Diagnosis and Treatment of Venous Eczema

Venous eczema, often referred to as gravitational eczema or stasis eczema is a skin condition affecting approximately 20 percent of adults over 70. Venous eczema can also occur in younger people if they have a genetic predisposition to varicose veins. If left untreated, the skin can break down to form ulcers. I have treated many patients with venous eczema in my over 40 years of practicing medicine and here I will explain the causes and treatments of venous eczema, so you have a better understanding of the condition.

What is venous eczema?

The term venous eczema derives from the appearance of a dermatitis on the lower legs that resembles eczema. This dermatitis appears as a reddened inflamed surface that may be flat or bubbly in appearance. Dry flaky skin is common. The extremity may also show signs of swelling. Occasionally there is a weeping of serum giving a wet appearance. 

Frequently, this condition is thought to represent a skin infection due to similarities in appearance, and the prescribing of antibiotics occurs. Sometimes, cracks or fissures in the skin can introduce bacteria and venous eczema may become secondarily infected, but as a rule, infection is not the initial cause.

Causes of venous eczema

Venous insufficiency or increased pressure within leg veins is the primary cause of this condition. The initiating problem can be multifactorial, but mainly it is due to malfunction of the one-way venous valves that direct vein blood upwards to return to the heart. This allows gravity to prevail, pulling leg vein blood down towards the feet and engorging the leg veins with increasing pressure. This results in swelling and the stimulation of an inflammatory process, producing many inflammatory compounds like cytokines, interleukins, and metalloproteases. So, this is a localized cytokine storm in the lower leg that affects the overlying skin.

Treating venous eczema

Reducing the pressure in the lower leg by means of elevating the feet higher than your heart can help alleviate venous eczema. Wearing a gradient support medical sock or using a pneumatic pump device also helps. Vein supplement Diosmin in a micronized purified formula in correct dosage also helps. Examination by a vein specialist can assist in employing these conservative therapies as well as obtaining appropriate ultrasound studies to detect venous disorders contributing to the problem that a specialist can correct.

The outlook for people with venous eczema

Venous eczema affects blood flow and can cause a range of skin conditions. This condition is most prominent in the lower legs and if left untreated it can lead to severe complications. If you have noticed any changes in your skin and have experienced varicose veins, then these changes may be venous eczema. It is best to contact your physician if you have experienced any of these symptoms so they can refer you to a vein specialist.

Author:
Dr. Lawrence Presant is the chief medical officer at Arizona Vein Specialists in Phoenix. He is a Doctor of Osteopathic Medicine and a certified diplomat of the American Board of Venous and Lymphatic Medicine.

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