We asked Prof Caitriona Ryan:
‘Stasis dermatitis, also known as venous eczema, is a very common condition of the lower legs often seen in middle-aged and older patients and it is reported to affect 20% of those over 70 years. It frequently affects people with venous insufficiency, when the valves in leg veins that help push blood back to the heart weaken and leak fluid. This allows water and blood cells to pool in the lower legs.
Women are more likely to get it than men, particularly those who have had multiple pregnancies. It is also more common in those with varicose veins, obesity, vein surgeries, a history of blood clots in the legs, kidney failure, or having a job that involves hours of sitting or standing.
Typically patients develop red itchy dry patches of the lower legs and ankles associated with mild ankle swelling. These patches can thicken, become cracked or blister and sometimes become secondarily infected. In extreme cases ulceration can occur. Even after the patches clear, orange-brown discolouration of the skin can persist. Stasis dermatitis often worsens in the winter-time when the skin is drier.
Prevention is key.
• Emollient Moisturisers: It is important to keep the skin well lubricated and moisturised. Some of our favourites include Silcocks Base, Elave Intensive Ointment and La Roche Posay Lipikaur Baume.
• Reduce swelling: Don't stand for long periods. Take regular walks. Elevate your feet when sitting: if your legs are swollen they need to be above your hips to drain effectively.
• When eczema has settled, wear graduated compression stockings.
• In those with varicose veins, seek the opinion of a vascular surgeon for treatment with surgery or endovenous laser.
When inflamed varicose eczema does not resolve with moisturising alone, treatment with topical steroid ointments may be required.’