Varicose eczema,  which also known as venous, gravitational or stasis eczema, is a long-term skin condition affects the lower legs. It’s very common in people with Varicose veins. Varicose Eczema is a long-term problem; however, there are some treatments to help keep it under control.

What are the Symptoms of Varicose Eczema?

Like types of eczema, the affected skin will become itchy, red and swollen dry and flaky, scaly or crusty. There may be periods when these symptoms improve and periods when they become more severe. Your legs will become swollen, especially towards the end of the day or after long periods of standing. Varicose veins are usually visible on the legs.

You can have other symptoms including:

• Red, tender and tight skin that can become hardened
• Brown discolouration of your skin skin
• Small, white scars
• Pain
• Eczema that affects other parts of the body
• Left untreated, leg ulcers can develop. These are long-lasting wounds which form where the skin has become damaged.

When to Worry?

You must see your doctor if you have symptoms of varicose eczema. He will often be able to make a diagnosis simply by looking at your skin. Your doctor will also ask  questions to determine if you have a problem with the flow of blood in your leg veins because this is this is the main cause of varicose eczema. To help make a diagnosis, your doctor may want to know if you have a history of:

• Leg ulcers: it is areas of damaged skin that take several weeks to heal

• Varicose veins: it is swollen and enlarged veins

• Deep vein thrombosis (DVT): which is a blood clot in one of the deep veins of your legs
• Cellulitis : it is an infection of the deeper layers of the skin and underlying tissue
• Surgery or injury to your legs

Your doctor may also check the pulse in your feet and  carry out an ankle brachial pressure index (ABPI) test to see if the compression stockings are suitable for you.

The ABPI test will involve comparing blood pressure readings taken from your ankles and upper arms. A significant difference in the readings will suggest a problem with the flow of blood in your arteries. In which case, compression stockings may not be safe to use.

You may be referred to a specialist in a local hospital for further tests. It might be a vascular specialist if:

• You have very poor blood flow in the blood vessels in your legs
• You have varicose veins and changes to your skin, such as varicose eczema, lipodermatosclerosis or a history of leg ulcers
• Your symptoms don’t get better despite treatment
• There is a possible that you have contact dermatitis

What’s Causing  Varicose Eczema?

Varicose eczema is commonly caused by increased pressure in the leg veins. When the small valves in the veins stop working, it’s difficult for blood to be pushed upwards against gravity and it can leak backwards.

This will increase the pressure in the veins, which can cause fluid to leak into the surrounding tissue. It’s thought that varicose eczema might develop as a result of the immune system reacting to this fluid.

Varicose eczema is more common in those with varicose veins, as these are also often a sign that the leg veins aren’t working properly. Some people develop it for no obvious reason; however, there are certain factors that increase the chances of this happening, including:

• Pregnancy : it can increase the pressure in your leg veins
• Gender: varicose eczema is more common in women
• Obesity: it can increase the pressure in your leg veins
• Not being able to move for a long period of time, it can affect the circulation in your leg veins
• Increasing age: people generally find it harder to move about as they get older, which can affect their circulation
• Having previously had deep vein thrombosis (DVT) which is blood clots that develop in leg veins, which can damage the valves in your veins

How to Treat Varicose Eczema?

For most cases, treatment involves a combination of:

• Self-help measures that includes ways to improve your circulation, such as keeping active and raising your legs
• Emollients: moisturisers that applied to your skin to stop it becoming dry
• Topical corticosteroids : ointments and creams that applied to your skin to help treat the eczema and relieve symptoms
• Compression stockings: the designed stockings, often worn every day, that squeeze your legs at the foot and ankle and become looser further up your leg, helping to improve your circulation

If these treatments don’t help, your doctor may refer you to a dermatologist in case there’s another cause for your symptoms or if they’re concerned you may have contact dermatitis.

If you have varicose veins, you may be referred to a vascular specialist who can talk to you about the treatments for varicose veins.

How to Prevent Varicose Eczema?

There are a number of things that you can do yourself in order to prevent varicose eczema from occurring:

• Lose weight.
• Look after your legs: you need to have extra care and attention to your legs for the rest of your life.
• Varicose veins can be treated, so talk your doctor if you think you have them. However, unfortunately, varicose vein surgery or laser treatment is not available on the NHS.
• If you have a venous ulcer, you need compression bandages, which will be applied by a nurse, when your leg ulcer is dressed.
• If you have varicose veins, your leg veins must be supported at all times. For mild cases which require low‐strength compression, use elastic support stockings or tights which available from most pharmacies. For more severe varicose veins, your doctor will prescribe compression hosiery which is made to measure.
• Always put any compression hosiery on before you get out of bed in the morning before any fluid can build up in your ankles.
• Exercise is very You can do a brisk walk twice a day or walking up stairs. This can make your leg muscles work and help push blood through their veins.
• Try not to stand for a long time. If you have to, then flex your feet or bend down at the knees. This will help to keep blood moving in the veins. Remember sitting is better than standing still, especially if you can sit with your feet up.

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