Varicose eczema is a dermatitis that is associated with varicose veins. It is a common problem affecting about 1% of the population. The eczema appears between the knee and the ankles around damaged veins. There are many names for this type of eczema: gravitational eczema, stasis eczema and venous eczema.
Causes
Varicose eczema is associated with venous insufficiency which affects approximately 15% of the population. It is caused by blood flowing in the wrong direction due to faulty valves in varicose veins.
Mainly affecting middle-aged to elderly people, the likelihood of developing this condition is increased if you are overweight and already have varicose veins. There is a strong genetic predisposition to developing varicose veins.
If you have a parent with varicose veins you are quite likely to get them too, especially if you are female and have had a few pregnancies.
However, it is not known why some people with varicose veins go on to develop varicose eczema while others do not. Some theories propose that some red blood cells leak into the surrounding skin, depositing iron (known as haemosiderin) which causes inflammation and irritation; other theories propose that the inflammation is due to small blood vessels being blocked and damaged.
The most likely cause is a combination of many factors that arise when the blood flow is slowed down in this way.
Symptoms:
Initially, the patient notices that the lower legs become swollen over the course of the day and then return to normal overnight as the fluid is drained away when the legs are level with the heart. Small patches of brown staining may be noticed (haemosiderin deposits) and then a general redness of the skin. This inflammation results in fibrosis of the deeper tissues in the leg and a scarring process known as lipodermatosclerosis. The lower half of the shin becomes very tightened and the overall appearance is that of an upside down wine bottle. The hameosiderin deposition spreads leading to a dark brown appearance of the leg. At this point, the skin is very thin and susceptible to tearing and ulcerating.
Varicose eczema is often present now and may appear as either a diffuse itchy area over the shin and lower calf or in patches that are extremely itchy. If scratched, the patches can become thickened; this is a process known as lichenification.
Treatment:
There are 2 components to treatment of this condition: 1. Skin therapy and 2. Vein therapy. A good moisturiser, used daily, can relieve symptoms and can allow the skin to heal. Steroid and other anti-inflammatory creams may be necessary to relieve itch in the short term and dampen down any inflammation.
In order to improve the circulation, a healthy diet and regular exercise can reduce the load that your body carries and strengthen the calf muscles. Calf muscle contraction is used to push blood up towards the heart from the leg. Your doctor may prescribe you special tight bandages or support stockings to assist the calf muscles in their job.
These interventions may have a dramatic impact on the symptoms of varicose eczema and could prevent serious problems such as leg ulcers in the future.
Do's and Dont's
The severity of Varicose Eczema can be lessened by following some simple advice:
- Do exercise to improve circulation in the legs
- Do moisturise frequently
- Do avoid sudden changes in temperature or humidity
- Do avoid sweating or overheating
- Do reduce stress, anxiety or depression as psychological factors can all influence eczematous conditions
- Don’t wear scratchy materials, such as wool directly against your skin
- Don’t use harsh soaps, detergents or solvents
Additional Links:
If you have any more questions about a particular skin condition, please feel free to“Ask our Dermatologist”. 
