Varicose Eczema

Varicose eczema is an inflamed area of skin on the leg caused by a fault in the function of the veins under the skin called superficial venous reflux or by a problem in the deep veins following a deep vein thrombosis.

What does varicose eczema look like?

The skin becomes itchy and swollen, dry and flaky or scaly. On lighter skin it looks red or brown and on darker skin it tends to look dark brown or grey. In addition to leg, the eczema may spread to other parts of the body.

Varicose Eczema is the Skin's Response to Underlying Vein Problems

The term varicose eczema is in fact a misnomer and it is very misleading. This condition is neither an eczema — a skin problem- nor is it 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 eczema suggesting that gravity somehow preferentially adversely affects some people — clearly ridiculous — or that blood is stagnant in some people — equally ridiculous. Varicose eczema is what we see when the skin is being damaged.

Abnormal leg veins prevent the exchange of nutrients and oxygen in the skin micro-circulation which in turn leads to the skin changes we can see and the symptoms.

itchy varicose eczema
what does varicose eczema look like with leg ulcer
what-does-varicose-eczema -look-like

What causes varicose eczema?

The true nature of varicose eczema is a malfunction of the 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. 

Can varicose eczema be cured?

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 laser, radiofrequency, foam sclerotherapy or superglue.

Will varicose eczema come back after vein treatment?

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.

cure-varicose-eczema

What about creams for varicose eczema?

Often the skin becomes dry and itchy. Moisturising creams can 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 for varicose eczema?

Medical stockings or socks help 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.

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 will progress to a leg ulcer.

Can I get varicose eczema on my arms?

If you have varicose eczema on your leg, it can spread to other parts of the body. The medical term is autoeczematisation. Once the leg vein problem is treated, the eczema elsewhere gets better.

Summary

  1. 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.
  2. Varicose Eczema is a complication of leg vein problems.
  3. Varicose Eczema indicates that the skin is being damaged and that the area is at risk of ulcers.
  4. Moisturising creams are helpful.
  5. Steroid creams provide temporary relief but if used frequently, the skin becomes more vulnerable to injury and ulceration.