What Is Dercum's Disease?

Written by Kim Painter
Medically Reviewed by Jabeen Begum, MD on July 18, 2025
8 min read

Dercum's disease is an extremely rare disorder. People with it have many painful, fatty lumps that grow just below their skin. There’s no cure yet, but some treatments can ease the symptoms.

Your doctor might call Dercum's disease adiposis dolorosa. Other names for this disorder include Ander syndrome, morbus Dercum, adipose tissue rheumatism, adiposalgia, and lipomatosis dolorosa.

The causes aren't clear yet.

A leading theory is that Dercum's disease is caused by something that triggers inflammation in the painful areas, says Thomas Wright, MD, a cosmetic surgeon and specialist in venous and lymphatic medicine in O'Fallon, Missouri. He has researched and treated the disorder in the past.

Wright says that some cases develop after trauma, such as injury in an auto crash. Some cases develop after an infection, such as Lyme's disease.

Some experts say Dercum's may be an autoimmune disorder. That means your body's immune system is attacking healthy tissues. That could cause inflammation and pain. But blood tests in people with Dercum's usually don't pick up signs of autoimmune activity or unusually high levels of inflammation.

Others say that a hormone or nervous system problem might be to blame.

And some studies suggest that there are differences in how fat tissue behaves in the bodies of people with the disease. Most people with the condition have obesity. 

There may be different causes or triggers in different people. For example, a few people with Dercum's have a family history of the disease, so some experts think it may come from a mutated fat gene that's passed down in families.

Men can get Dercum's, but it's at least five times more common in women. Those who have obes ity and are aged 35 to 50 are most likely to be diagnosed. Children rarely get Dercum's.

Is Dercum's disease a rare condition?

While researchers don't know the exact number of people with Dercum's disease, it seems to be quite rare. Fewer than 200,000 people in the U.S. likely have it, and the actual number could be quite a bit lower than that, researchers say.

"It may be underdiagnosed," because it can look like other conditions, "but still relatively rare," Wright says.

If you have Dercum's, the growths of fatty tissue (lipomas) may appear all over your body. They'll show up most often on your torso (trunk), upper arms, and upper legs. Less commonly, they are found on the head, neck, hands, or feet. A lump can be as small as a pea or as big as a fist.

Pain from the lumps can be mild or severe, and it may come and go, or linger. It might feel aching, stabbing, or burning. You might only notice it when you touch the lumps, or it might get worse when you move around. If the pain doesn't come from inflammation, it might come from fatty tissues pressing on nearby nerves.

In addition to painful lumps that last at least three months, people with Dercum's usually have obesity or are overweight, though people can develop it at any weight, Wright says. You may also have:

  • Weakness
  • Fatigue
  • Foggy thinking (brain fog)
  • Depression
  • Anxiety
  • Trouble sleeping
  • Easy bruising
  • Headaches
  • Swollen hands, legs, or arms
  • Stiffness after resting (like when you first get up in the morning)
  • Shortness of breath
  • Constipation
  • Rapid heartbeats
  • An increased risk for diabetes

There's no specific test to check for Dercum's. Instead, your doctor will ask about your symptoms and do a thorough physical exam. They'll consider whether your symptoms fit another disorder. For example, fibromyalgia causes pain and tender points all over the body, along with symptoms such as fatigue and trouble concentrating.

You might also get some tests to rule out other medical issues that share some of the same symptoms. These include:

  • Endocrine (hormone) disorders, such as Cushing's disease and hypothyroidism (low thyroid hormones)
  • Lipedema, a buildup of fat, most often in the legs, but sometimes in the arms as well
  • Other rare fatty tissue disorders, such as Madelung's disease and familial multiple lipomatosis

Your doctor might also order an imaging test, such as an MRI or ultrasound, to look at the fatty lumps inside your body and see if they look typical for Dercum's disease.

Since this is a very rare condition, you may need to be diagnosed by a specialist. This could be an internist, dermatologist (skin doctor), or an endocrinologist who treats hormone (gland) problems. You may also want to see a pain specialist.

Although there's no cure or standard treatment yet for Dercum's, your doctor may suggest treatments to ease your symptoms. Treatments vary depending on your specific symptoms and how they affect you. The choices include:

Medicine. Some drugs will ease specific symptoms. Most are aimed at pain relief. These can include nonsteroidal anti-inflammatory drugs and narcotics, as well as corticosteroids, lidocaine, ketamine, infliximab, calcium-channel modulators, methotrexate, and interferonalfa-2b. Some patients also benefit from medications used to treat or prevent diabetes, such as GLP-1 agonists and metformin, Wright says.

