+ mild: both feet / ankles ++ moderate: both feet, plus lower legs, hands or lower arms +++ severe: generalised bilateral pitting edema, including both feet, legs, arms and face edema may be described as pitting edema, or non-pitting edema. pitting edema is when, after pressure is applied to a small area, the indentation persists after the release of the pressure. peripheral pitting edema, as shown in the illustration, is the more common type, resulting from water retention. it can be caused by systemic diseases, pregnancy in some women, either directly or as a result of heart failure, or local conditions such as varicose veins, thrombophlebitis, insect bites, and dermatitis. non-pitting edema is observed when the indentation does not persist. it is associated with such conditions as lymphedema, lipedema, and myxedema. edema caused by malnutrition defines kwashiorkor, an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates. treatment vein obstruction causes facial edema while lying down to sleep.after being upright all day, the swelling disappears. when possible, treatment involves resolving the underlying cause. many cases of heart or kidney disease are treated with diuretics. treatment may also involve positioning the affected body parts to improve drainage. for example, swelling in feet or ankles may be reduced by having the person lie down in bed or sit with the feet propped up on cushions. intermittent pneumatic compression can be used to pressurize tissue in a limb, forcing fluids—both blood and lymph—to flow out of the compressed area.