Varicose eczema is a serious and common condition
and I am going to tell you seven essential facts about it that you should know.
Number 1 — varicose eczema is in fact a misnomer and it is very misleading. This condition
is neither an eczema — a skin problem- nor is it caused by varicose veins. The term arose
before we fully understood the true nature of the problem. So varicose eczema can develop
in the absence of visible varicose veins and unlike skin problems it should not be managed
solely by dermatologists. Other misleading synonyms are gravitational eczema and stasis
eczema suggesting that gravity somehow preferentially adversely affects some people — clearly ridiculous
— or that blood is stagnant in some people — equally ridiculous.
Number 2 — the true nature of varicose eczema is a malfunction of the veins of the legs
causing inflammation and scarring of the skin and underlying fat layer. A better medical
term is lipodermatosclerosis, certainly vein specialists prefer this term –often abbreviated
to LDS. But it is a mouthful so you can see why non-specialists such as GPs as well as
the general public prefer the term varicose eczema.
Number 3 — varicose eczema should not be treated with steroid creams except for very
brief periods when itch and pain are very troublesome. Longer term use of steroids will
help the relieve symptoms and the area will look and feel better but the use of steroids
will thin the skin over time making it more vulnerable to further damage.
Number 4 — medical stockings or socks help normalise the function of the leg veins and
therefore wearing them will go a long way to improving the varicose eczema. Ideally
they should be put on first thing in the morning before getting out of bed and they should
be taken off last thing at night. Number 5 – a duplex ultrasound scan is essential
in all cases of varicose eczema. It will detect the exact vein abnormality and the results
of the scan will form the basis of the plan for curative treatment.
Number 6 — over half of all cases of varicose eczema are caused by a malfunction in the
superficial veins of the leg- veins which lie deep to the skin but superficial to the
leg muscles. These problems in the superficial veins can nearly always be cured by non-invasive
procedures under local anaesthetic on a walk in walk out basis — procedures such as laser,
radiofrequency, foam sclerotherapy or superglue. Finally, Number 7 — varicose eczema should
be taken seriously. It is a warning sign that the skin is being damaged by inflammation
and if neglected and not treated, varicose eczema will progress to a leg ulcer.
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