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World Elephantiasis Day is celebrated annually on March 12 to raise awareness about the most severe form of lymphedema (Stage III), including its causes, signs, symptoms, complications, prevention, and treatment options. March is also Lymphedema Awareness Month, which includes both Primary Lymphedema (a genetic condition) and Secondary Lymphedema (caused by various factors such as surgery, radiation, infection, insects, etc.). Read about the myths and facts of elephantiasis HERE.
In specialized medical and scientific literature, the term elephantiasis refers to the most severe degree of lymphatic dysfunction, both in Primary Lymphedema and Secondary Lymphedema caused by different factors. Some organizations have been mistakenly using the term elephantiasis as if it were a synonymous with lymphatic filariasis. It should be noted that most people who suffer from lymphatic filariasis (Secondary Lymphedema) and have access to adequate treatment do not inevitably progress to the stage of elephantiasis, since elephantiasis can be prevented by treating lymphedema in its early stages with appropriate treatment. It is therefore incorrect to use the term elephantiasis as a synonym to refer exclusively to lymphatic filariasis, nor is it correct to say that all lymphatic filariasis is, or ends up being, elephantiasis.
Lymphedema (Organic Lymphatic Vascular Disease) is due to impaired lymphatic drainage resulting in skin disease, characterized by persistent and progressive swelling, and abnormal thickening of the skin and subcutaneous connective tissue. Lymphedema is not just a localized swelling problem, but a condition that can affect multiple body systems, structures and functions, leading to a range of physical, physiological and psychosocial symptoms and complications. Read about the symptoms and complications of lymphedema HERE.
An uncomplicated lymphedema can easily turn complicated with inadequate management options. There is a safe and effective treatment for lymphedema, which helps to reduce edema and halt the progression of the disease towards its advanced stages. Simple health care packages alone are usually not enough to control disease progression and subsequent complications (lymphatic dysfunction).
The safe and effective first-line treatment for lymphedema is Complete Decongestive Therapy (CDT) carried out by a lymphatic therapist at specialist level, which is considered the “Gold Standard” conservative treatment. This specialized treatment consists of Manual Lymphatic Drainage (MLD) and Multi-layered Bandaging, as well as other components such as skin care, diet, exercise, and patient education. Read about the best treatment option for lymphedema HERE.
Compression therapy for the initial reduction phase applied without Manual Lymphatic Drainage (MLD), or treatment that is not carried out by a lymphatic therapist at specialist level, can cause very severe complications such as displacement of lymph to previously non-affected areas, which can provoke Genital Edema in the case of lower limb lymphedema. People with lymphedema need access to specialized care throughout their lives, both to manage the disease and to prevent progression to more advanced stages such as elephantiasis. Read more about the principal functions of Manual Lymphatic Drainage HERE.
Conservative treatment is indicated for all edema stages, and even advanced lymphedema can be successfully treated with CDT. Avoiding the initial progression toward the elephantiasis stage, can help evade the need for ablative surgery. Radical reductive ablative surgery, aimed at removing subcutaneous tissue, should always be the last option, for it is associated with possible significant blood loss, morbidity, infections, permanent disfigurement, and recurrence of symptoms. Read more about the best treatment for elephantiasis HERE.
Apart from the patient's daily basic self-care, patients also need to wear compression garments (orthotic devices) throughout the day. Without compression, it is impossible to stop the progression of lymphatic edema. The daily use of standard bandages for lymphedema is not practical. Bandages lose pressure after application due to edema reduction, and they also tend to loosen and slip off when undertaking work that requires continuous physical activity, likewise, dirty bandages can also be an important source of infection. While bandages are mainly used for the initial phase of reduction therapy, compression garments are recommended for the maintenance and long-term management. Read more about the importance of compression garments in the treatment of lymphedema HERE.
Lymphedema (Organic Lymphatic Vascular Disease) is not a rare disease but a major public health problem, and it is necessary to sensitize governments and international health organizations, that access to adequate treatment for lymphedema and lymphatic diseases should be a global priority. Up to 10 million Americans may be affected by lymphedema, and it's estimated that over 250 million people worldwide suffer from the disease, creating pain, disability, and suffering for patients of all ages, including children. The only way to avoid elephantiasis (Stage III Lymphedema) is to provide early lymphatic therapy and compression garments. Read more about why the world is not treating a treatable disease like elephantiasis HERE.
March 12 is the date to remember all those people living with Primary and Secondary Lymphedema in its most severe stage "Elephantiasis". No one should be allowed to progress to this stage of severity due to lack of treatment or undetreatment, as elephantiasis can be prevented in most cases by treating lymphedema in its early stages with appropriate treatment.
