Stasis Dermatitis: Why Won’t My Legs Get Better?
Stasis dermatitis is a common condition of one or both of the legs which can be acute or chronic. It affects 67% of people 50 years of age and older. This condition affects 15 to 20 million people in the United States annually. It causes itching, red to brown discoloration of the skin, swelling, and scaling with reddened patches. It can affect the legs from the foot to the knee. If it is left untreated, it can lead to blistering, oozing, cracking, and ulceration with infection. It can also lead to other chronic skin conditions such as chronic contact dermatitis and eczema.
The main cause of stasis dermatitis is a condition called venous insufficiency. What this means is that as we get older, the valves in our blood vessels don’t work as well as they did when we were younger. This is caused by aging, ineffective pumping of the heart, blood clots, surgery, trauma, or a combination of these. Because of this, the blood in our legs tends to pool and there is a leakage of fluid into the skin surrounding the blood vessels. This decreases the amount of oxygen that gets into the cells, and therefore the cells become damaged. White blood cells can also become trapped around the blood vessels and cause inflammation and scarring of the skin.
There are other risk factors that can contribute to the development of stasis dermatitis. These include: being female, elderly, varicose veins, congestive heart failure, high blood pressure, kidney failure, and obesity. While you can’t change your gender or your age, managing these other factors can decrease the possibility of developing stasis dermatitis and the problems that go along with this condition.
The treatment of stasis dermatitis is ongoing due to the chronic and recurrent nature of the condition. Elevation of the legs when seated helps fluid move from the legs back toward the heart. The use of compression stockings and elastic wraps on a daily basis do the same thing, but more effectively. Also, increasing your physical activity helps to increase circulation in your legs. Occasionally, medicated wraps need to be used to treat the inflammation and swelling, especially if the skin is blistering, oozing, and cracking. When ulcerations occur, specialized wound care may be necessary. Topical steroid creams and ointments or non-steroidal creams may be used to help with the itching and irritation.
Stasis dermatitis is a treatable condition. The main considerations are consistency and compliance. If you adhere to the use of elevation of the legs, use of the medications and compression stockings when needed, and follow-up with your medical provider, you should be able to manage the skin on your legs. Adherence to treatments for your other medical conditions is also important to obtaining the best possible outcome.