Stasis Dermatitis

What is Stasis Dermatitis

Stasis dermatitis is a long-term (chronic) skin condition that happens when veins can no longer pump blood back to the heart (poor circulation). This condition causes a red or brown scaly rash or sores (ulcers) from the pooling of blood (stasis).

This condition usually affects the lower legs. It may affect one leg or both legs.

Without treatment, severe stasis dermatitis can lead to other skin conditions and infections.

What are the causes?

This condition is caused by poor circulation.

What increases the risk?

This condition is more likely to develop in people who:

  • Are not very active.
  • Stand for long periods of time.
  • Have veins that have become enlarged and twisted (varicose veins).
  • Have leg veins that are not strong enough to send blood back to the heart (venous insufficiency).
  • Have had a blood clot.
  • Have been pregnant many times.
  • Have had vein surgery.
  • Are obese.
  • Have heart or kidney failure.
  • Are 50 years of age or older.

What are the signs or symptoms?

Common early symptoms of this condition include:

  • Swelling in your ankle or leg. This might get better overnight but be worse again in the day.
  • Skin that looks thin on your ankle and leg.
  • Brown marks that develop slowly.
  • Skin that is easily irritated or cracked.
  • Red, swollen skin.
  • An achy or heavy feeling after you walk or stand for long periods of time.
  • Pain.

Later and more severe symptoms of this condition include:

  • Skin that looks shiny.
  • Small, open sores (ulcers). These are often red or purple.
  • Dry, cracking skin.
  • Skin that feels hard.
  • Severe itching.
  • A change in the shape or color of your lower legs.
  • Severe pain.
  • Difficulty walking.

How is this diagnosed?

Your health care provider may suspect this condition from your symptoms and medical history. Your health care provider will also do a physical exam. You may need to see a health care provider who specializes in skin diseases (dermatologist). You may also have tests to confirm the diagnosis, including:

  • Blood tests.
  • Imaging studies to check blood flow (Doppler ultrasound).
  • Allergy tests.

How is this treated?

Treatment for this condition may include medicine, such as:

  • Corticosteroid creams and ointments.
  • Non-corticosteroid medicines applied to the skin (topical).
  • Medicine to reduce swelling in the legs (diuretics).
  • Antibiotics.
  • Medicine to relieve itching (antihistamines).

You may also have to wear:

  • Compression stockings or an elastic wrap to improve circulation.
  • A bandage (dressing).
  • A wrap that contains zinc and gelatin (Unna boot).

Follow these instructions at home:

Skin Care

  • Moisturize your skin as told by your health care provider. Do not use moisturizers with fragrance. This can irritate your skin.
  • Apply cool compresses to the affected areas.
  • Do not scratch your skin.
  • Do not rub your skin dry after a bath or shower. Gently pat your skin dry.
  • Do not use scented soaps, detergents, or perfumes.

Medicines

  • Take or use over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take or use it as told by your health care provider. Do not stop taking or using the antibiotic even if your condition starts to improve.

Lifestyle

  • Do not stand or sit in one position for long periods of time.
  • Do not cross your legs when you sit.
  • Raise (elevate) your legs above the level of your heart when you are sitting or lying down.
  • Walk as told by your health care provider. Walking increases blood flow.
  • Wear comfortable, loose-fitting clothing. Circulation in your legs will be worse if you wear tight pants, belts, and waistbands.

General instructions

  • Change and remove any dressing as told by your health care provider, if this applies.
  • Wear compression stockings as told by your health care provider, if this applies. These stockings help to prevent blood clots and reduce swelling in your legs.
  • Wear the Unna boot as told by your health care provider, if this applies.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your condition does not improve with treatment.
  • Your condition gets worse.
  • You have signs of infection in the affected area. Watch for:
    • Swelling.
    • Tenderness.
    • Redness.
    • Soreness.
    • Warmth.
  • You have a fever.

Get help right away if:

  • You notice red streaks coming from the affected area.
  • Your bone or joint underneath the affected area becomes painful after the skin has healed.
  • The affected area turns darker.
  • You feel a deep pain in your leg or groin.
  • You are short of breath.
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