What is venous eczema?
Venous eczema (stasis eczema, gravitational eczema) is a common form of eczema on the lower legs and ankles. It develops in people with a poorly working vein system in the legs, called venous insufficiency.
How does venous eczema develop?
It is not yet entirely clear how venous eczema develops. There is a direct link with fluid build-up (oedema) in the lower legs, which is one of the features of persistent venous insufficiency, when there are varicose veins. These can lie deep (between the leg muscles) or superficially (just under the skin), and very often both are present. Drying out of the skin also plays an important role.
Who can get it?
People with deep leg varices are at greatest risk. Other risk factors are a history of thrombosis or erysipelas in the leg — which are also the risk factors for a leg ulcer, so a leg ulcer (ulcus cruris) is often seen together with venous eczema.
What does venous eczema look like?
Red, slightly scaly patches around the ankles and on the lower legs. Small blisters and wounds can also occur in the eczema area.
How is the diagnosis made?
It is not difficult for the doctor to recognise venous eczema. If a contact allergy is suspected of also activating the eczema, patch tests can be arranged, as allergy can sometimes develop to ingredients of ointments or dressing material.
How is venous eczema treated?
The most important part of treatment is to combat the oedema in the leg well, for example with compression bandages or therapeutic compression stockings. In addition, a corticosteroid ointment can be applied temporarily for extra-quick reduction of the inflammation, and a good moisturising maintenance ointment is important to prevent the eczema returning. When superficial varicose veins play an important role, they can be treated surgically or with sclerotherapy (“injecting”).
When to see a doctor
See a doctor if you develop red, scaly, itchy skin around the ankles or lower legs, especially with leg swelling or varicose veins, so the eczema and the underlying venous problem can be treated and a leg ulcer prevented.