What is Venous Statis Dermatitis?
Venous Dermatitis is also known as varicose eczema, gravitational or stasis eczema. It is found in people with chronic venous insufficiency where the veins in the legs have trouble sending blood back to the heart. It is also common in people with varicose veins, and it mainly effects the lower legs. Skin can be inflamed, itchy, dry and painful. This is long term condition and early recognition, and management is essential to prevent complications.
People might develop venous stasis dermatitis after medical treatments for cancer. After radiation therapy, oedema can occur and put pressure on your skin in some rare cases surgery may also damage the vein pressure.
Anyone can get venous stasis dermatitis. But the condition is more common in people who have:
- Chronic venous insufficiency (CVI).
- Varicose veins
- Heart disease/ failure
- History or active Lymphoedema.
- Kidney Failure
What causes Venous statis dermatitis ?
The underlying cause is usually chronic venous insufficiency (CVI). In venous insufficiency the blood pools in the lower legs because the veins stop working properly.
The blood can not be pushed up and gravity also pulls the blood back down. This puts pressure on the veins and can cause them to stretch and the valve to be damaged. Fluid can leak into he surrounding tissue. It is thought that the combination of the pressure and the immune system reaction to the excess fluid causes eczema in the skin.
Twisted varicose veins can also contribute to poor circulation and people with a history of blood clots (DVT) as also at risk due to vein damage. This pressure leads to skin discoloration, pain, itching and sores.
What are the Symptoms?
Venous stasis dermatitis is a condition in which your skin becomes swollen or inflamed. Skin can become painful, dry, scaley and breakdown. This condition can cause permanent changes to your skin and scaring.
Symptoms include:
In sever case skin breakdown can lead to open sores that can become infected if not managed.
- Changes in skin colour
skin may become discolored and become thickened and scaly
Inflammation can cause redness around the affected areas. - Oedema (swelling)
Fluid can accumulate in lower legs and patients may have noticeable swelling. - Itching
Effected areas can become itchy and painful. Excessive scratching can lead to further skin damage and increase risk of infection. - Blistering/Ulcers
How do I treat venous stasis dermatitis ?
Treating venous statis dermatitis may involve a combination of therapies to help manage the symptoms.
Compression stockings:
These are specially designed garments that help improve the blood flow in your legs. They may need to be made to measure for you. These are usually worn everyday are and available indifferent strengths and sizes depending on the shape and size of your legs. These help to improve the function of the veins in your legs and improve your circulation and reduce swelling. Advice should be sought from a clinician on the type of compression you may need.
Lifestyle:
Weight management and regular physical activity, especially for the legs, can improved your circulation. You may be asked to avoid long periods of sitting or standing.
Skincare:
You maybe asked to use emollients or topical corticosteroids to prevent the skin from becoming dry and to relieve symptoms. In some cases, medication may be required to manage inflammation and infections.
Treatment of underlying conditions:
You may be referred to a specialist to manage your underlying condition. You may be referred to a doctor or surgeon specialising in conditions affecting the blood vessels (vascular specialist) who treat varicose veins.
Where can I find more information?
Regular follow up and guidance from a health care professional is essential to monitor and adjust treatment, as necessary.
More Information on the condition can be found at:
References:
Silverberg J, Jackson JM, Kirsner RS, Adiri R, Friedman G, Gao XH, Billings SD, Kerkmann U. Narrative Review of the Pathogenesis of Stasis Dermatitis: An Inflammatory Skin Manifestation of Venous Hypertension. Dermatol Ther (Heidelb). 2023 Apr;13(4):935-950. doi: 10.1007/s13555-023-00908-0. Epub 2023 Mar 22. PMID: 36949275; PMCID: PMC10060486.
Yosipovitch G, Nedorost ST, Silverberg JI, Friedman AJ, Canosa JM, Cha A. Stasis Dermatitis: An Overview of Its Clinical Presentation, Pathogenesis, and Management. Am J Clin Dermatol. 2023 Mar;24(2):275-286. doi: 10.1007/s40257-022-00753-5. Epub 2023 Feb 17. PMID: 36800152; PMCID: PMC9968263.