What is stasis dermatitis

Stasis dermatitis also called venous eczema, venous stasis dermatitis or gravitational dermatitis, is skin irritation and breakdown due to the fluid accumulating under the skin. Stasis dermatitis happens when there is a problem with circulation in the veins, generally in the lower legs. These problem veins cause pressure to build up as the blood tries to flow upward through the body and heart. This pressure makes fluid leak out of the veins and into the skin. Stasis dermatitis can be due to venous insufficiency (vein valve malfunction), heart failure, and other conditions that cause swelling, usually in the legs, but sometimes in other areas as well. Stasis dermatitis is most common in the lower legs because leg veins have one-way valves, which play an important role in circulating our blood. These valves push blood up the legs. As we age, these valves can weaken and stop working properly. Some blood can leak out and pool in the legs. Your dermatologist may refer to this as “venous insufficiency.”

Stasis is a term used to describe leg swelling seen in conditions of poor circulation and fluid buildup. Dermatitis is a term used to describe irritation of the skin with scaling, rough or dry skin, redness, itching, and sometimes oozing, crusts, and erosions. People with stasis dermatitis are at increased risk of developing allergic contact dermatitis.

Swelling around the ankle is often the first sign of stasis dermatitis. The swelling tends to clear while you sleep — and return during the day. Other early signs are discolored skin and varicose veins.

Common signs and symptoms of stasis dermatitis (venous eczema, gravitational dermatitis) include:

• Thickened, discolored (reddish) skin on the ankles or shins
• Itching
• Open sores, oozing and crusting
• Swelling, especially around the ankles that goes away while sleeping but returns in the day
• Discolored skin
• Scaling and dryness
• Varicose veins
• Leg ache

In the US, stasis dermatitis occurs in 6–7% of those over the age 50. The risk of developing stasis dermatitis increases with age. Women are slightly more likely to be affected, perhaps due to the effect of pregnancy on the leg vein system.

When seen in younger people, it is usually due to surgery, trauma, or a history of deep vein blood clots or repeated infections.

If you have stasis dermatitis, an accurate diagnosis and treatment are essential. Treatment can prevent the disease from worsening.

How to get rid of stasis dermatitis

The most important step is to correct the underlying problem causing the fluid buildup. It is also important to understand that the condition is usually a chronic one requiring ongoing care for the rest of one’s life. If you get little or no exercise, becoming more active may reduce your risk of developing stasis dermatitis. Exercise can improve your blood flow, help you shed excess body fat, and possibly reduce high blood pressure.

If the stasis dermatitis is mild and clearly related to leg swelling, which is minimal upon arising in the morning but worse after a day of standing, simple measures can assist the veins and reduce the chance of progression of the disease, requiring medical care.

These steps include:

• Wearing your compression stocking (worn to at least knee height) should be put on in the morning upon arising. Many non-prescription and attractive styles are available for men and women. Although they are initially tight, discomfort is less as the swelling is controlled. Most patients stop wearing a compression garment (compression stockings or Unna boots) because it feels uncomfortable. The discomfort tends to lessen as the swelling subsides. Compression stocking can:
  • Improve the circulation in your legs
  • Prevent open sores
  • Reduce your risk of another flare.
• Raising the legs above the level of the heart when sitting reduces fluid buildup.
• Applying 1% hydrocortisone cream (available over the counter) to the red, itchy areas twice daily.
• Practicing a proper skin-care routine, which includes using only mild soaps or cleansers and applying a moisturizer (such as petrolatum) after each bath on the legs.
• Avoiding the use of other creams or topical antibiotics, as allergic reactions are common.
• Take breaks when you must sit or stand for long periods. If you must sit or stand for long periods, take a break every hour and walk briskly for 10 minutes.
• Get physical. Exercise can improve your circulation and strengthen your calf muscles. Ask your dermatologist how often you should exercise.
• Wear loose-fitting cotton clothing. Wearing cotton clothes help to avoid irritation. Rough fabrics like wool, polyester, and rayon can irritate your skin. Loose-fitting clothing is important, too. Tight waistbands and snug pants interfere with your circulation. When clothing rubs against the stasis dermatitis, it can irritate the sensitive skin.

Avoid anything that could aggravate the stasis dermatitis. The skin with stasis dermatitis is very sensitive, so you want to prevent the stasis dermatitis from touching anything that could irritate it, such as:

• Pet hair
• Plants
• Grass
• Cleaning products
• Perfume
• Any skin care product that does not say “fragrance free.”