Surgery. In severe cases, your doctor may recommend removing your fatty growths. It might relieve pain for a while. But this "should be done very cautiously," because the trauma of surgery may encourage the growth of new painful lumps, Wright says.

Liposuction . Your pain may be temporarily reduced by this procedure that suctions out extra fat. But this also may cause inflammation and new growths, Wright says.

Alternative therapies. Acupuncture, hypnosis, and biofeedback might make a difference in how you feel. Your doctor also might recommend some supplements, Wright says, including guaifenesin (the active ingredient in Mucinex). You should always discuss any supplements or other alternative treatments you want to try with your doctor.

No treatment has been shown to cure Dercum's disease. It's usually chronic, meaning it doesn't go away completely, even with time and treatment. "It can worsen, but it's not always progressive," Wright says. "Sometimes it will get better."

For many people with Dercum's disease, some days are better than others. When Dercum's pain flares up, problems such as fatigue and foggy thinking can worsen, too.

In some cases, the pain can be disabling, making it hard for you to do the things you want to do. It can also lead to depression and make it hard for you to sleep. That's why it's important to work with your health care team to manage the condition.

Tips for living with Dercum's disease

In addition to following your medical treatment plan, you may improve your daily life by:

Seeking emotional support. Chat with friends or family members, or reach out to online support groups. Work with a mental health provider if you are depressed or are struggling with the stress of dealing with a chronic disease.

Eating healthy. Your fatty lumps likely won't go away with diet or weight loss, but better nutrition could boost your energy and overall health. Some experts in fatty tissue disorders recommend a diet plan created to reduce inflammation. You might eat more vegetables, fruits, fish, and nuts, and eat less sugar and meat.

Moving more. While pushing yourself with intense exercise could make you feel worse, some low-impact exercise might make you feel better, physically and mentally. Talk with your doctor about whether activities such as swimming, water aerobics, walking, stationary biking, tai chi, yoga, or stretching might be good for you.

Getting more sleep. Having a painful disorder can interfere with sleep. But you may be able to improve your sleep by following good basic habits, such as going to bed at the same time each night and engaging in soothing activities, like bathing or listening to relaxing music, just before bed. If those kinds of changes don't work, talk with your doctor about other options.

If you or your primary care provider thinks you might have Dercum's disease — because you've had the possible symptoms for three months or more — it's a good idea to seek out expert care to confirm the diagnosis or figure out what else might be going on.

Depending on your symptoms and the doctors available near you, you might start with a dermatologist, endocrinologist (hormone doctor), or other specialist. If you do have Dercum's, ideally, you'll find a team that includes multiple doctors, nurses, and pharmacists familiar with the disorder and able to work with you to minimize symptoms.

Dercum's disease is a chronic disorder that can cause painful fatty lumps on your body. The pain can be mild or severe and may come and go or linger. In serious cases, it can be disabling. If you think you have Dercum's disease, it's important to get a diagnosis. If you do have Dercum's disease, you may need to work with a team of doctors and other health professionals to find the treatments and lifestyle changes that can help you feel better.

Is Dercum's disease hereditary?

Dercum's disease does run in some families, so in those cases, mutated genes may pass it down. But most cases don't seem to fit that pattern.

What treatments are available for handling Dercum's disease pain?

Many different drugs have been tried to treat Dercum's disease pain. In general, they have limited effectiveness. But some people report relief from nonsteroidal anti-inflammatory drugs (NSAIDs) and narcotics. Others say they've been helped by injections of lidocaine and/or ketamine. While surgery and liposuction are sometimes done for pain relief, the results are often temporary. Some people also try alternative therapies, like acupuncture. A care team that includes pain medicine specialists and psychotherapists can help you deal with pain.

How do you lose weight with Dercum's disease?

The painful lumps may not go away with weight loss. But aiming for a healthy weight, by gradually increasing physical activity and having a diet rich in fruits, vegetables, and grains, and low in sugar (such as the Mediterranean or DASH eating plans) may ease symptoms. Those lifestyle changes, along with medications, if needed, can also lessen your risk of diabetes and other health problems associated with obesity and overweight.