Here are important facts about Varicose Eczema
- What is varicose eczema? The term varicose eczema is very misleading. This condition is not a skin problem and it is not caused by varicose veins. The term arose before we fully understood the true nature of the problem. So varicose eczema can develop in the absence of visible varicose veins and unlike skin problems it should not be managed solely by dermatologists. Other misleading synonyms are gravitational eczema and stasis dermatitis suggesting that gravity somehow preferentially adversely affects some people or that blood is stagnant in some people. Varicose eczema is what we see when the skin is being damaged.
- What causes varicose eczema? The true nature of varicose eczema is either a malfunction of the valves in the superficial veins of the legs or a blockage of the deep veins of the legs which causes inflammation and scarring of the skin and underlying fat layer. These changes are seen when biopsies of varicose eczema are looked at under the microscope. A better medical term is lipodermatosclerosis.
- What is the treatment for varicose eczema? The underlying vein problem should be diagnosed by ultrasound and it should be rectified if possible. The treatments have been independently reviewed by experts at the National Institute for Health and Care Excellence. Everyone with varicose eczema should be seen by a specialist team and have a duplex ultrasound scan. The vein problem should be treated by Endovenous Laser or Ultrasound-Guided Foam Sclerotherapy.
- What about creams for varicose eczema? Often the skin becomes dry and itchy. Moisturising creams do help. Varicose eczema should not be treated with steroid creams except for very brief periods when itch and pain are very troublesome. Longer term use of steroid creams will help the relieve symptoms and the area will look and feel better, but the use of steroids will thin the skin over time making it more vulnerable to further damage.
- What about medical stockings? Medical Compression helps normalise the function of the leg veins and therefore wearing them will go a long way to improving the varicose eczema. Ideally, they should be put on first thing in the morning before getting out of bed and they should be taken off last thing at night. They are not a long-term solution and most people do not like wearing them.
- Should everyone with varicose eczema have a scan? YES. A duplex ultrasound scan is essential in all cases of varicose eczema. It will detect the exact vein abnormality and the results of the scan will form the basis of the plan for curative treatment.
- Can varicose eczema be cured? Well over half of all cases of varicose eczema are caused by a malfunction in the superficial veins of the leg– veins which lie deep to the skin but superficial to the leg muscles. These problems in the superficial veins can nearly always be cured by non-invasive procedures under local anaesthetic on a walk-in walk out basis – procedures such as Endovenous Laser Ablation and Ultrasound-Guided Foam Sclerotherapy.
- Will varicose eczema come back? Varicose eczema is a condition in which the skin is damaged and there may be permanent scarring and changes only visible under the microscope. The area is vulnerable and although the vein condition can be cured, the skin may not completely return to normal.
- What happens if I ignore varicose eczema? Varicose eczema should be taken seriously. It is a warning sign that the skin is being damaged by inflammation and if neglected and not treated, varicose eczema may progress to a leg ulcer.