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Social media is full of videos promoting a facial routine that involves slowly massaging the cheekbones and jaw using tools made of semi-precious stones, some cylindrical, some flat, in many shapes and colors. The creators of this content claim that this ritual activates “lymphatic drainage,” reduces facial puffiness, rids the skin of toxins, and even reduces fine wrinkles and gives the face a slim, “tight” appearance.
So what exactly does “lymphatic drainage” mean, and how true are these claims?
Multifunctional "sewage" system
In the human body there is a vital multifunctional network consisting of tissues and organs known as the “lymphatic system”. This system includes: lymphatic fluid or “lymph,” lymphatic vessels, bone marrow, thymus gland (a small gland located in the chest), lymph nodes, spleen, tonsils, adenoids, and lymphatic tissue within the small intestine and other parts of the body.
“It's a drainage system, and I think of it as a sewage system that removes metabolic waste, large molecules, bacteria, etc., and transports these materials and fluids to the lymph nodes where the access of the lymph fluid and its contents to the nodes allows them to respond and start defending the body,” Professor Neil Beller, director of the Lymphoedema Clinical Research Unit at Flinders University in Australia, who has studied the lymphatic system for five decades, tells me.
Professor Hiroo Swamy, Associate Professor at the Australian Center for Lymphoedema Education, Research and Treatment, identifies three basic functions of the lymphatic system:
1-Immune defense mechanism: If microbes or foreign substances enter the body, the immune system surrounds them and carries them to the lymph nodes through the lymphatic vessels. Lymph nodes are a center for immune reactions and immune cells, including B-cells and T-cells, work to attack foreign agents.
2- Absorption of nutrients: The lymphatic system absorbs fatty substances from the small intestine.
3- Coordinating fluid exchange: by absorbing the excess interstitial (or tissue) fluid that leaks from the capillaries into the tissues, then filtering this fluid (which at this stage is called lymphatic fluid or lymph) through the lymph nodes to remove any pathogenic factors or organic residues, then returning it safely to the bloodstream to ensure fluid balance and prevent tissue swelling.
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When lymphatic fluid accumulates and does not drain properly, a person develops a chronic condition known as “lymphedema,” the most prominent symptom of which is swelling of parts of the body, especially the arms and feet.
Lymphedema may be the result of a genetic defect that causes some parts of the lymphatic system not to grow or not function properly (called primary lymphedema), or it may be affected by people whose lymphatic system previously functioned normally. It may be caused by several things, most notably surgical or radiation treatment for cancer, microbial infection, or infections resulting from some medical conditions.
Professor Swamy says that breast cancer-related lymphedema is a common side effect that occurs after receiving treatment. “Axillary lymphadenectomy leads to damage to the lymphatic vessels in the upper extremity [shoulder, arm, hand] or breast, and in the early stage there may be fluid accumulation in them. This disease is due to a decrease in the number of healthy lymphatic vessels, which is primarily a result of the surgery. Cancer treatment also creates an imbalance in fluid exchange in the lymphatic system, which makes the affected limb more susceptible to infection.” Due to a defect in the function of the immune system.
According to the British National Health Service website, lymphedema is treated through compression bands, specialized massage procedures known as Manual Lymphatic Drainage (MLD), exercise, and skin care. In a small number of cases, surgery is performed to remove liposuction from the affected areas, or surgery in which the flow of lymphatic fluid in the damaged area is restored: for example, by connecting the lymphatic system to nearby blood vessels.
Do we need a lymphatic detox?
In recent years, the idea that we need to “detox,” or remove toxins and harmful substances from the body, has been widely promoted to improve health, skin, and lose weight.
The most popular examples of "detox" on social media include: consuming juices and drinks made from certain fruits, vegetables, or herbs, following a diet, drinking a large amount of water, taking nutritional supplements, massaging the belly button with castor oil, and perhaps the most recent of these is massaging the lymphatic pathways in the body and face.
Doctors and nutritionists often warn to be cautious about commercial claims in this regard because they are often not based on scientific evidence, and the body is equipped with organs and mechanisms to get rid of toxins, such as the kidneys, liver, lungs, and immune system (including the lymphatic system).
Do healthy people need manual lymphatic drainage?
