Offering Manual Lymphatic Drainage in Your Esthetic Practice



Manual lymphatic drainage—it may sound quite clinical, even a bit unpleasant, but for those who’ve undergone the treatment while in the capable hands of an esthetician, it’s the holy grail of skincare procedures, encouraging cell renewal, enhancing skin tone, and decreasing puffiness.

What is Manual Lymphatic Drainage?

Manual lymphatic drainage is a pleasant, gentle, and non-invasive massage designed to improve the appearance of the skin by facilitating proper lymphatic flow and drainage.

It is often used as an anti-aging procedure, as proper lymphatic drainage results in the reduction of fine lines and wrinkles. However, it is also used as an effective treatment for a number of skin maladies, such as acne, cellulite and rosacea.

The lymphatic system, as part of the immune system, has a number of functions: to remove excess fluid from body tissues; to absorb fats; and to protect the body against disease. The processes of the lymphatic system may slow down for a variety of reasons, such as autoimmune disorders, environmental conditions, lifestyle choices, and injuries.

Enter Zip:

Manual lymphatic drainage encourages the movement of the lymphatic system, which reduces swelling and puffiness, induces relaxation, and improves the skin’s tone and texture.

Manual lymphatic drainage was originally developed by Emil and Estrid Vodder, both physical therapists in the 1930s. After finding that many of their patients with chronic colds also had swollen lymph nodes, they began researching the lymphatic system and found that a light, rhythmic massage with stretching movements was effective at stimulating the lymph flow throughout the body. By 1936, their technique had gained recognition in the medical community, and they subsequently presented their findings to a health and beauty committee in Paris.

Since the Vodder’s time, many physicians, researchers, and lymphologists have perfected the technique of manual lymphatic drainage and have come up with their own methods for stimulating the lymphatic system, many of which are similar to the Vodder method.

Manual Lymphatic Drainage Massage: The Technique

One of the first things you will notice is that manual lymphatic drainage is not a typical massage. Instead, it is a complex process that should only be performed if you have completed a comprehensive program that includes both theory and hands-on training.

Although manual lymphatic massage may, at first, seem like a simple massaging technique, if it is performed improperly, it can cause serious side effects for individuals with certain medical conditions, including heart disease, autoimmune disorders, and cancer.

Manual lymphatic drainage consists of an extremely light, feathery pressure, with all movements performed in the direction of the lymphatic flow, toward the right lymphatic duct and the thoracic duct—both of which drain into the circulatory system at the right and left subclavian veins (located at the base of the neck, below the clavicle bone).

The massage technique of manual lymphatic drainage involves smooth, circular, pump-like strokes where lymph nodes likely exist. Most of the lymph nodes of the body (there are more than 600) are located in the face and neck. The massage technique is often described as a “pumping and draining” motion.

Note: Lymphatic drainage may also include the use of lymphatic drainage devices. These may include simplistic vibration/pressure devices and/or complex machines that address specific areas of lymphatic drainage. Some of these devices include compression pumps, electro-lymphatic drainage therapy machines, vacuum systems, and combination units. Manual lymphatic drainage does not generally include the use of any machines/devices, although training in these machines may be part of an advanced esthetics program or course in lymphatic drainage.

Settings in Which Manual Lymphatic Drainage is Performed

Estheticians in a medical spa or plastic surgeon’s office often perform manual lymphatic drainage in a pre- or post-operative capacity for liposuction. Many times this procedure is also performed to lessen the side effects of cosmetic surgery, such as bruising, swelling, and the buildup of scar tissue.

Estheticians in medical offices may also perform manual lymphatic drainage as a supportive service for patients with any number of existing conditions, such as:

  • Autoimmune disorders, such as lupus
  • Neurological diseases, such as Parkinson’s and multiple sclerosis
  • Migraines headaches
  • Lyme disease
  • Lymphedema
  • Chronic pain

In spa settings, estheticians perform manual lymphatic drainage as part of a relaxing facial, as it increases circulation to the face, reducing puffiness and the appearance of fine lines and wrinkles. Many patients with skin disorders, such as acne and rosacea, also benefit from manual lymphatic drainage, as it aids in the healing process.

Advanced Training in Manual Lymphatic Drainage for Estheticians

An initial esthetician training program leading to state licensure does not include study and training in manual lymphatic drainage; therefore, you will always need to seek additional training in this technique. However, many states do not allow estheticians to perform manual lymphatic drainage, regardless of their advanced training in this procedure. It is always important to check with your state regulatory agency before pursuing training in manual lymphatic drainage.

Currently, a handful of states, including Washington State, Utah, and Virginia, recognize a two-tier licensing system for estheticians—esthetician and master esthetician. Only master estheticians are allowed to perform manual lymphatic drainage in these states.

To earn a master esthetician state license in states with a two-tier licensing system, you must complete an advanced program beyond your initial esthetician program—consisting of about 600 hours—and take and pass the NIC National Advanced Esthetics written and practical exams.

In some states without a two-tier licensing system, such as New York, estheticians may perform manual lymphatic drainage upon the completion of an advanced course/program approved by their regulatory agency.

Training in manual lymphatic drainage encompasses about 120 hours of instruction and covers topics such as:

  • Cellulite
  • Etiology of edema
  • Face and neck treatment sequence
  • Functions of the lymphatic system
  • Immunity
  • Indications and contraindications for lymphatic drainage
  • Lymphatic drainage manipulations and movements
  • Lymphatic drainage on the trunk and upper and lower extremities
  • Machine-aided lymphatic drainage
  • Tissues and organs of the lymphatic system
  • Using lymphatic drainage with other treatments

Some of the schools offering advanced courses (many of which lead to certificates/diplomas of completion) in manual lymphatic drainage include:

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