Apply moisturizer when your skin feels dry. Moisturizer helps prevent scaly skin and irritation. Petroleum jelly works well for most patients. If you prefer to use another moisturizer, choose an ointment or thick cream that says “fragrance free” on the container.

Avoid scratching the stasis dermatitis. Scratching can worsen stasis dermatitis and lead to an infection. To reduce the itch, apply your medicine as directed. Other ways to calm the itch include:

• Applying a cool compress
• Spreading on a fragrance-free moisturizer
• Adding colloidal oatmeal to a cool bath

Take care when bathing. Soaps and rough-textured towels can irritate the stasis dermatitis. Dermatologists recommend the following to their patients with stasis dermatitis:

• Use a mild, fragrance-free cleanser rather than soap. When you shower or take a bath, use this cleanser. Rinsing soap from other parts of your body can irritate the stasis dermatitis.
• After bathing, gently pat the water from your skin with a clean towel. You’ll want to keep a bit of water on the skin with stasis dermatitis.
• Within 2 minutes of bathing, apply petroleum jelly or a thick, creamy moisturizer that is fragrance free. This helps to keep moisture in your skin. Keeping your skin moisturized helps to prevent scaly skin and irritation.

Who gets stasis dermatitis?

Stasis dermatitis is most likely to develop in someone who has the following traits:

Age: Because poor circulation leads to stasis dermatitis, this type of dermatitis usually develops in people who are middle aged or older. In the United States, stasis dermatitis:

• Tends to develop in people 50 years of age and older
• Rarely occurs before 40 years of age

Gender: Women are slightly more likely to develop stasis dermatitis.

Medical history: Having one or more of the following increases your risk of developing stasis dermatitis:

• Venous insufficiency (your body has trouble returning blood from your legs to your heart, so some blood pools in your legs)
• Varicose veins (or blood relatives who have them)
• High blood pressure
• Previous blood clot, especially a blood clot in a leg like deep vein thrombosis
• Previous injury to the area
• Many pregnancies
• Surgery (to the area or removing a vein from the area)
• A heart condition, such as congestive heart failure (a weakened heart cannot pump blood effectively)
• Kidney failure
• Being very overweight

Lifestyle: Having any of the following also increase your risk of developing stasis dermatitis:

• Standing or sitting for long periods of time, such as at work
• Getting little or no exercise
• Excess body fat

Stasis dermatitis causes

Stasis dermatitis affects people with varicose veins or poor circulation such as heart failure, and other conditions that cause fluids to build up in the lower legs, but sometimes in other areas as well. The swelling produces pressure beneath the skin and prevents adequate blood and oxygen from reaching the skin. Stasis dermatitis usually affects people over the age of 50. Women are more likely to get it than men.

There are a number of conditions that can increase your risk for developing stasis dermatitis. These include:

• High blood pressure
• Varicose veins
• Congestive heart failure
• Kidney failure
• Obesity
• Many pregnancies
• Blood clots in leg veins or deep vein thrombosis (DVT)

Risk factors for stasis dermatitis

Obesity, congestive heart failure, deep vein thrombosis (DVT), history of a leg fracture, venous hypertension secondary to prolonged standing, and congenital absence of venous valves are known risk factors. Additionally, stasis dermatitis is most prevalent in older individuals.

Stasis dermatitis symptoms

Itching and red, dry areas are usually the first signs of stasis dermatitis. The inside ankle area is often first affected, gradually involving the lower leg up to the knee. The skin may appear shiny or have reddish-brown patches.

Swelling (edema) is usually present, but in chronic cases of stasis dermatitis, there is gradual tightening and scarring of the skin leading to hard and sometimes tender areas.

In severe cases of stasis dermatitis, the skin breaks down with oozing, crusted areas and ulceration. White, shiny scars are often left after healing.

In long-standing cases, there may be significant thickening and darkening of the skin from rubbing.

Early signs and symptoms of stasis dermatitis

Most people develop stasis dermatitis on their lower legs. When it begins in the legs, you may notice the following in one or both legs:

• Heaviness or aching when you stand or walk for a long time
• Swelling, often on the inside of the ankle, at the end of the day
• Swelling clears when you sleep, but re-appears during the day
• Varicose veins
• Itchy, dry skin over the varicose veins
• Skin may feel irritated — red, swollen, and sore.

