About varicose eczema

Varicose eczema, also known as ‘gravitational eczema’ or ‘stasis eczema’, is a common skin condition which affects the lower legs of adults. If left untreated, the skin can break down to form ulcers, which are then difficult to heal. Varicose eczema is usually seen in middle-aged or older people, but it can occur in younger people if they have a genetic predisposition to varicose veins. You are most likely to develop this type of eczema if you have high blood pressure or varicose veins, or have had a deep vein thrombosis, phlebitis or cellulitis in the past.

What causes varicose eczema and what does it look like?

Varicose eczema is associated with the veins becoming less efficient and often occurs alongside varicose veins. Normally, the return of blood from the leg veins to the heart is good, but sometimes the blood moves less well and the resulting increase in pressure causes fluid to pool in the lower legs and then leak through the very small vessels in the legs, causing red-brown speckled spots to appear on the skin, which become hot and itchy. If left untreated, the skin becomes thin and fragile and looks shiny and flaky. If the affected skin breaks down, a varicose ulcer can develop, and this can be difficult to heal.

How is it treated?

Emollients (medical moisturisers) are the main first-line treatment for eczema and are necessary to keep your skin moisturised. Emollients can be bought over the counter in pharmacies and some supermarkets, or supplied on prescription. There is a wide range of emollients, which vary in their levels of greasiness. The dryer the skin, the greasier an emollient is needed. Ointments are the greasiest type of emollient.

Topical steroids can be used if the eczema is very itchy. They should be used according to the instructions of your GP.

Compression hosiery or bandages can help improve circulation, but shouldn’t be used if peripheral artery disease is present.

Bandages covered in zinc oxide (zinc paste bandages BP or Zipzoc), with an outer bandage applied to prevent mess, can be very soothing when applied to eczema. They help reduce scaliness and protect the skin from knocks and scratching.

Try to exercise or move your legs during the day. For example, flex the foot at the ankle so that the calf muscle moves to pump blood up the leg. Try to do this frequently, whether you are standing, sitting or lying down. Elevate your legs when resting – high enough for the blood to flow back up your legs. Avoid standing still or sitting with your legs down for too long.

For more information on varicose eczema, please see our Varicose eczema factsheet