Stasis Dermatitis

What is stasis dermatitis?

Stasis dermatitis, also called gravitational dermatitis, venous eczema, and venous stasis dermatitis, happens when there is venous insufficiency, or poor circulation in the lower legs.  Venous insufficiency happens when the valves in leg veins that help push blood back to the heart weaken and leak fluid. This allows water and blood cells to pool in the lower legs.

Venous insufficiency can be caused by aging, but it can also signal a serious underlying medical condition, such as heart or kidney disease.

Who gets stasis dermatitis and why?

Stasis dermatitis most frequently affects people with poor circulation, usually people over the age of 50. Women are more likely to get it than men.

Not everyone with venous insufficiency develops stasis dermatitis, but poor circulation increases risk.

Other risk factors include:

  • varicose veins
  • high blood pressure
  • obesity, vein surgeries
  • multiple pregnancies
  • a history of blood clots in the legs
  • congestive heart failure
  • kidney failure
  • certain lifestyle factors such as getting little physical activity or having a job that involves hours of sitting or standing

What are symptoms of stasis dermatitis?

Stasis dermatitis can affect the feet or lower legs on one or both sides. It can appear on other parts of the body, but this is uncommon.

Besides ankle swelling, early signs include orange-brown speckles of discoloration sometimes called cayenne pepper spots. These spots develop when pressure and swelling cause capillaries, the smallest blood vessels, to burst.

Other symptoms of stasis dermatitis include:

  • redness in lighter skin tones that may appear brown, purple, gray or ashen in darker skin tones
  • itching
  • scaling
  • dryness
  • a heavy or achy feeling after long periods of sitting or standing
  • increased risk of developing contact dermatitis

If stasis dermatitis goes untreated, swelling can move beyond the ankle to the calf and skin can become shiny. Open sores, called venous ulcers, can form on the lower legs and tops of feet. These ulcers can bleed, ooze and leave scars once they’ve healed.

Severe stasis dermatitis can cause permanent skin changes, including thickening, hardening, darkening or a bumpy, cobblestone-like appearance.

How is stasis dermatitis treated?

Treatment for stasis dermatitis includes identifying and treating its root cause as well as controlling its various symptoms.

Physicians typically diagnose stasis dermatitis by examining the skin but may also run tests to check blood flow and to help identify the root causes of poor circulation.

Treatment can include:

  • compression stockings to reduce swelling
  • elevating legs above the heart every two hours to reduce swelling
  • avoiding foods high in salt
  • supplemental vitamin C and rutin, a plant pigment and antioxidant, to help keep blood vessels flexible and healthy
  • for red or darker-colored, itchy skin, dermatologists may prescribe a topical corticosteroid to calm inflammation
  • topical or oral antibiotic if skin is infected

What do the ecz-perts have to say?

“Recognizing stasis dermatitis early may help reveal a life-threatening condition and prevent the skin condition from progressing from swelling, redness and itching to open, oozing ulcerations that are vulnerable to infection,” notes Dr. Jenny Murase, associate clinical professor of dermatology at the University of California, San Francisco.