What Is Varicose Eczema, and How Is It Treated?

Varicose eczema is a skin condition that causes skin changes in your lower legs when you have varicose veins.

The condition is also referred to as:

• venous eczema
• venous stasis
• gravitational dermatitis
• stasis dermatitis

Along with itchy varicose veins, early varicose eczema symptoms may include:

• dry, scaly rash
• red or discolored, inflamed, and slightly shiny skin
• hyperpigmentation or discolored skin (usually a rust or brown color)
• aching legs
• ankle swelling that tends to get better when you sleep but swells when you wake up
• warm feeling in your legs, although your skin remains cool when you touch it

Some areas of your skin may break down over time and form painful varicose leg ulcers or open sores, most often near your ankle. A 2017 research review showed that about 500,000 people in the United States have these venous ulcers.

Other severe symptoms include:

• crusty or cracked skin
• weeping eczema or oozing, fluid-filled blisters on your skin
• swelling in your legs that persists

You may also experience a condition called lipodermatosclerosis as your varicose eczema worsens. This happens as subcutaneous fat, the fat under your skin, grows inflamed causing your skin to become:

• hard and thick
• tender and painful
• red to red-brown or violet-brown colored

Varicose veins occur when the one-way valves in the veins in your legs grow weak. This causes venous insufficiency or improper blood flow from your limbs upward to your heart.

Blood then pools in the veins in your legs and leaks into your body tissues. Your immune system reacts by making your skin inflamed and causing eczema symptoms to appear.

Varicose eczema often appears in the advanced stages of chronic venous insufficiency (CVI). About 2 to 6 million people in the United States have advanced forms of CVI, according to a 2017 research review.

Along with having CVI, your dermatologist will look for hallmark skin changes and ask about your symptoms.

These are often enough to diagnose varicose eczema, but other tests may be needed to confirm findings or exclude other types of skin conditions.

These tests may include:

• Skin patch test. In this test, your doctor will expose your skin to different potential allergens your skin may react to. This test helps determine if your eczema is caused by allergic contact dermatitis.
• Doppler ultrasound. This imaging test uses sound waves to create pictures that help doctors measure blood flow through your limbs.
• Ankle brachial index test. This test measures blood flow to your legs and looks for areas where blood flow is fully or partly blocked.
• Cardiac tests. There are several tests like electrocardiograms (ECG or EKG), chest X-rays, echocardiograms, and others that measure your heart function.
• Artery studies. These tests measure blood flow in your arteries and are used to check for conditions that may contribute to your varicose eczema.

The American Academy of Dermatology Association (AADA) makes these suggestions that may help lower your risk and reduce symptoms:

Take breaks from sitting or standing

If you sit or stand for more than an hour, take breaks from doing so by walking briskly for at least 10 minutes to boost blood flow.

Work out

Working out helps enhance blood flow and strengthen your leg muscles.

Avoid injury at or near varicose veins

Try to protect affected areas of your skin from getting injured as these can lead to open sores.

Do not scratch these areas or touch things that can further inflame your skin such as:

• harsh cleaning products
• grass
• pet hair
• perfumes
• skin care products with fragrance

Wear cotton clothing that fits loosely

Rough fabrics such as wool and rayon can chafe your skin while tight clothes can hamper blood flow and rub against your skin.

Maintain a moderate weight

Try to get to and stay at a moderate weight. This helps ease swelling and pressure on your veins. It also helps support your total health and lower your risk of other health conditions related to varicose eczema.

Hydrate well

Make sure you get enough fluids each day by drinking healthy fluids such as water or eating water-rich fruits and vegetables. This can improve blood flow and ease swelling.

Watch your salt intake

Try to limit your daily salt intake as having too much of it can hamper blood flow.

Varicose eczema occurs most often in middle-aged and older adults, occurring in about 20 percent of people who are more than 70 years old. Older age along with having varicose veins increases your risk of developing varicose eczema.

Living with overweight or obesity or pregnancy can also raise your risk of developing varicose eczema due to your veins’ added pressure.

Current or past health conditions can also elevate your risk. These include conditions that affect blood flow or your limbs, such as:

• high blood pressure
• phlebitis or inflamed veins
• cellulitis
• deep vein thrombosis
• leg surgery
• heart failure
• kidney disease or kidney failure
• Swelling of your lower leg that persists

Varicose eczema treatment aims to ease your skin conditions and boost blood flow. These may include:

• corticosteroid creams on a short-term basis to quell inflamed skin
• wet dressings soaked in a special solution to treat weeping eczema
• compression garments such as graduated compression stockings or an Unna boot with zinc-oxide dressing built in to boost blood flow and lessen the pressure in your veins
• topical antibiotic if your limb(s) develops an infection
• systemic therapy such as flavonoids (e.g., hesperidin), horse chestnut seed extract, or pentoxifylline to improve blood flow
• ablation therapy to treat venous insufficiency and varicose veins

Read this for information about Ayurvedic treatments for eczema.

Varicose eczema affects blood flow through your limbs and causes a range of skin conditions, most often in your lower legs. Left untreated, it can lead to severe complications.

It is a skin condition that you may have for life, but treatments may help you manage your symptoms and keep them from getting worse. Treatments for varicose veins such as ablative therapy may also cure varicose eczema.

Once you know what works for you, you can help curb symptoms at home with healthy habits and prescribed treatments.

Sticking with your care plan and practicing healthy habits can help you squelch flare-ups. Your care plan includes going to your follow-up visits and letting your doctor know if and how well your treatment is working.