Lymphoedema is known to affect the dermal and subcutaneous layers of the skin. High-frequency ultra- sonography provides a non-invasive approach to skin assessment and has been shown to give information on intradermal oedema (Gniadecka 1996; Hu et al. 1998). In the present study, it was assumed that an increase in water content (oedema) would directly influence dermal thickness. Certainly, the baseline dermal thickness mea- surements at all four sites used in this study were greater on the oedematous side. It is likely, however, that the use of ultrasound images in the assessment and measurement of skin and tissue condition in lymphoedema is complex. Lower frequency ultrasound would provide more infor- mation on subcutaneous thickness, and further studies are required to validate the use of ultrasound in the assess- ment of lymphoedema and measurement of treatment response.