Venous (stasis) Eczema
Varicose eczema, also called stasis, occurs more often in later life and is due to poor circulation. Itchy and irritated patches form on the skin, often around the ankles. An effective and hypoallergenic emollient cream such as Kalmaderm Emollient cream can be useful in soothing the red and itchy skin. Varicose eczema affects the lower legs people in their middle to late years. It is caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed.
In people with varicose veins, the blood pressure in the lower leg veins is increased (venous hypertension) and this has a knock-on effect on the skin here. Instead of being soft, it turns woody hard with a rusty brown discoloration, and meshes of blue-purple thread veins can be seen around the sides of the feet. These changes can occur even with mild varicose veins and may also follow a deep vein thrombosis. Eczema may develop around the inner calves and ankles, and this is called variously 'gravitational eczema', 'varicose eczema','venous eczema' or 'stasis eczema'. It is most common in elderly women, but can occasionally 'affect younger adults. Sometimes one leg is affected much more than the other. Venous eczema is usually itchy, sore and uncomfortable, and tends to be a chronic form of eczema, although with correct treatment some cases can be cleared.
How should venous eczema be treated?
Venous eczema may improve if the underlying varicose veins are treated surgically. However, not everyone is suitable for an operation. Venous eczema usually responds to routine eczema treatment with moisturizers and topical steroids. It is important to keep things simple because the skin in venous eczema has an increased tendency to develop allergies to things which are applied here, including moisturizers, antibiotics, and rubber chemicals in elasticated bandages and stockings. If someone with venous eczema develops an allergy to the creams they are using, the eczema will worsen and may spread to the arms and body. It is therefore important to only apply topical treatments that are very unlikely to cause allergic reactions. Greasy ointments such as mixtures of equal parts of liquid paraffin and white soft paraffin (50/50 mix) or emulsifying ointment can be used to moisturize the skin, and topical steroids should be used in the form of ointments rather than creams as the former contain fewer additives. If someone's venous eczema does not improve with treatment or is proving difficult to control, patch tests should be considered to make sure there are no contact allergies.
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