“There are good benefits to manual lymphatic drainage, but unfortunately there are not a lot of high-quality clinical studies...that prove that it is a direct cause of the benefits and not just a factor associated with them,” says Professor Beller. “So there are different opinions, some of which are very negative! But I am a strong supporter of manual lymphatic drainage and using it to keep the drains working optimally.”
“Everyone can benefit from improved lymphatic drainage if it is not working at optimal efficiency for any reason, or not enough to ensure optimal cell and tissue health,” Beller adds. “A sign that it is exhausted or not working well is the gradual buildup of fluid in the superficial tissues, which is subtle at first.”
Dr. Swamy believes that it can be encouraged for healthy people to resort to self-lymphatic drainage if they feel swelling in certain areas of the body, adding that “self-lymphatic drainage helps the flow of lymph, and is expected to contribute to improving local swelling.” But at the same time, he stresses the need to "understand the normal anatomy of the lymphatic system and how the lymphatic vessels extend throughout the body."
“Trend” facial massage tools
The first time I heard about gua sha was when my teenage daughter asked me to buy it. Then I discovered many videos on social media explaining how to use it for facial massage, and claiming that this leads to reducing puffiness and getting rid of accumulated fluids, which improves sagging skin and gives the face a slim appearance.
Gua sha is a traditional Chinese facial massage tool made of smooth semi-precious stones, such as jade or quartz, and are usually heart-shaped, flat-comb-shaped, or wave-shaped. There is also a face roller, which is also made from the same stones.
Social media platforms are credited with the rapid spread of this “trend,” which is consistent with a phenomenon that has spread in recent years on these platforms, which is following morning and evening rituals aimed at improving the appearance of the face and making it more fresh and youthful.
Is there a scientific basis that justifies the promotion of these tools?
Professor Beller says that while some treatments and strategies promoted by beauty experts and influencers may lack sufficient or clear objective scientific evidence, there are some massage techniques that are very important, and “researchers can learn from case studies and observational studies to determine what may be effective.”
Beller adds that it is possible that “applying variable pressures to the face (as well as the head and neck) can help improve the health of cells and tissues, and thus improve the appearance of these areas, provided that an attempt has first been made to empty the drainage pathways in these areas.”
He explains that the face is a highly active area, especially in the nose and around the eyes, because of the muscles associated with facial expressions. “Therefore, this area is relatively rich in blood vessels, which requires good delivery of nutrients, oxygen, etc., in addition to the effective elimination of waste. When the face is stimulated, especially the areas surrounding the eyes and nose, using a variety of massage devices and techniques, the blood supply to these areas and to the face in general improves, and the process of eliminating metabolic and inflammatory waste also improves, which reflects positively on the appearance and health of the skin.”
But Professor Beller points out the importance of remembering, “We are all different, and our responses also differ, and therefore what works for you may not work for me.” He then advises the importance of experimenting, and changing only one thing at a time to see if it is useful, as well as “understanding the role of the lymphatic system and targeting it in a way that helps it perform its function efficiently.”
“Yes, look at the claims the companies market for the tools you use, but also consider the science and evidence that backs them up. Find a balance between the two, then decide what is right for you.”
How can we help the lymphatic system work efficiently?
Maintaining a healthy lymphatic system does not require special tools or “detox” products, but rather healthy daily habits.
“Live well: dress appropriately, breathe well, sleep well, eat healthy, be active, follow warm-up and cool-down practices after strenuous activity, pay attention to any changes and act early and do not wait to see what happens,” advises Professor Piller.
For example, good sleep, Beller explains, "helps the brain get rid of metabolic waste. The brain makes up about 2% of the body's mass but consumes about 20-25% of total energy."
Deep breathing (diaphragmatic or abdominal), exercise, and movement also enhance the flow of lymphatic fluid in the body and reduce fluid retention in it.
You should also avoid wearing tight clothing, such as bras, underwear, etc., because they put pressure on the lymphatic vessels that collect lymphatic fluid and drain it to the veins, according to Professor Beller.
In conclusion, it seems that the lymphatic system has become an axis where science and health trends intersect on social media platforms. While facial massage practices using tools such as gua sha may have temporary cosmetic benefits, evidence for dramatic claims such as detoxification or “sculpting” of the face remains limited or absent. The most effective way to support the health of our lymphatic system is to follow the same healthy habits recommended by doctors from various specialties in order to enhance our overall physical and mental health.
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