Signs and symptoms as disease progresses

As the stasis dermatitis progresses, people often notice the following:

• Swelling spreads beyond the ankle to the calf
• Dry, cracked, itchy skin
• Red to violet-colored open sores (medical term: venous ulcer), which can appear on the lower legs and tops of the feet
• Sores leak fluid and scab as they heal
• Sores can cause scars when they heal
• Shiny skin

Severe stasis dermatitis (venous eczema, gravitational dermatitis)

Left untreated, stasis dermatitis can worsen over the years and cause the following:

• Oozing
• Area feels hard
• Open areas (cracking or larger ulcers)
• Intensely itchy skin
• Infection
• Lower part of the calf shrinks, often making the calf look like an upside-down wine bottle
• Shiny skin
• Skin becomes deeply pigmented
• Scars where ulcers healed
• Infection, most notably, cellulitis
• Redness and scale cover the area, including the top of the foot

Other medical conditions can develop where a person has stasis dermatitis. Two common conditions are:

• Allergic contact dermatitis (skin becomes very sensitive to almost everything that touches it, including medicines and ingredients in moisturizers, such as lanolin)
• Cellulitis (a serious infection that extends deep into the skin)

Over time, recurrent stasis dermatitis (venous eczema, gravitational dermatitis) can result in more permanent changes in the skin including:

• Lipodermatosclerosis: scar-like changes in the fat and other soft tissues
• Atrophie blanche: white scars surrounded by tiny capillaries
• Lichenification: thickened skin due to chronic scratching or rubbing

Stasis dermatitis diagnosis

To diagnose stasis dermatitis or venous stasis dermatitis, your dermatologist will examine your skin, looking closely at the skin that shows signs of stasis dermatitis. Your dermatologist will also want to know about your medical history.

It is important to mention the following:

• Past blood clot
• Injury to the area
• Heart disease
• Surgeries

Medical tests may be necessary to find out exactly why you have poor circulation in the area. Your dermatologist may refer you to another doctor or recommend one or more of following tests:

• Blood tests
• Doppler ultrasound (to look at how your blood flows)
• Tests to rule out problems with your heart
• Allergy testing (stasis dermatitis increases the risk of developing an allergic reaction on your skin)

Stasis dermatitis treatment

Your doctor will do an exam to determine the cause of the swelling; vein studies may be suggested and rarely, a culture or skin biopsy may be done.

If you have stasis dermatitis (venous eczema or gravitational dermatitis), your doctor will create a treatment plan that addresses your specific needs. Because the problem starts with poor circulation, your doctor may recommend treating the damaged veins in your legs by surgery. However, sometimes the surgery for the veins is not possible, or is not able to repair the veins completely.

Your treatment plan will include treatment for each of your signs and symptoms, which may include:

• Swelling: To reduce the swelling in a lower leg, most patients wear a compression stocking, compression dressing, or Unna boot. Compression stockings, a specially designed stocking that applies pressure to the leg to prevent fluid from pooling and help mechanically move the fluid out of the skin and soft tissues may be recommended. Compression can reduce swelling as well as improve your circulation. Because it is so important to reduce swelling, it helps to elevate your legs throughout the day. If possible, your doctor will recommend that you elevate your legs above your heart:
  • Once every two hours for 15 minutes
  • While you sleep (keep your legs elevated with pillows)
  • Oral medications may be used to control heart failure or reduce the presence of fluid.
• Inflammation (redness, swelling, and pain): Like in other forms of eczema (dermatitis), a topical strong corticosteroid creams may be used for short periods (not prolonged periods, due to the possible thinning of the skin from chronic use) can help calm the inflammation and itch. Sometimes covering the steroid with wet or dry wrap or an Unna boot can greatly assist in severe cases. An Unna boot is a type of gauze bandage with healing medications in it and provides compression to help with fluid build up. In cases where corticosteroids are not appropriate, or when they have been used for a prolonged period, a non-corticosteroid topical calcineurin inhibitor such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed. Your doctor may also review medications that are known to have edema (swelling from fluid in the tissues) as a side effect, which can contribute to stasis dermatitis.
• Infection: If you have an infection, taking oral or intravenous antibiotic or applying an antibiotic to the stasis dermatitis can help clear the infection.
• Wounds: For open sores or skin ulcers, a special dressing may need to be applied to promote healing.
• Itch: Taking an antihistamine can help calm an intense itch.
• Dry skin: Applying a moisturizer a few times per day can help get rid of the dry skin. Because stasis dermatitis makes the skin so sensitive, you’ll want to use a moisturizer that is free of:
  • Fragrance
  • Dyes
  • Perfumes

Good options include petroleum jelly and a thick cream that says “fragrance free” on the label. Your dermatologist may also recommend a moisturizer.

