Varicose eczema

Introduction 

Varicose eczema is a long-term skin condition that affects the lower legs and is common in people with varicose veins.

It is also known as venous eczema, gravitational eczema and stasis eczema.

Signs and symptoms

Like all types of eczema, the affected skin becomes:

• 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 may become swollen, especially towards 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:

• brown discolouration of the skin
• red, tender and tight skin that can eventually become hardened (lipodermatosclerosis)
• small, white scars (atrophie blanche)
• pain
• eczema affecting other parts of the body

Left untreated, leg ulcers can develop. These are long-lasting wounds that form where the skin has become damaged.

When to seek medical advice

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

What causes varicose eczema? 

Varicose eczema is caused by increased pressure in the leg veins.

When the small valves in the veins stop working properly, it's difficult for blood to be pushed against gravity and it can leak backwards.

This increases the pressure in the veins, which can cause fluid to leak into the surrounding tissue. It is thought that varicose eczema may develop as a result of the immune system reacting to this fluid.

Varicose eczema is more common in people with varicose veins, as these are also often a sign that the leg veins aren’t working properly.

How varicose eczema is treated

Varicose eczema tends to be a long-term problem. However, treatments are available to help keep it under control.

For most people, treatment involves a combination of:

• self-help measures – including ways to improve your circulation, such as keeping active and frequently raising your legs
• emollients – moisturisers applied to the skin to stop it becoming dry)
• topical corticosteroids – ointments and creams applied to the skin to help treat the eczema and relieve symptoms
• compression stockings – specially designed stockings, usually worn every day, that steadily squeeze your legs and help to improve your circulation

If these treatments don’t help, your GP may refer you to a dermatologist (skin specialist) in case there is another cause for your symptoms or if they are concerned you may also have a type of eczema called contact dermatitis.

If you also have varicose veins, you may be referred to a vascular specialist (a doctor or surgeon specialising in conditions affecting the blood vessels) who can talk to you about the treatment options for varicose veins.

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 occurs when the body comes into contact with a particular substance
• discoid eczema – a type of eczema that occurs in circular or oval patches on the skin

• discoid eczema 
• Atopic eczema
• contact dermatitis