The excess protein also acts as a stimulus for chronic inflammation. One of the results of this is the formation of much excess fibrous tissue. The chronic inflammation causes more blood capillaries to form and to be dilated. This makes the limb feel hot. The patient may be very ill, with constant infections, and need hospitalisation.
Fungal infections are also very frequent, and are often difficult to clear up.
These infections, themselves, place greater loads on the lymphatics, and so worsen the lymphoedema. This is because the tissues are being torn apart. If the lymphoedema is severe, especially if more than one limb is involved, the patient is excessively heavy. Even if only one limb is affected, the added weight can cause clumsiness and this makes the limb more liable to injury and consequent bacterial infection. Lymphatic drainage from the legs is more difficult than from the arms, walking is more difficult and the excess weight discourages this.