Stillness Health · Andreia Ferreira

Self-Lymphatic Drainage
Head & Neck

A guide for clients receiving manual lymphatic drainage treatment

Before you begin

Important — when not to massage

Do not carry out self-massage if you have an active infection in your head or neck. Signs of infection include:

Swelling with redness of the skin, which may spread quickly
Pain in the head and/or neck
Tenderness or warmth in the area
Fever, chills, or feeling generally unwell

If you notice any of these signs, please seek medical attention rather than continuing with massage. Contact your GP, a walk-in centre, urgent care, an emergency department, or NHS 111.

Also avoid self-massage if any of the movements are causing you pain, or if you are straining your shoulders, neck, arm or hand to complete them.

Your lymphatic system

Your lymphatic system plays a vital role in your overall health. It removes excess fluid and waste from the body’s tissues and is central to immune function. It consists of a network of lymph nodes connected by lymph vessels, with large clusters of nodes found in the neck, underarms and groin.

When the flow of lymphatic fluid is disrupted, fluid can accumulate in the tissues, a condition known as lymphoedema. The diagram below shows the normal direction of lymphatic flow in the head and neck.

Diagram of the lymphatic system showing major node clusters at the neck, underarms and groin

Major lymph node clusters of the body

Anatomy of the lymphatic system in the head and neck, labelling the parotid, submental, occipital and submandibular lymph nodes

Lymph nodes of the head and neck

Diagram showing normal flow of lymphatic fluid in the head and neck, with directional arrows

Normal lymphatic flow in the head and neck

How self-lymphatic drainage helps

Self-lymphatic drainage (SLD) is a gentle, specialised form of massage designed to encourage lymphatic fluid to move away from areas of swelling, or those at risk of swelling, and toward regions where the lymph nodes are functioning well. It works through light, rhythmic movements that stimulate the contraction of the lymphatic vessels.

It is not the same as conventional massage. The techniques are specific, and the pressure used is intentionally very light.

Technique: what to keep in mind

Pressure should be very light. Your touch should gently stretch the skin to its natural limit, then release. If you can feel the muscles beneath your fingers, you are pressing too firmly.
Use the flat of your hands rather than your fingertips, to maximise skin contact and stimulate the lymph vessels more effectively.
Always work toward unaffected areas of the body, following the natural direction of lymphatic flow.
Warm muscles respond better. Try to carry out your massage when you are comfortably warm.
Find a position that works for you, seated, standing or lying down, whichever is most comfortable.
Daily practice is ideal. A short daily session is more beneficial than longer, less frequent ones.
If working on both sides, complete all steps on one side before repeating on the other.

Some people find it easiest to build self-massage into an existing routine, in the evening while relaxing, for example. Consistency matters more than duration.

The sequence

1 Begin here · every session

Deep breathing

Deep breathing is one of the most effective ways to stimulate lymphatic flow throughout the whole body, and it is the best place to begin every session.

Place the palms of your hands on your stomach
Breathe in slowly and deeply through your nose, allowing your stomach to rise
Breathe out slowly through pursed lips, letting your stomach fall
Repeat 5 times, pausing briefly between each breath to avoid dizziness

Two-panel illustration showing breathing in through the nose with stomach rising, and breathing out through pursed lips with stomach falling

2 Preparation

Preparing your lymph nodes

This step activates the lymph nodes just above your collarbone and in your underarms, preparing them to receive fluid from your face and neck during the massage that follows.

Collarbone nodes — repeat 15 times

Place the flat of your second and third fingers on either side of your neck, just above the collarbone. Shrug your shoulders briefly, you should feel a small dip in the skin. That is the correct position.
Using a gentle “J”-shaped stroke on each side, massage downward and inward toward the collarbone. Keep your fingers above the collarbone at all times.
Gently stretch the skin to its natural limit, then release.

You may massage one side at a time, or both sides simultaneously, crossing your hands if needed.

Illustration showing finger placement at the collarbone for J-stroke lymph node preparation

Underarm nodes — repeat 10–15 times each side

Place your palm against your underarm, with your arm in a comfortable, slightly elevated position
Gently pull upward and inward toward your body, then release
Repeat on the other side

Illustration showing palm placement in underarm for lymph node stimulation, with arrow indicating upward and inward direction

Tip: The underarm step can also be done using a soft ball or rolled-up flannel, pumping your arm gently against your chest wall.

3 Repeat 10–15 times

Side of the neck

Place your flat hands on either side of your neck, just below your ears
Gently stretch the skin backward, away from your face, and downward, then release
Work slowly and rhythmically

Keep your pressure light throughout.

Illustration showing hand placement on side of neck just below the ears, with arrow indicating backward and downward stroke direction

4 Repeat 10–15 times

Back of the neck

Place your flat hands on the back of your neck, just below the hairline, on either side of the spine
Stretch the skin toward the spine and then down toward the base of the neck, then release

5 Repeat 10–15 times

Upper chest

This step moves lymphatic fluid from the neck and chest toward the underarm nodes.

Place your hand on your collarbone and move it downward toward your underarm
Gently stretch the skin downward and toward the underarm, then release

Illustration showing hand movement from the collarbone downward and toward the underarm, with directional arrows

6 Face massage

Face

Work through each area in sequence, keeping your touch light and your movements slow. Each stroke should finish in front of your ears, directing fluid toward the peri-auricular lymph nodes.

Lips and cheeks

Stroke above and below your lips, sweeping outward toward your ears. Then stroke from the bridge of your nose outward across your cheeks, finishing in front of your ears.

Illustration showing outward strokes from nose across the cheeks and around the lips toward the ears

Lip and cheek strokes

Illustration showing outward strokes at nose-bridge level toward the ears

Bridge of nose outward

Illustration showing gentle outward strokes beneath the eyes toward the ears

Under the eyes

Working upward from the nose toward the eyes, use a lighter touch. Continue stroking outward, being especially gentle around the eye area.

Illustration showing eyebrow pinching technique with fingers, with arrows pointing outward from inner to outer brow toward the peri-auricular nodes

Eyebrows — peri-auricular drainage

Lightly pinch along your eyebrows, starting from the inner brow and moving to the outer brow, directing fluid toward the peri-auricular nodes in front of your ears.

Forehead

Stretch the skin from the outer forehead downward toward the hairline and in front of your ears.

7 Repeat each row ×3

Back of the head

Gently stretch the skin from the outer back of the head downward toward the neck
Work systematically, beginning at the lower hairline and moving upward in rows, following the numbered sequence shown in the diagram
After completing each row, stroke down across the central shoulder blades toward the underarm
Repeat each row three times before moving to the next