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Stasis Dermatitis

What is stasis dermatitis?

Stasis dermatitis is sometimes called venous stasis dermatitis because it happens when there is a problem with the veins, generally in the lower legs. These problem veins cause pressure to build up as the blood tries to flow through the body and heart.

mild statis dermatitis

An early case of stasis dermatitis showing redness and swelling

This pressure makes fluid leak out of the veins and into the skin, which then causes:

  • Swelling
  • Redness
  • Scaling
  • Itching or pain

In severe cases of stasis dermatitis, there can be:

  • Oozing
  • Open areas (cracking or larger ulcers)
  • Infection

Over time, recurrent stasis 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

What causes stasis dermatitis?

Stasis Dermatitis - Image: Skinsight.com

Long-standing stasis dermatitis and varicose veins associated with swelling and inflammation in the skin.

Stasis dermatitis affects people with poor circulation. It’s common among adults 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

Stasis dermatitis treatment

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.

Stasis Dermatitis - Image: Skinsight.com

Lower leg with poor vein function (stasis) that has developed red, itchy dermatitis as well as swelling.

Pressure stockings or wraps can be used to help mechanically move the fluid out of the skin and soft tissues. Elevating the feet when possible can also help along these lines.

Like in other forms of eczema, a topical steroid 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 medication such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed.

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