What Is Varicose Eczema?

Varicose eczema causes itchy, red, and scaly skin usually of the lower legs. Most people who get varicose eczema also have varicose veins, which are enlarged, twisted veins caused by increased blood pressure in the veins near the surface of the skin. Varicose eczema is also known as venous, gravitational, or stasis eczema.

Varicose Eczema Symptoms

Like all types of eczema, the affected skin becomes:

• Itchy and swollen
• Dry and flaky 
• Scaly or crusty

In people with lighter skin, the affected area may look red, while in those with darker skin, it may be grayish. It generally first appears as a patch of skin just above the ankle but may spread to other parts of the body.

Your legs may also become swollen, especially at the end of the day or after long periods of standing.

Some people with varicose eczema develop other symptoms, including:

• Discoloration of the skin
• Tender and tight skin that can eventually become hardened (lipodermatosclerosis)
• Small white scars (atrophie blanche)
• Pain
• Eczema in other parts of the body

Left untreated, varicose eczema can progress to leg ulcers, long-lasting wounds where the skin has become damaged. If varicose eczema begins emitting discharge, it is important to seek medical care immediately. 

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 since they are a sign that the leg veins are not working properly and circulation is poor. One example is chronic venous insufficiency, which occurs when your leg veins don’t allow blood to flow back up to your heart.

Risk factors of varicose eczema include:

• Gender: Varicose eczema is more common in women than in men.
• Obesity: Obesity can increase the pressure in the veins of your legs.
• Pregnancy: Pregnancy can increase the pressure in your leg veins.
• Certain occupations: Jobs requiring sitting or standing in one place can affect the circulation of blood in your legs.
• A history of deep vein thrombosis (DVT): Blood clots that develop in leg veins can damage the valves in your veins.
• Older age: Lack of mobility in older people can affect circulation.

Diagnosis

A dermatologist, a specialist in conditions of the skin, hair, and nails, or a primary care physician can diagnose varicose eczema. They will make the diagnosis based on your medical history and a physical exam. They will ask you some questions to determine whether you have a problem with the flow of blood in your leg veins.

Your doctor will also want to know whether you have had the following conditions:

• Varicose veins
• DVT 
• Leg ulcers 
• Cellulitis, which is an infection of the deeper layers of the skin and underlying tissue
• Surgery or injury to your legs

Your doctor may also perform an ankle-brachial pressure index (ABPI) test to see if there is reduced blood flow to your lower limbs. If so, you may need to wear compression socks or stockings to improve circulation and possibly prevent varicose veins from becoming worse.

The ABPI test compares blood pressure readings taken from your ankles and upper arms. A significant difference in the readings can suggest a narrowing or blockage of blood flow in your legs.

Treatment

Treatment for varicose eczema includes:

• Elevate and move your legs: The treatment and prevention of varicose eczema go hand in hand. Elevating your legs and moving them can help promote blood flow and avoid increased pressure in your veins.
• Moisturize: Skin affected by varicose eczema is usually dry, so using emollients, or moisturizing treatments, like lotions is important for people with this condition.
• Wear compression stockings: Compression stockings or socks are specially designed stockings to be worn every day. They squeeze your legs tightly at the foot and ankle and become looser further up your leg, helping to improve circulation.
• Steroid cream: Steroids may be used to relieve severe symptoms of varicose eczema, such as itchiness.

Summary

Varicose eczema commonly affects people who have varicose veins, which are bulging veins caused by increased pressure in the legs. People who have had deep vein thrombosis, cellulitis, and surgery in their legs are also more likely to get this condition.

Similar to other types of eczema, varicose eczema can cause itchy, swollen, and scaly skin. It can be managed by moving more, moisturizing the affected area, wearing compression stockings, and applying steroid cream.

A Word From Verywell

From both a cosmetic and long-term health perspective, varicose eczema can create unique challenges in your life. Work with your primary care provider to ensure you receive a proper referral to a dermatologist who can help you identify the causes and treatment options to manage your varicose eczema.

Frequently Asked Questions

What causes varicose eczema?

Chronic venous insufficiency and general poor circulation to the skin, particularly the legs, can lead to varicose eczema. When blood reaches your legs, valves in your legs allow it to flow back toward your heart. As we age, these valves tend to weaken. A bad leg injury, heart disease, or another condition can also damage these valves in your legs. When the valves weaken, some blood stays in your legs and cause venous insufficiency.

What type of cortisone cream do you use for varicose eczema?

To reduce swelling, corticosteroids like triamcinolone 0.1% ointment are often used. These drugs require a doctor's prescription. You may need to use triamcinolone for a few weeks, along with a compression stocking or wrap that you will wear all day.

How do you treat varicose eczema?

Varicose eczema is treated by both addressing the causal factors, such as chronic venous insufficiency, and with skin-based treatments such as steroid creams. You can also manage your condition with compression stockings, oral antibiotics if your skin is infected, vitamin C supplements, and rutin, a plant pigment and antioxidant. You can try elevating your legs above your heart every two hours to reduce swelling and avoiding foods high in salt.

What type of specialist do you see for varicose eczema?

A dermatologist is a doctor who treats conditions of the skin, hair and nails. This specialist is the best doctor to see for varicose eczema.