• Varicose veins: Sometimes varicose veins — those large blue or purple veins that rise above the skin’s surface — can cause discomfort and pain. In rare cases, they can cause bleeding leg sores. Removing troublesome vein can alleviate your discomfort and may reduce bleeding leg sores. If vein removal is recommended, your dermatologist can recommend an appropriate procedure for you. Many procedures are minimally invasive.
• Skin discoloration: Stasis dermatitis can cause the affected skin to turn a brownish color. This discoloration often remains even when the swelling, sores, and other signs clear. If the discoloration bothers you, ask your dermatologist about treatment options that could reduce the discoloration.

Stasis dermatitis tends to come back until the underlying cause (damaged veins) is addressed.

Stasis dermatitis prognosis

You may have stasis dermatitis for life. Many patients are able to manage the disease on their own once they get the stasis dermatitis under control. Managing the disease often involves:

• Wearing compression stockings
• Elevating your legs as needed
• Following a skin care plan
• Applying medicine when you have a flare

You’ll also need to see your dermatologist for follow-up appointments.

Self-care plays an important role in getting stasis dermatitis under control. It is essential to keep it under control.

Stasis dermatitis vs Cellulitis

Cellulitis is a common bacterial infection of the deep dermis and subcutaneous tissue characterized by redness (erythema), pain, warmth, and swelling. Cellulitis is most often caused by the bacteria Streptococcus pyogenes or Staphylococcus aureus. These bacteria are able to enter the skin through small cracks (fissures), causing the sudden appearance of redness, swelling, and warmth in the skin. Cellulitis is sometimes accompanied by fever, chills, and general fatigue. If the infection is left untreated for too long, cellulitis can result in pockets of pus (abscesses) or the spread of bacteria into the bloodstream (bacteremia). However, most cases of cellulitis resolve with appropriate antibiotic therapy.

Pathogens of cellulitis are strongly correlated with age and immune status:

• Immunocompetent adults: Staphylococcus aureus and Streptococcus pyogenes. Staphylococcus aureus is the most frequent etiology in children and in purulent cellulitis.
• Immunocompromised individuals, including those with diabetes and decubitus ulcers: mixture of gram-positive cocci and gram-negative aerobes and anaerobes.

Cellulitis can occur in anyone. Factors that increase the risk of developing cellulitis include:

• Diabetes
• Lymphedema
• Skin wounds
• Chronic lower leg swelling (edema)
• Athlete’s foot (tinea pedis)
• Bites from insects, animals, or other humans
• Obesity
• Poor circulation in the legs (peripheral vascular disease)
• Weakened immune system due to underlying illness or medication
• Intravenous drug abuse

Cellulitis can affect any part of the body, but the most common locations are:

• Lower legs
• Arms or hands
• Face

Cellulitis initially appears as pink-to-red minimally inflamed skin. The involved area may rapidly become deeper red, swollen, warm, and tender and increase in size as the infection spreads. Occasionally, red streaks may radiate outward from the cellulitis. Blisters or pus-filled bumps may also be present.

Cellulitis may be accompanied by swollen lymph nodes, fever, chills, and fatigue.

Stasis dermatitis is often mistaken for cellulitis. Unlike cellulitis, the lesions of stasis dermatitis are often scaly and present bilaterally. While the patient may rarely complain of severe pain and present with a red leg, signs of infection (fever, elevated white blood cell count, and tachycardia) will be absent. Frequently, other signs of venous insufficiency, such as varicosities, will also be apparent on physical examination.

If you develop a tender, red, warm, enlarging area on your skin, make an appointment with your physician as soon as possible to get treatment and to avoid complications that may occur if cellulitis is left untreated. If you also have fever and chills, or if the area involves the face, you should go to the emergency room.

If you are currently being treated for a skin infection that has not improved after 2–3 days of antibiotics, return to your doctor. You may need treatment with different medications, or the infection may have spread deeper into your skin.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of “staph” bacteria that is resistant to antibiotics in the penicillin family. This class of antibiotics has been the cornerstone of antibiotic therapy for staph and skin infections for decades. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) previously infected only small segments of the population, such as health care workers and persons using injection drugs. However, CA-MRSA is now a common cause of skin infections in the general population. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most CA-MRSA infections can easily be treated with commonly available nonpenicillin antibiotics. Rarely, CA-MRSA can cause a deeper skin infection, which usually requires intravenous (IV) antibiotics to treat the infection. There is an additional strain of MRSA (hospital-acquired MRSA), usually found in health care settings, that is susceptible only to intravenous antibiotics, so admission to the hospital is often needed for effective treatment.

