughout the body during activity, but it also promotes a lasting presence of these immune cells for up to three hours after exercise is completed. This provides extra time for the immune cells to identify unwanted intruders and keep you from getting sick.
With consistent exercise comes more time for immune cells to patrol the body for bacteria and viruses. Therefore, it’s beneficial to get into a routine of moving your body rather than exercising just occasionally.
Exercise doesn’t have to mean running or going on a lengthy hike; start small and adjust your routine as needed. Do short bursts of activity throughout your day if you can’t do it all at once; some movement is better than none”

— Laura Birkel, RD, CD, Gundersen Nutrition Therapy

If exercise can boost the immune system through movement and muscle contraction then any activity that improves lymphatic function should also improve the immune system. This might include: Lymphatic Drainage massage, Nutrition, Less stress.

Cellulitis and Lymphoedema: Chronic Oedema in Aged Care

Did you know around 1 in 4 older adults living in the community may have chronic swelling in their lower legs? 🦵

A new systematic review published in Age and Ageing looked at all the available research on chronic lower-limb oedema in people aged 60 and over. Here’s what it found:

About 24% of older adults living in the community are affected.
It often shows up alongside other health conditions, especially diabetes, heart disease and obesity.
It’s frequently linked to cellulitis, wounds and difficulty moving around, which can affect health, mobility and how often people need healthcare.
There’s very little research from aged-care homes, so the real numbers there may be higher than we think.
We still don’t know enough about the independent risk factors, so more research is needed.

The big takeaway is that swelling in older people isn’t just “part of getting older”. Spotting it early and managing it well can help prevent complications and support better outcomes. The researchers also raise a good question: should checking for leg swelling be a more routine part of caring for older adults, especially those with several chronic conditions?

This review was led by Maree O’Connor with Suzanne Kuys, Michael Steele, Peter Franks and Dr Helen Badge.

Prevalence, characteristics and risk factors for chronic lower-limb oedema in the older population living in the community or in an aged-care home: a systematic review. Age and Ageing.

*More information in the PDF