Overview - Varicose eczema

Varicose eczema is also known as venous, gravitational or stasis eczema. It is a long-term skin condition that affects the legs. It's common in people with varicose veins. Treatments are available to help keep it under control.

Symptoms of varicose eczema

Like all types of eczema, skin affected by varicose eczema becomes:

• itchy and swollen
• dry and flaky
• scaly or crusty

On lighter skin it looks red or brown. On darker skin it tends to look dark brown, purple or grey and can be more difficult to see.

There may be periods when these symptoms improve and periods when they are more severe.

Your legs may become swollen, especially at the end of the day or after long periods of standing. Varicose veins (swollen and enlarged veins) are often visible on the legs.

Some people also have other symptoms, such as:

• discolouration of the skin
• heavy tired legs
• small, white scars (atrophie blanche)

Read more about symptoms of varicose eczema

When to get medical advice

See a GP if you have symptoms of varicose eczema. Your doctor will often be able to make a diagnosis simply by looking at your skin.

To help make a diagnosis, a GP may want to know if you have ever had health conditions such as:

• varicose veins – swollen and enlarged veins
• DVT (deep vein thrombosis) – a blood clot in the veins of your legs
• leg ulcers – areas of damaged skin that take several weeks to heal
• surgery or injury to your legs

A GP may also check the pulses in your feet. This is to test to see if compression stockings are suitable for you.

Referral to a specialist

You may be referred to a hospital specialist for further tests.

This could be a:

• vascular specialist – a doctor or surgeon specialising in blood vessels
• a dermatologist – a specialist in skin conditions

Your GP will refer you to a specialist if:

• you have varicose veins and changes to your skin. This includes varicose eczema, lipodermatosclerosis (tightened skin) or a history of leg ulcers
• you have other skin changes such as thickening and discolouration above the ankle which can be a sign of a leg ulcer
• your symptoms do not get better, despite treatment
• it's possible you have contact dermatitis

Read more about diagnosing varicose eczema

Causes of varicose eczema

Varicose eczema is usually caused by increased pressure in the leg veins and swelling of the veins under the skin of the leg.

The small valves in the superficial veins stop working as they should which makes it difficult for blood to flow upwards. This means blood can leak backwards, causing increased pressure in the veins under the skin. This can cause fluid to leak into the nearby tissue. It is thought that the immune system reacts to this fluid, causing varicose eczema.

Almost everyone who gets varicose eczema has visible varicose veins. These are also often a sign that the leg veins are not working properly.

Some people develop the condition for no obvious reason.

But there are some factors that increase the chance of this happening, including:

• gender – varicose eczema is more common in women
• obesity – this can increase the pressure in your leg veins
• pregnancy – this can also increase the pressure in your leg veins
• not being able to move for a long period of time or standing or sitting for long periods of time
• having had DVT (deep vein thrombosis) – blood clots in leg veins can damage the valves in your veins
• increasing age – people generally find it harder to move about as they get older.

Read more about the causes of varicose eczema

Treating varicose eczema

For most people, treatment involves a combination of:

• self-help measures – keeping active and frequently raising your legs to improve the blood flow in the veins
• emollients – moisturisers applied to the skin to stop it from becoming dry
• topical corticosteroids – ointments or creams used sparingly are applied to the skin to help treat the eczema and relieve symptoms
• compression stockings – special stockings to help improve your venous blood flow. They squeeze your legs at the foot and ankle and become looser further up your leg

If you have varicose veins, you may be referred to a doctor or surgeon (vascular specialist). They can talk to you about the treatment options for varicose veins.

If these treatments do not help, a GP may refer you to a skin specialist (dermatologist). This is in case there's another cause for your symptoms, or if they're concerned you may also have contact dermatitis.

Read more about treatment for varicose eczema

Other types of eczema

Eczema is the name for a group of skin conditions that cause dry, irritated skin.

Other types of eczema include:

• atopic eczema (also called atopic dermatitis) – the most common type of eczema
• contact dermatitis – a type of eczema that happens when you come into contact with a particular substance
• discoid eczema – a long-term type of eczema that appears as circular or oval patches on the skin