Stasis dermatitis causes inflammation, ulcers, and itchiness on the skin of the lower legs. It can result from conditions that affect blood flow in the legs, such as chronic venous insufficiency, varicose veins, and congestive heart failure.
Stasis dermatitis is sometimes called gravitational dermatitis, venous stasis dermatitis, venous eczema, or varicose eczema. According to the National Eczema Association, stasis dermatitis occurs mostly in people ages 50 years or older and is more common in women than men. It is a long-term, or chronic, condition.
An ulcer on the leg may be a sign of stasis dermatitis. A lack of circulation can affect the health of a person’s skin. If the skin breaks, an ulcer can form. An ulcer
In this article, we look at the causes, risk factors, and symptoms of stasis dermatitis. We also cover the diagnosis, treatment, and prevention of this condition.
The following pictures show how stasis dermatitis can develop and affect the legs.
Stasis dermatitis tends to develop in people with conditions that cause poor blood circulation in the legs, such as chronic venous insufficiency.
For example, in chronic venous insufficiency, the valves in the leg veins
In addition to chronic venous insufficiency, various other conditions and risk factors can affect blood flow in the legs and feet and lead to stasis dermatitis.
- being female
- being age 50 years or older
- varicose veins, or enlarged and swollen veins
- high blood pressure
- having had surgery to the veins
- multiple pregnancies
- history of blood clots in the legs, such as deep vein thrombosis (DVT)
- congestive heart failure
- kidney failure
- low levels of physical activity
- having a job that involves many hours of sitting or standing
- severe leg injury
- long-term swelling in the legs
- history of cellulitis
- family history of circulatory problems
The early symptoms of stasis dermatitis primarily affect the lower legs and include:
- irritation and itching
- changes in skin color, which may appear brown, purple, or gray in brown or black skin and red in lighter skin
- other speckles of discoloration, as pressure causes the capillaries to break
- scaling and dryness on the skin
- swelling in the ankles
- feelings of heaviness or aching after standing for a long time
- increased likelihood of having contact dermatitis
As stasis dermatitis progresses, these earlier symptoms can worsen. In addition, new symptoms can appear, including:
poorly definedplaques of inflamed skin on both lower legs
- swelling that spreads into the calves
- shiny, swollen skin
- itchy, dry, and cracked skin
- open sores, called venous ulcers, on the tops of the feet and the lower legs
- bleeding or oozing from ulcers
Permanent skin changes can occur. The skin may become:
- deeply pigmented
- intensely itchy
- bumpy, like cobblestones
- shrunken on the lower calf
A doctor will diagnose stasis dermatitis by asking about the person’s symptoms and medical history. Previous or current conditions that they should be aware of include:
- problems with the heart or circulation
- blood clots
- injuries to the lower legs
The doctor may then examine the skin on the lower legs to check for visual signs of stasis dermatitis.
They may also order a Doppler ultrasound, a noninvasive test that uses sound waves to check the blood flow through blood vessels. These tests can help identify underlying reasons for stasis dermatitis.
Additional tests to look for underlying causes include:
- an echocardiogram to assess heart function, including checking for congestive heart failure
- blood pressure monitoring
- in some cases, allergy testing
Other conditions with similar symptoms
The goal of treatment for stasis dermatitis is to relieve symptoms, improve circulation, and prevent the condition from progressing. Treatment can include:
- wearing compression stockings to promote circulation and relieve swelling
- wearing a type of compression bandage called an Unna boot, which contains calamine and other medications to help heal a wound
- sleeping with legs elevated
- raising the legs for 15 minutes once every 2 hours
- taking medications to ease pain and reduce swelling, such as topical corticosteroids
- using antihistamines to relieve itching
- using antibiotics and special dressings to treat infected ulcers
- applying emollients to moisturize and protect the skin
- taking vitamin C and rutin supplements to boost blood vessel health
In some cases, a doctor
- endovenous thermal ablation, a type of laser therapy
- ultrasound-guided foam sclerotherapy, which destroys unwanted veins by injecting a combination of air and a special foaming solution
- ambulatory phlebectomy, a surgical procedure
to removesuperficial veins under local anesthetic
These are treatments for varicose veins that may be used to manage underlying problems leading to stasis dermatitis.
A person can take steps to manage stasis dermatitis by:
- wearing loose, cotton clothing and avoiding wool, polyester, and rayon, as they can irritate the skin
- taking care to avoid injuring the affected area
- avoiding touching the skin with pet hair, plants, grass, cleaning products, and scented cosmetics
- applying a clean, cool compress for 15 minutes to soothe itching
- adding colloidal oatmeal to a lukewarm bath
- using a mild cleanser instead of soap
- after bathing, patting the affected area with a clean towel but leaving it a little damp
- moisturizing with a fragrance-free product, such as petroleum jelly, 2 minutes after bathing
- drinking plenty of fluids to improve circulation and reduce swelling
- taking a brisk walk for 10 minutes after sitting or standing for one hour, where possible
- raising the legs when seated
People with stasis dermatitis should prevent the following products from coming into contact with the affected area, as they can irritate the skin and may make symptoms worse:
- fragranced or scented soaps
- perfumed cosmetics and skin care products
- household chemicals
Stasis dermatitis is not always preventable. However, making the following lifestyle changes can reduce the risk of developing stasis dermatitis or making it worse:
- maintaining an appropriate body mass index (BMI)
- getting enough exercise
- following a low-sodium diet
- avoiding sitting or standing for a long time, if possible
- checking the skin regularly for changes if circulatory problems are already present
- seeking early treatment if changes occur
If a person is living with a condition that increases the risk of stasis dermatitis, they should be sure to follow their doctor’s recommendations for treatment. Doing so can reduce their risk of developing this condition.
Without treatment, stasis dermatitis can worsen and lead to complications that include:
There is no cure for stasis dermatitis, but early treatment and preventive measures can stop it from progressing.
A person can improve their outlook by:
- seeking help as soon as symptoms appear or worsen
- following a doctor’s instructions for treating symptoms
- treating any underlying conditions that increase the risk
Stasis dermatitis is a long-term condition that can cause a range of skin and circulation problems in the lower legs.
Treatment can help manage symptoms and prevent them from progressing. Without treatment, stasis dermatitis can lead to severe complications and discomfort.
Anyone who believes they may have symptoms of stasis dermatitis should see a doctor.