Reducing the risk of lymphoedema in the head and neck area

Lymphoedema is a swelling which can affect any part of the body. It develops when part of the lymphatic system is damaged and cannot work properly.

Cancer treatments, such as surgery and radiotherapy can affect how your lymphatic system works.

Not all swelling is lymphoedema. Swelling after surgery or radiotherapy is common and usually gets better within a few weeks. If the swelling does not improve, or if you are worried, talk to your GP or another healthcare professional.

The lymphatic system is an important part of your immune system. It is made up of lymphatic organs (for example tonsils and spleen), lymph nodes (glands) and lymph vessels that run through your body. 

The lymphatic system: 

• helps your body fight infection 
• keeps the right balance of fluid in your tissues and bloodstream 
• detects and responds to bacteria and other foreign materials in your body

A diagram of the lymphatic system

This image was produced by Macmillan Cancer Support and is reused with permission

Lymphoedema does not affect everyone and there is no way to know whether you will develop it. Each person’s lymphatic system is unique and recovers differently after cancer treatment.

You may be at risk of developing lymphoedema if you have had:

• lymph nodes removed from your head or neck area. This can change how lymph drains and may cause fluid to build up in the tissues.
• radiotherapy to your head or neck as part of your cancer treatment.

Lymphoedema can develop on the side of your head or neck where you had surgery.

Signs to look out for include:

• tightness, fullness or ache in the head or neck area
• a change in the shape of the affected area

If you notice these symptoms, contact your GP or healthcare team.

1. Take good care of your skin 

Good skin care around the treated area reduces your risk of skin infection (cellulitis).  

Please follow the tips below: 

• Keep the skin in and around the treated area moisturised. This helps to prevent dryness and cracking. 
• If needed, use insect repellent to minimise bites. 
• Protect your skin from sunburn. Use sunscreen with SPF 30 or higher on treated areas. 
• Maintain good oral hygiene as advised by your healthcare team. 

You may have a higher risk of cellulitis if you had lymph nodes removed or radiotherapy to the area. 

Even small cuts or skin damage in your head or neck area can lead to cellulitis, which may trigger lymphoedema. 

2. Act quickly if your skin is damaged 

If you cut or scratch your skin, or notice any skin damage, wash the area carefully with soap and water. Look out for signs of cellulitis which include: 

• redness 
• increasing swelling 
• skin that feels hot and painful 
• flu-like symptoms or raised temperature

If you notice any of these symptoms, please contact your GP without delay. If your GP surgery is closed, call NHS 111 or go to your nearest walk-in centre or Emergency Department (A&E). If you have cellulitis, you will need antibiotics. 

The British Lymphology Society recommends taking antibiotics for at least 14 days if you develop cellulitis in ‘the area at risk’. 

The Guidelines on the Management of Cellulitis in Lymphoedema are available on the Lymphoedema Support Network (LSN) website. 

It may be helpful to download the information and show it to your GP or A&E doctor if they suspect you have cellulitis. 

Please note: 

• Always finish the full course of antibiotics. 
• Tell your doctor if you don’t start to feel better after 48 hours of taking them. 

3. Keep active

Regular exercise helps lymph fluid move around your body and can lower your risk of lymphoedema.

• Start gently and increase your activity slowly.
• Speak to your healthcare team if you need advice.
• You can find some helpful exercise videos on the Lymphoedema Service web page.

4. Follow general advice below 

• If you wake up with swelling in your head or neck area, try sleeping with an extra pillow.
• Try to keep a good posture to reduce your risk of swelling and support your spine.
• Eat a balanced diet to maintain a healthy weight.
• Be aware that extreme heat, such as saunas and steam rooms, can trigger swelling for some people.

Contact your GP or healthcare team if: 

• you notice any swelling in the treated area 
• swelling does not improve
• you develop symptoms of cellulitis 
• you feel worried about any changes

The Macmillan Support and Information Service offers advice, support and information to anyone affected by cancer or a blood condition. You can drop in any time between 9am and 4.45pm, Monday to Friday, or call 020 3447 8663.

Lymphoedema Service, University College Hospital Macmillan Cancer Centre, Huntley street, London WC1E 6AG 

Telephone: 020 3447 3925

Lymphoedema Support Network (LSN) 
The LSN is a patient organisation providing advice and a range of information about lymphoedema. It also holds support groups around the UK and can advise on local lymphoedema services. 

St Luke’s Crypt, Sydney Street, London SW3 6N1T 

Information and support: 020 7351 0990 
Email: adminlsn@lymphoedema.freeserve.co.uk

Lymphoedema treatment – lymphatic drainage massage, exercise | Macmillan Cancer Support 
Provides helpful information about cancer-related lymphoedema.

Telephone: 0808 808 00 00 

Cancer Research UK 
Funds research to help beat cancer sooner and provides information about cancer.

Telephone: 0808 800 4040 

Lymphoedema – NHS

University College London Hospitals NHS Foundation Trust cannot accept responsibility for information provided by external organisations.