Compression garments provide support to areas of the body affected by lipoedema. They mimic (and improve) the natural effect of the skin, increasing the pressure in the tissues. In someone with lipoedema the fat tissues enlarge and the skin is soft. This leads to reduced tissue pressure, and may explain why the lymphatics and veins do not work so well in people with lipoedema.
Why are these useful in lipoedema?
Compression garments increase tissue pressure, reducing the amount of leakage out of the blood capillaries into the tissues. They also improve the drainage of fluid from the tissues, through the lymphatics and veins, back into the blood circulation. It has been suggested that wearing compression may help reverse the progression of lipoedema, by reducing fluid accumulation and inflammation in the fat tissues.
Good fitting compression garments can help with symptoms such as heaviness and pain. Many women with lipoedema require light compression. Stronger compression may be required for some people, for example, after liposuction, or if lymphoedema is also a problem.
How do I know if I need to wear a compression garment?
If you have lipoedema of any stage, wearing compression will have benefits. Compression is helpful for varicose or thread veins, and for those who previously had a blood clot. If you have symptoms such as heaviness, discomfort or pain, fluid swelling, or changes such as hardness in your skin, then you should be wearing compression as often as possible, as you may have later stage lipoedema, or lymphoedema.
Signs of possible lymphoedema are: persistent swelling; tissue hardness; mis-shaped bulges of tissue with deep skin folds; cellulitis. People with late stage lipoedema or lymphoedema may require a course of compression bandaging before being fitted with compression garments. The layered bandages are reapplied by a health professional, sometimes daily. Treatments such as manual lymph drainage massage may also be used. Some people learn to apply the bandages themselves and alternate this with wearing garments.
What choice of compression is available?
There is a wide range of garments available, although the choices may be limited by cost, or by what can be prescribed in your area. You can buy garments yourself, such as those from the Solidea range (see below). Most of the prescription garments can be bought, although they are expensive. Some people with early lipoedema find that support leggings or panty garments are effective. Others with more persistent symptoms may need a health professional to fit and supply a specific type of garment on prescription.
- Leg: below knee, thigh length and panty (like tights) garments; these can be made with or without a foot part; toe ‘glove’ garments are also available.
- Arm: sleeves with or without a hand piece; some come over the shoulder or back; gloves are available.
- Circular knit: these are arm or leg garments knitted in a round pattern, with no seam; they may be highly elastic, and may gather in skin folds or behind the knee, so are not always suitable for people with lipoedema.
- Flat knit: these are arm or leg garments knitted flat with a seam; they are often referred to as ‘stiffer’ garments as they are less elastic; however, this type of garment has a good effect on the lymphatics and veins, and is less likely to gather in skin folds, so can be more comfortable and easier to apply.
- Colours: most common are the ‘beige’ coloured garments; many women with lipoedema like the black colour that is also available on prescription; a few companies also do different colours (for example, blue, red, brown, pink), but these may not be available on prescription.
- Length: most garments come in different lengths; if you have it custom-made, it will be made to match the exact length and circumference of your limb at different points.
- Silicone band: some garments have a band of silicone at the end to stop them slipping down. Some people react to this material, particularly if they get hot.
- Compression class: prescription garments are graded according to the level of compression they provide; this includes compression class 1 (lightest), 2, 3 or 4. People with lipoedema mainly require compression 1 and 2, while the stronger garments are required for lymphoedema. Compression levels can vary between different companies and countries.
- Velcro®compression wraps: these are useful if you need to be able to adjust the pressures (if swelling reduces), if you are unable to apply a stocking, or after liposuction. The wraps cover the limb, and pressure can be adjusted by a series of velcro® straps along the length of your limb. There are usually separate sections for the foot, lower leg and thigh if required; arm garments are also available. Examples are: Juxta-Fit©, CircAid© and FarrowWrap®.
How do I get a compression garment that fits me?