What is venous stasis dermatitis

Venous stasis dermatitis also known as stasis dermatitis,  stasis eczema or gravitational dermatitis, is dermatitis due to poor vein function (venous insufficiency). Venous stasis dermatitis can arise as discrete patches or affect the leg circumferentially. The affected skin is red and scaly, and may ooze, crust and crack. Stasis dermatitis is frequently itchy. Irregular hemosiderin pigmentation is usually present. Chronic venous disease is common with manifestations that include varicose veins, skin changes such as venous stasis dermatitis, hyperpigmentation, lipodermatosclerosis, and chronic leg ulcers ¹. Venous stasis dermatitis is involved in 70 to 90 percent of all lower-extremity ulcers treated. Venous hypertension, due to inadequate venous return associated with a defective valvular system, is the main culprit ². Lipodermatosclerosis is an indurated plaque in the medial malleolus that can, at times, be quite tender and painful ³.

Normally during walking the leg muscles pump blood upwards and valves in the veins prevent pooling. Deep venous thrombosis or varicose veins may damage the valves resulting in edema, particularly after prolonged standing and during hot weather.

Venous stasis dermatitis common complications include:

• Impetiginisation
• Cellulitis
• Autosensitisation dermatitis (autoeczematisation)
• Lichenification
• Lipodermatosclerosis (panniculitis): woody induration
• Atrophie blanche: white scarred areas surrounded by capillary ectasia
• Ulceration, frequently over the medial malleolus and provoked by a minor injury
• Contact allergy to one or more components of topical treatment

Figure 1. Venous stasis dermatitis

Venous stasis dermatitis treatment

The most important step is to correct the underlying problem causing the fluid buildup. It is also important to understand that the condition is usually a chronic one requiring ongoing care for the rest of one’s life. If you get little or no exercise, becoming more active may reduce your risk of developing stasis dermatitis. Exercise can improve your blood flow, help you shed excess body fat, and possibly reduce high blood pressure.

If the stasis dermatitis is mild and clearly related to leg swelling, which is minimal upon arising in the morning but worse after a day of standing, simple measures can assist the veins and reduce the chance of progression of the disease, requiring medical care.

These steps include:

• Wearing your compression stocking (worn to at least knee height) should be put on in the morning upon arising. Many non-prescription and attractive styles are available for men and women. Although they are initially tight, discomfort is less as the swelling is controlled. Most patients stop wearing a compression garment (compression stockings or Unna boots) because it feels uncomfortable. The discomfort tends to lessen as the swelling subsides. Compression stocking can:
  • Improve the circulation in your legs
  • Prevent open sores
  • Reduce your risk of another flare.
• Raising the legs above the level of the heart when sitting reduces fluid buildup.
• Applying 1% hydrocortisone cream (available over the counter) to the red, itchy areas twice daily.
• Practicing a proper skin-care routine, which includes using only mild soaps or cleansers and applying a moisturizer (such as petrolatum) after each bath on the legs.
• Avoiding the use of other creams or topical antibiotics, as allergic reactions are common.
• Take breaks when you must sit or stand for long periods. If you must sit or stand for long periods, take a break every hour and walk briskly for 10 minutes.
• Get physical. Exercise can improve your circulation and strengthen your calf muscles. Ask your dermatologist how often you should exercise.
• Wear loose-fitting cotton clothing. Wearing cotton clothes help to avoid irritation. Rough fabrics like wool, polyester, and rayon can irritate your skin. Loose-fitting clothing is important, too. Tight waistbands and snug pants interfere with your circulation. When clothing rubs against the stasis dermatitis, it can irritate the sensitive skin.

Avoid anything that could aggravate the stasis dermatitis. The skin with stasis dermatitis is very sensitive, so you want to prevent the stasis dermatitis from touching anything that could irritate it, such as:

• Pet hair
• Plants
• Grass
• Cleaning products
• Perfume
• Any skin care product that does not say “fragrance free.”

Apply moisturizer when your skin feels dry. Moisturizer helps prevent scaly skin and irritation. Petroleum jelly works well for most patients. If you prefer to use another moisturizer, choose an ointment or thick cream that says “fragrance free” on the container.

