Stasis Dermatitis

What is stasis dermatitis?

Stasis dermatitis is a type of eczema that happens when you have poor blood circulation, which usually happens in your legs.¹

Stasis dermatitis is also sometimes called gravitational dermatitis, venous eczema or venous stasis dermatitis, because it happens when there is venous insufficiency in the lower legs.¹ Venous insufficiency happens when the valves in leg veins that help push blood back to the heart weaken and leak fluid.¹ This allows water and blood cells to pool in the lower legs, which can cause them to swell.¹ Stasis dermatitis can also appear on other areas of your body, but only in rare cases.¹

What does stasis dermatitis look like?

The most common sign of stasis dermatitis is abnormal skin color around the ankles, shins or lower legs, which can appear red to brown, depending on your skin tone.² Usually this discolored skin is thicker than normal, hard, scaly and has a constant itch, pain and/or swelling.² It’s also possible for there to be blisters, oozing or crusting in the affected area.² These changes usually begin on the inside of your ankles, and can spread to the tops of your feet.²

Over time, stasis dermatitis can change the shape of your legs without treatment, causing your legs to appear like an upside-down bowling pin, with your lower calf appearing shrunken.²

Who gets stasis dermatitis and why?

Stasis dermatitis most frequently affects people with poor circulation, usually people over the age of 50.¹ It is estimated that around 20% of adults over the age of 50, about 15-20 million people in the United States, have stasis dermatitis.^1,3 Women are more likely to get it than men.³

Exercise and maintaining a healthy weight can help decrease your risk of getting stasis dermatitis.³

Some medical conditions can increase your risk of developing stasis dermatitis such as blood clots, high blood pressure, congestive heart failure, cellulitis, varicose veins, obesity and kidney disease.³ You are also more prone to developing stasis dermatitis if you have leg injuries or leg or vein surgeries.³

Is stasis dermatitis contagious?

No, stasis dermatitis is not contagious.¹ You can’t “catch” it or spread it to others.

---

What causes stasis dermatitis?

Stasis dermatitis is caused by poor blood circulation.³ Poor blood circulation is usually caused by aging.³ The leg valves that pump blood back up to your heart weaken over time.³ When they work properly, leg valves push blood from the heart to the legs and circulate it back.³ When the veins aren’t working, some of the blood leaks and causes swelling and inflammation.³ Not everyone with venous insufficiency develops stasis dermatitis, but poor circulation increases risk.³ Surgical procedures (knee replacements, hip surgery, etc.) or injuries of the legs (broken leg) can also cause stasis dermatitis due to disruption of the veins in the legs.

The exact reason why stasis dermatitis forms in some people with poor blood circulation but not others is unknown.³ Because of this, most treatments focus on managing symptoms and avoiding future flares. Researchers are still working to determine exactly why stasis dermatitis forms.³

---

What are the 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.¹

Besides ankle swelling, early signs include orange-brown speckles of discoloration (capillaritis) sometimes called cayenne pepper spots.⁴ These spots develop when pressure and swelling cause capillaries, the smallest blood vessels, to burst.⁴

Other symptoms of stasis dermatitis include:

• Redness in lighter skin tones that may appear brown, purple, gray or ashen in darker skin tones
• Itching²
• Scaling²
• Dryness²
• A heavy or achy feeling after long periods of sitting or standing²

If stasis dermatitis goes untreated, swelling can move beyond the ankle to the calf and skin can become shiny.² 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.² Severe stasis dermatitis can cause permanent skin changes, including thickening, hardening, darkening or a bumpy, cobblestone-like appearance.

---

How is stasis dermatitis diagnosed?

A dermatologist can diagnose stasis dermatitis. They will most likely check for ankle swelling and symptoms in the lower legs and feet.⁵ They will ask about your medical history, including if you’ve experienced these symptoms before or if you had a similar flare before in the same part of your body.⁵

If you had these symptoms elsewhere too, such as on your face or hands, or the symptoms started much younger than 50, it’s possible that your symptoms are from something other than stasis dermatitis. Since poor blood flow can be a sign of something more serious, they might also recommend running additional tests either in their office or with a different specialist.⁵ These tests could include:

• Blood tests to look for blood clots or thinning: These tests can also look for blood count or signs of kidney failure⁵
• A CT scan or ultrasound of the legs⁵

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.^1,2

Once you have a diagnosis, you can work with your dermatologist and your eczema care team to create a treatment and prevention plan. With the right treatment, symptoms can be managed and swelling and redness will usually decrease.^1,2

---

How is stasis dermatitis treated?

Treatment for stasis dermatitis depends on your symptoms and how severe they are.⁵

Medical treatments for stasis dermatitis include:

• Corticosteroid to calm inflammation and reduce skin discoloration⁵
• Topical antibiotic creams or oral antibiotics or steroids if skin is infected⁵
• Antihistamines to help with itch⁵
• Topical creams for alleviating pain⁵
• Intense pulsed light treatments to help reduce skin discoloration⁵
• Vein surgery⁵

There is no one-size-fits-all treatment for stasis dermatitis. The best treatment depends on your specific case and treatment preferences. Other possible management strategies your dermatologist might recommend can include:

• Compression garments to reduce swelling⁵
• Elevating legs above the heart every two hours to reduce swelling⁶
• Avoiding foods high in salt⁶

How can I prevent stasis dermatitis flares?

It is possible to eliminate the symptoms of stasis dermatitis and to prevent future flares. Many of the above treatment options can also be used for prevention.

Some actions you can take to “reverse” stasis dermatitis include:

• Wearing compression socks⁶
• Walking/moving your body frequently instead of sitting still for long periods of time^1,6
• Elevating your legs above your heart while sleeping and several times throughout the day⁶
• Wearing loose fitting cotton clothing⁶
• Avoiding irritants such as grass, pet hair, plants, products with fragrance and cleaning products⁶
• Limiting salt⁶
• Moisturizing daily⁶

There are preventative measures to ease varicose vein symptoms and to improve blood circulation. These preventative steps include:

• Try to move every 30 minutes and avoid staying still for longer than a half hour⁶
• Exercise regularly to improve blood circulation⁶
• Take regular breaks throughout your workday — ideally, these breaks would be active instead of sitting still⁶

---

What other related conditions can you have with stasis dermatitis?

Venous insufficiency can be caused by aging, but it can also signal a serious underlying medical condition, such as heart or kidney disease. If you experience venous insufficiency, consult with your doctor. Most likely they will want to run some tests in order to determine the cause of the condition and create a comprehensive treatment plan.

Can stasis dermatitis put you at higher risk for developing another skin condition?

Many of the symptoms of stasis dermatitis are similar to psoriasis, nummular eczema, atopic dermatitis and contact dermatitis. It’s also possible to have stasis dermatitis and one or more of these skin conditions.² That’s why it’s so important to consult with a dermatologist to determine the cause of your symptoms.