An Overview of Stasis Dermatitis

Symptoms, Causes, Diagnosis, Treatments, and Prognosis

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Stasis dermatitis (a.k.a. gravitational dermatitis, venous eczema, and venous stasis dermatitis) causes a red, itchy, scaly rash on the lower extremities. The condition most often occurs when there’s insufficient blood flow and decreased circulation to the veins in one or both of the legs. Obesity, high blood pressure, and multiple pregnancies are risk factors, though there are others.

Symptoms

Stasis dermatitis usually occurs on the lower body. The condition may develop in other areas of the body, according to the American Academy of Dermatology (AAD). However, this is a rare occurrence.

The following are symptoms of stasis dermatitis:

  • Red or inflamed skin
  • Dry, itchy, or scaling rash
  • Swelling around the ankles that usually goes away while you’re asleep but comes back the next day
  • Discoloration of the skin or hyperpigmentation on the lower extremities
  • The presence of varicose veins
  • Aching of the legs

When stasis dermatitis becomes severe, other symptoms may develop as well, including:

  • Weeping or oozing of the skin
  • Areas of cracking or crusting of the skin
  • The formation of ulcers
  • The development of an infection like cellulitis
  • A chronic state of swelling in the lower legs
  • A thickening of the skin
  • The presence of lipodermatosclerosis, an inflammatory process that occurs in the fatty tissue under the skin

In some cases, the skin takes on a shiny appearance. Scars can appear where ulcers have healed.

Causes

The veins in your legs contain one-way valves that pump blood upward to prevent it from pooling in your lower limbs. As you age, the integrity of the valves can weaken, causing them to stop functioning properly. As a result, they can leak fluid into the lower legs and cause inflammation.

Many factors may contribute to the formation of stasis dermatitis. Typically, the condition impacts people with poor circulation.

Furthermore, certain illnesses may place you at greater risk of developing it. Those conditions include:

  • A history of high blood pressure
  • A diagnosis of congestive heart failure
  • Obesity or a high amount of body fat
  • Kidney failure
  • A blood clot, such as a deep vein thrombosis (DVT), in the legs
  • Surgery to or around the affected area
  • Multiple pregnancies

Lifestyle factors like sitting or standing for long periods of time and inadequate exercise can also play a role in the development of stasis dermatitis.

Stasis dermatitis is more likely to affect people who are age 50 and older, and it affects women more than men.

Diagnosis

To diagnose stasis dermatitis, your doctor will take a detailed medical history and examine your skin for symptoms that may indicate venous insufficiency, inflammation, or other signs of the condition.

When your doctor asks about your medical history, be sure to mention the contributing factors like:

  • A history of blood clots
  • A past injury to the area of concern
  • A history of heart disease
  • Any prior surgeries

Your doctor may perform other diagnostic tests like blood work, a Doppler ultrasound to check blood flow, cardiac tests to assess heart function, and skin allergy testing. Once they have confirmed a diagnosis of stasis dermatitis, they will be able to formulate a treatment plan to help you control and manage the condition.

Treatment

When treating stasis dermatitis, the goal of care is to control the condition and alleviate the symptoms. There are several different treatment plans that you might discuss with your physician.

Stasis dermatitis can be a condition you have for life. But by adhering to your treatment protocol and attending your follow-up appointments, you can learn to take control of your health and manage the condition on your own.

Reduce Swelling 

Most patients need to wear compression garments, like stockings, wraps, or a specialized boot (called an Unna boot), to increase circulation and keep fluid moving.

Fluid can accumulate in the lower extremities when your legs are below your heart for several hours of the day.

The American Acadamy of Dermatology guidelines to reduce fluid accumulation in the legs are as follows:

  • Elevate your legs above the level of your heart.
  • Do this in 15-minute increments every two hours.
  • Use pillows to prop your legs up while you sleep.

Treating Inflammation

The National Eczema Association (NEA) states that a topical steroid can quell the irritation and itchiness you might feel as a result of inflammation. For severe cases of stasis dermatitis, a combination of medications may be used with a wet or dry wrap or an Unna boot to optimize your treatment outcome.

Dressing Wounds

Stasis dermatitis wounds must be handled with care; in some circumstances, you might need to apply certain dressings, bandages, or gauze to facilitate wound healing.

Addressing Infections

If an infection is present on your skin, your doctor will likely want to address this with either an oral or a topical antibiotic until it goes away.

Caring for the Skin

Dry skin is a common problem with stasis dermatitis. AAD recommends applying a moisturizer several times a day to lessen itchiness and add hydration. A skin cream that doesn’t contain dyes, perfumes, or fragrances is the best choice to soothe sensitive, delicate skin.

If you are uncertain of what to buy, your dermatologist or pharmacist can recommend a brand that meets the above criteria.

Managing Varicose Veins

Occasionally, varicose veins can cause pain or bleeding. In some instances, surgery to remove or repair damaged veins may be an appropriate course of action to treat stasis dermatitis.

Nowadays, there are several options for minimally-invasive surgical produces to treat varicose veins and reduce symptoms. Talk to your doctor about which treatment options are right for you.

A Word From Verywell

Managing stasis dermatitis requires vigilance and commitment, so it’s important that you find a doctor you trust and feel satisfied with. There’s a lot you can do to manage stasis dermatitis on your own. However, if new signs or symptoms form, don’t ignore them. Be sure to seek the advice of your doctor so that you can stay on top of the current treatment options.

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