Stasis dermatitis is a red and often itchy rash on the lower legs. It occurs after long-term swelling of the lower leg, usually from poor blood circulation.
What is going on in the body?
Poor blood flow from the lower legs back to the heart causes swelling of the lower legs. Over time, this creates poor circulation in the skin of the legs. The skin becomes discolored and develops a rash, typically over the shins, Sometimes weeping sores appear on the affected areas.
What are the causes and risks of the condition?
Stasis dermatitis is usually caused by poor blood flow from the veins of the legs back to the heart. It is seen most often in middle-aged people or people who are elderly.
The poor blood flow may be associated with the following conditions:
- varicose veins, which are bulging veins caused by damage to the valves within the veins
- blood clots in the veins of the lower legs or pelvis
- congestive heart failure, a condition in which a weakened heart is unable to pump blood effectively throughout the body
- kidney failure
- chronic leg swelling
The rash is often made worse by the use of improper salves or ointments. It may be aggravated by infection with bacteria or fungi.
What can be done to prevent the condition?
The most important way to prevent stasis dermatitis is to keep the legs from swelling. This can be done by exercising, wearing compression stockings to help blood circulation, and elevating the legs. These measures must be kept up for months to years.
In cases of obesity, weight loss may also be helpful. Skin salves or ointments should be used only under medical supervision because they may further irritate skin that is already irritated.
How is the condition diagnosed?
A healthcare professional can diagnose stasis dermatitis with a medical history and physical examination.
Long Term Effects
What are the long-term effects of the condition?
Stasis dermatitis can lead to leg ulcers, which may be slow to heal because of the poor circulation to the area. The ulcers may infect deeper layers of tissue, a condition known as cellulitis, which may be serious and sometimes life threatening.
What are the risks to others?
Stasis dermatitis is not contagious and poses no risk to others unless infection is present.
What are the treatments for the condition?
Treatment of stasis dermatitis includes the following:
- cool compresses with a preparation known as Burow's solution, followed by application of plain petroleum jelly
- topical hydrocortisone creams
- compression of the leg with elastic bandage wraps, compression stockings, or a compression pump
- antibiotic or antifungal medications if the skin is infected
What are the side effects of the treatments?
Hydrocortisone creams may cause thinning and increased pigmentation of the skin with prolonged use. Allergic reactions may develop to topical agents.
What happens after treatment for the condition?
Stasis dermatitis should clear up with effective treatment. However, the discolored skin rarely returns to its normal color.
How is the condition monitored?
Any new or worsening symptoms should be reported to the healthcare professional.