Stasis dermatitis is also called gravitational dermatitis and venous eczema, can happen to anyone, but it is more common in people who have venous insufficiency or heart failure. Stasis dermatitis develops when blood pools in the lower legs. The veins in the legs are responsible for bringing deoxygenated blood back up to the heart. If this one-way blood flow becomes compromised, blood will pool around the ankles like stagnant water in a pond. This will likely lead to swelling, discolouration and irritation of the skin. If sores and ulcers develop, there is a high risk for infection.
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Symptoms
Swelling in the lower legs and ankles are typically the first sign that veins in the leg are not working properly. Skin around the ankles and on the legs may be itchy, discoloured or have purple, red, scaly or thick patches of skin. Stasis dermatitis usually causes pain and discomfort. If left untreated, stasis dermatitis can lead to bacterial infection, such as cellulitis. Stasis dermatitis can resemble other conditions such as blood clots and skin reactions from an allergy therefore diagnostic tests may be required to be sure.
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Causes
Risk factors of stasis dermatitis include: ageing, sedentary lifestyle, high blood pressure, pregnancy, obesity, heart disease and varicose veins. Veins have one-way valves to keep blood flowing upwards to the heart to be reoxygenated again. These valves also prevent blood from flowing back down the leg. The veins also rely on the muscles in the legs to help squeeze the blood upwards. Sitting for long periods of time with the feet in a dependent position is a perfect storm for blood to pool in the lower legs and ankles. Blood that accumulates and stays here, can cause skin irritation. Faulty valves or inactive muscles are a cause for pooling blood.
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Treatment
Stasis dermatitis should be assessed by a primary care professional. If the skin is intact but irritated, wash gently using a mild, fragrance-free soap, rinsing well afterwards. Keep the skin moisturised with an unscented cream. If stasis dermatitis has resulted in sores or ulcers, thorough cleansing and treatment with an appropriate dressing is crucial. Oral antibiotics and antibacterial creams are effective in managing infection and can help prevent worsening and further complications. At home, elevate feet when sitting to reduce pooling of blood and wear compression socks daily if they have been recommended. Compression socks work best if applied as soon as possible after waking up from slumber.
