Medicines for Venous eczema

What it is

Venous eczema (also called varicose or stasis eczema) is a type of eczema that develops on the lower legs, usually in older adults, and is caused by problems with the flow of blood in the leg veins. When the valves in the leg veins do not work well (as in varicose veins or after a leg clot), blood does not drain from the legs as efficiently, and the resulting increased pressure and fluid in the lower legs affects the skin, leading to eczema. It causes the skin on the lower legs (often around the ankles) to become itchy, red or discoloured, dry, scaly, swollen, and sometimes weepy or crusted; over time, the skin can become discoloured (brownish staining), hardened or tight, and, if the condition is longstanding and untreated, the affected skin is at risk of breaking down to form a leg ulcer. It is often associated with other signs of poor leg circulation, such as swelling (oedema) and varicose veins. Because venous eczema results from the underlying vein problem, managing it involves both treating the skin and improving the circulation — and doing so helps prevent complications such as ulcers.

How it is treated

Management combines caring for the skin with, importantly, addressing the underlying venous problem. For the skin, the mainstays are regular, generous use of emollients (moisturisers) to hydrate and protect the skin, and topical steroids for active, inflamed eczema (guided by a doctor), along with treating any infection. Crucially, improving the leg circulation is key: compression (such as compression stockings or bandaging, once it has been checked that the arterial circulation is adequate) helps reduce the swelling and venous pressure that drive the eczema, and is central to treatment and to preventing ulcers; elevating the legs when resting, and staying active (walking and ankle exercises help the leg muscles pump blood), also help. Where significant varicose veins are contributing, treating them can improve the eczema and reduce the risk of ulcers. Good skin care and avoiding injury to the fragile leg skin are important, as breaks can lead to ulcers. Because leg skin changes can occasionally mimic or coexist with other conditions (such as cellulitis or arterial problems), assessment is helpful. The reassuring message is that venous eczema is manageable by treating the skin and, importantly, improving the leg circulation with compression and other measures — which also helps prevent leg ulcers.