Stasis dermatitis is skin irritation and breakdown due to the fluid accumulating under the skin.
Stasis dermatitis can be due to venous insufficiency (vein valve malfunction), heart failure, and other conditions that cause swelling, usually in the legs, but sometimes in other areas as well.
When seen in younger people, it is usually due to surgery, trauma, or a history of deep vein blood clots or repeated infections.
Swelling (edema) is usually present, but in chronic cases of stasis dermatitis, there is gradual tightening and scarring of the skin leading to hard and sometimes tender areas.
In severe cases of stasis dermatitis, the skin breaks down with oozing, crusted areas and ulceration. White, shiny scars are often left after healing.
In long-standing cases, there may be significant thickening and darkening of the skin from rubbing.
If the stasis dermatitis is mild and clearly related to leg swelling, which is minimal upon arising in the morning but worse after a day of standing, simple measures can assist the veins and reduce the chance of progression of the disease, requiring medical care.
These steps include:
- Wearing elastic support hose (worn to at least knee height) should be put on in the morning upon arising. Many non-prescription and attractive styles are available for men and women. Although they are initially tight, discomfort is less as the swelling is controlled.
- Raising the legs above the level of the heart when sitting reduces fluid buildup.
- Applying 1% hydrocortisone cream (available over the counter) to the red, itchy areas twice daily.
- Practicing a proper skin-care routine, which includes using only mild soaps or cleansers and applying a moisturizer (such as petrolatum) after each bath on the legs.
- Avoiding the use of other creams or topical antibiotics, as allergic reactions are common.
Evidence of infection includes pain, fever, increased swelling and redness, or open areas accompanied by pus.
Ulcers or sores require medical attention.
Stronger corticosteroid creams may be used for short periods (not prolonged periods, however, due to the possible thinning of the skin from chronic use). Infection may be treated with oral or intravenous antibiotics. Oral medications may be used to control heart failure or reduce the presence of fluid.