Stasis Dermatitis and Leg Ulcers | Better Living

Stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg or a skin inflammation caused by blood pooling in the veins in your legs. Pooling of blood in the veins of the legs is called venous insufficiency or venous stasis.

Venous pooling causes the pressure inside the veins to be higher than normal (venous hypertension). This elevated pressure in the veins causes damage to your capillaries. When capillaries are damaged, a protein
called fibrinogen leaks out into your tissues. Your body converts fibrinogen to fibrin. The buildup of fibrin (fibrin cuffs) is thought to cause a decrease in oxygen supply to the skin, resulting in cell death. This inflammatory process causes your skin to change in its appearance.

Stasis dermatitis is a chronic condition that can cause considerable discomfort. This condition is most likely to occur in people over the age of 50. About six to seven percent of people in that age group have stasis dermatitis. Incidence of this condition may be as high as 20 percent in those over age 70. Women are slightly more likely than men to have stasis dermatitis. This is thought to be due to increased stress on leg veins caused by pregnancy. 

Symptoms

You may have symptoms of venous insufficiency including:

• Dull aching or heaviness in the leg
• Pain that gets worse when you stand
• Swelling in the leg

At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.

The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.

Over time, some skin changes become permanent:

• Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
• A bumpy or cobblestone appearance of the skin
• Dark brown color

Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.

Treatment

You may take the following steps to manage venous insufficiency, which is causing stasis dermatitis:

• Use elastic or compression stockings to reduce swelling
• Avoid standing or sitting for long periods
• Keep your leg raised when you sit
• Try varicose vein stripping or other nonsurgical procedures

Some skin care treatments can make the problem worse. Talk with your health care provider before using any lotions, creams, or antibiotic ointments.

Things to avoid:

• Topical antibiotics, such as neomycin
• Drying lotions, such as calamine
• Lanolin
• Benzocaine and other products meant to numb the skin

Treatments your health care provider may suggest include:

• Wet dressings (use only when instructed)
• Topical steroid creams or ointments
• Oral antibiotics