Varicose eczema
Overview
Varicose eczema, also known as venous, gravitational or stasis eczema, is a long-term skin condition that affects the lower legs. It's common in people with varicose veins.
Symptoms
The affected skin can change colour and become: itchy and swollendry and flakyscaly, crusty or blistered On white skin it looks red or brown. On black or brown skin it tends to look dark brown, purple or grey and can sometimes be more difficult to see. There may be periods when these symptoms improve and periods when they are more severe. Your legs may become swollen, especially at the end of the day or after long periods of standing.Varicose veins(swollen and enlarged veins) are often visible on the legs. Some people also have other symptoms, such as: tender and tight skin that can eventually become hardened (lipodermatosclerosis)small, white scars (atrophie blanche)paineczema affecting other parts of the body If varicose eczema is not treated,leg ulcerscan develop. These are wounds that form where the skin has become damaged.
Causes
Varicose eczema is usually caused by increased pressure in the leg veins. When small valves in the veins stop working properly, it's difficult for blood to be pushed upwards against gravity and it can leak backwards. This increases the pressure in the veins, which can cause fluid to leak into the surrounding tissue. It's thought that varicose eczema may develop as a result of the immune system reacting to this fluid. Varicose eczema is more common in people with varicose veins, as these are also often a sign that the leg veins are not working properly. Some people develop the condition for no obvious reason, although there are some factors that increase the chance of this happening, including: sex – varicose eczema is more common in womenobesity– this can increase the pressure in your leg veinspregnancy – this can also increase the pressure in your leg veinsa family history of venous insufficiency (where the veins in your legs have trouble sending blood back to your heart)not being able to move for a long period of time – this can affect the circulation of blood in your leg veinshaving previously hadDVT (deep vein thrombosis)– blood clots that develop in leg veins which can damage the valves in your veinsincreasing age – people generally find it harder to move about as they get older, which can affect their circulation
Treatment
Emollients; Steroid creams; Compression stockings.
Prevention
Keep active; Elevate legs; Compression stockings.
When to see a doctor
See a GP if you have symptoms of varicose eczema. Your doctor will often be able to make a diagnosis simply by looking at your skin. A GP will also ask you questions to determine whether you have a problem with the flow of blood in your leg veins, as this is the main cause of varicose eczema. To help make a diagnosis, a GP may want to know if you have ever had health conditions such as: varicose veins – swollen and enlarged veinsDVT (deep vein thrombosis)– a blood clot in the veins of your legsleg ulcers– areas of damaged skin that take several weeks to healcellulitis– an infection of the deeper layers of the skin and underlying tissuesurgery or injury to your legs A GP may also check the pulse in your feet and may do an ankle brachial pressure index (ABPI) test to see if compression stockings are suitable for you. The ABPI test involves comparing blood pressure readings taken from your ankles and upper arms. A significant difference in the readings suggests a problem with the flow of blood in your arteries – in which case, compression stockings may not be safe to use.