Avoid scratching the stasis dermatitis. Scratching can worsen stasis dermatitis and lead to an infection. To reduce the itch, apply your medicine as directed. Other ways to calm the itch include:

• Applying a cool compress
• Spreading on a fragrance-free moisturizer
• Adding colloidal oatmeal to a cool bath

Take care when bathing. Soaps and rough-textured towels can irritate the stasis dermatitis. Dermatologists recommend the following to their patients with stasis dermatitis:

• Use a mild, fragrance-free cleanser rather than soap. When you shower or take a bath, use this cleanser. Rinsing soap from other parts of your body can irritate the stasis dermatitis.
• After bathing, gently pat the water from your skin with a clean towel. You’ll want to keep a bit of water on the skin with stasis dermatitis.
• Within 2 minutes of bathing, apply petroleum jelly or a thick, creamy moisturizer that is fragrance free. This helps to keep moisture in your skin. Keeping your skin moisturized helps to prevent scaly skin and irritation.

Your doctor’s treatment plan will include treatment for each of your signs and symptoms, which may include:

• Swelling: To reduce the swelling in a lower leg, most patients wear a compression stocking, compression dressing, or Unna boot. Compression stockings, a specially designed stocking that applies pressure to the leg to prevent fluid from pooling and help mechanically move the fluid out of the skin and soft tissues may be recommended. Compression can reduce swelling as well as improve your circulation. Because it is so important to reduce swelling, it helps to elevate your legs throughout the day. If possible, your doctor will recommend that you elevate your legs above your heart:
  • Once every two hours for 15 minutes
  • While you sleep (keep your legs elevated with pillows)
  • Oral medications may be used to control heart failure or reduce the presence of fluid.
• Inflammation (redness, swelling, and pain): Like in other forms of eczema (dermatitis), a topical strong corticosteroid creams may be used for short periods (not prolonged periods, due to the possible thinning of the skin from chronic use) can help calm the inflammation and itch. Sometimes covering the steroid with wet or dry wrap or an Unna boot can greatly assist in severe cases. An Unna boot is a type of gauze bandage with healing medications in it and provides compression to help with fluid build up. In cases where corticosteroids are not appropriate, or when they have been used for a prolonged period, a non-corticosteroid topical calcineurin inhibitor such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed. Your doctor may also review medications that are known to have edema (swelling from fluid in the tissues) as a side effect, which can contribute to stasis dermatitis.
• Infection: If you have an infection, taking oral or intravenous antibiotic or applying an antibiotic to the stasis dermatitis can help clear the infection.
• Wounds: For open sores or skin ulcers, a special dressing may need to be applied to promote healing.
• Itch: Taking an antihistamine can help calm an intense itch.
• Dry skin: Applying a moisturizer a few times per day can help get rid of the dry skin. Because stasis dermatitis makes the skin so sensitive, you’ll want to use a moisturizer that is free of:
  • Fragrance
  • Dyes
  • Perfumes

Good options include petroleum jelly and a thick cream that says “fragrance free” on the label. Your dermatologist may also recommend a moisturizer.

• Varicose veins: Sometimes varicose veins — those large blue or purple veins that rise above the skin’s surface — can cause discomfort and pain. In rare cases, they can cause bleeding leg sores. Removing troublesome vein can alleviate your discomfort and may reduce bleeding leg sores. If vein removal is recommended, your dermatologist can recommend an appropriate procedure for you. Many procedures are minimally invasive.
• Skin discoloration: Stasis dermatitis can cause the affected skin to turn a brownish color. This discoloration often remains even when the swelling, sores, and other signs clear. If the discoloration bothers you, ask your dermatologist about treatment options that could reduce the discoloration.

Stasis dermatitis tends to come back until the underlying cause (damaged veins) is addressed.

1. Bergan J. Molecular mechanisms in chronic venous insufficiency. Ann Vasc Surg. 2007;21(3):260–266. doi: 10.1016/j.avsg.2007.03.011
2. Worley CA. ‘It hurts when I walk:’ venous stasis disease-differential diagnosis and treatment. Dermatol Nurs. 2006;18(6):582–583.
3. Barron GS, Jacob SE, Kirsner RS. Dermatologic complications of chronic venous disease: medical management and beyond. Ann Vasc Surg. 2007;21(5):652–662. doi: 10.1016/j.avsg.2007.07.002