There are many ‘off-the shelf’ garments available, but not everyone fits the standard range and some people need to be measured for a custom-made garment. Measurement is usually done by a nurse such as a GP practice nurse, community nurse, specialist lymphoedema nurse or MLD therapist. Some NHS areas have an orthotic department to fit and supply garments, or community pharmacists may also fit simple garments.
Each company has its own measurement sheet (most are available on the company website) and a health professional fitting one of these will measure circumference and length at a variety of set points on the body. Hopefully, this means that the garment will fit you exactly, but it can take time to find one that is absolutely right for you.
What do I do if it doesn’t fit or keeps falling down?
Get in touch with whoever measured or supplied the garment as soon as possible. There may be different solutions: sometimes a garment feels tight when first applied, and in time our body gets used to the feeling. It is good to break yourself in gently when you first get a new garment, and wear it for a couple of hours to start, building up time until you can wear it as long as required.
The garment may be wrongly sized, and should be re-measured and exchanged. If a garment rolls down, it may be the wrong length or poorly fitted. Another possible solution is that you require a roll-on adhesive body glue, to ‘glue’ the garment to the top of your thigh (this washes off easily!). If in any doubt, or if you develop skin problems from the garment, get in touch with whoever supplied it as soon as possible.
How often should I wear the garment?
This is individual to the person and you should talk to a health professional for personal recommendations. Some people only wear a garment when doing certain activities, and others wear them all day. Usually in lipoedema, it is advisable to go without the garment at night, but some people wear some (lighter) support at night. Times when it is advisable to wear a garment is when you are sitting or standing for a long time, doing repetitive tasks or exercising.
Applying the garments is really difficult; what is available to make this easier?It can take time and practice to find the easiest way to do this, and some garments are much more difficult to apply than others. Usually it is best to apply them in the morning, before swelling becomes worse. Try to avoid applying immediately after a bath/shower or when you have recently applied cream, when the skin can be ‘sticky’. Applying a stocking when sitting with your leg raised is usually easier than bending down to the floor.
There are specific techniques you can use and may different applicators available, some of which are on prescription. Some are slippery material to help the garment slide over the foot, ankle and up the leg. Other examples are frame applicators; here, the garment is spread over a small frame, which then guides the garment onto the limb. Some frames have long handles for those who cannot bend down. If you have a carer, they may need to be taught the easy application techniques. Some of these can be found as short videos on the Internet.
Care of the garments
It is advisable to wash the garment every 1-3 days as this helps to renew the elasticity of the material, and may help lower the risk of infection. Most garments last longer if hand washed, but some can be put in the machine, for example, at a light wash. Avoid using fabric conditioner as this coats the lycra® and other fibres of the garment, making them softer, and more easily degraded. Dry flat, spin dry lightly, but avoid tumble drying or drying directly on a radiator.
I don’t want to wear compression garments
It can be daunting to think of having to wear compression garments regularly. We all have different experiences of compression garments. Sometimes garments aren’t properly fitted, are uncomfortable, or don’t fit with our lifestyle. It can help to break yourself in gradually, wearing light compression for short periods, or getting a colour and style that you like. Once you start wearing a well-fitting compression garment, you will likely feel encouraged and motivated to continue when you notice that it improves your symptoms.
Getting a garment: examples of companies that supply compression garments and their websites. We cannot make any recommendations, and we advise you to talk to a health professional who understands you condition before contacting any companies or ordering any garments privately. If you are in the UK you are usually entitled to two new garments every six months on prescription.
You may wish to buy garments to give yourself more choice.
- Solidea: non-prescribed, available etc….
- BSN: Jobst Elvarex and other garments in beige, black and a few other colours for some; FarrowWrap garment
- Juzo: garments, many different colours
- Medi: garments and Juxta-Fit®
- Sigvaris: wide range of off-the-shelf round knit garments in various styles and colours
- Haddenham Healthcare:
- Credenhill: online private orders of some garments that are usually on prescription
- Activa Healthcare:
Above to be completed as required.
Please note: we do not take responsibility for providing medical advice; the above information should be used in combination with specific, individualised advice from a health professional who knows and understands your situation, where possible.