Venous eczema can be very uncomfortable. The skin around your ankles or lower legs might become itchy, red, even a bit crusty or discoloured. If you’ve noticed any of these symptoms, you are far from alone. These are the classic signs of venous eczema, which you might also know as ‘stasis eczema’ or ‘varicose eczema’. These are medical terms for eczema caused by pooling blood and increased vein pressure.
While this looks like a simple skin rash on the surface, a diagnosis of venous eczema means you’ve got a deeper issue at play. Understanding what’s going on is your first step toward feeling better, so let’s unpack everything you need to know about venous eczema management: what it is, what you need to do to feel better, and how to reach out to a professional team like ours for help.
What is Venous Eczema?
If you’ve already received a diagnosis, then you probably already understand this term. But if you’re new, exploring potential conditions, or if you just want a refresher, here it is:
Venous eczema is a skin rash that appears when your leg circulation needs attention. When the vein valves in your legs aren’t working as well as they should be, they have trouble pushing the blood back up to your heart. This means the blood starts to pool in your lower legs, increasing the pressure in the veins. Over time, this increased pressure can cause fluid to leak into the tissue of your lower leg, eventually irritating the skin and causing inflammation.
Good news! With a consistent approach to your venous eczema management, you can reduce symptoms significantly and protect your skin’s long-term health. We’ll walk you through professional treatments we offer now, along with home remedies you can use to manage lifestyle factors that contribute to the problem.
What Does Professional Venous Eczema Management Look Like?
Seeing a professional to build a venous eczema management plan is very important, so the sooner you seek treatment after noticing symptoms, the better. Since the root cause is your veins, moisturising usually isn’t enough to solve the problem.
A vein specialist like those on the Delphic Clinic team will take a look at the health of your veins and the condition of your skin to help you create a tailored plan. This will usually involve both professional in-clinic treatment and at-home management.
Generally speaking, the cornerstone of professional venous eczema management is compression therapy. We set you up with specially designed compression stockings or bandages, which provide the extra external pressure your veins need to push blood back to your heart. It might take a bit of time to get used to this feeling, but most patients find the relief from swelling and that “heavy legs” feeling is well worth the adjustment.
We may also prescribe a topical steroid cream to reduce active inflammation and relieve intense itching. With that in mind, let’s turn our attention to some at-home venous eczema management tips.
Methods for At-Home Venous Eczema Management:
While professional treatments provide the foundation, what you do at home every day makes the biggest difference in how your skin feels. Think of home care as the daily maintenance that keeps the symptoms at bay.
Moisturise.
The most important rule for home care is to keep your skin hydrated. Venous eczema makes the skin very dry and prone to cracking, which can lead to infections or ulcers if left untreated. Look for “emollients” (medical-grade moisturisers).
Unlike the scented lotions you find in a supermarket, emollients are thick, greasy, and designed to create a protective barrier on your skin. If you’re unsure what to grab, we have a few recommendations.
Apply these at least twice a day, smoothing them gently into the skin in the direction of hair growth. Never rub them in vigorously, as this can further irritate the delicate skin.
Elevate.
Another vital part of your venous eczema management at home is the “rule of elevation.” Ideally, your feet should be higher than your heart. This uses gravity to help blood flow back toward your heart, reducing pressure on the veins in your lower legs. When you’re relaxing on the sofa in the evening, use a few pillows to prop your legs up.
Adjust your lifestyle where you can.
Since venous eczema is closely tied to your circulation, your overall lifestyle plays a huge role in your recovery. You don’t have to make massive, overnight changes, but small, consistent shifts can do a lot to help you feel better long term.
One of the biggest adjustments you can make is movement. The more you move your calves, the more those muscles contract and squeeze your veins, pushing the blood upward. If you’ve got a pretty sedentary job, then taking a five-minute walk every hour is a great way to strengthen the blood flow in your lower legs. Even simple ankle flexes (rolling from heel to tip toe) movements can help to get the blood moving.
We know venous eczema management can feel overwhelming at first, but once you find a rhythm, these at-home steps become a natural part of life. You deserve to feel comfortable in your own skin, and taking these steps is the best way to protect your mobility and comfort for years to come.
Corticosteroids
Commonly known as steroid creams, these topical medications reduce the inflammation associated with varicose veins and can temporarily relieve itch and reduce redness associated with varicose vein eczema. Corticosteroids work by damping down the inflammatory response in the skin.
Within a few days of starting treatment, most people notice the itch easing, the redness fading and the skin becoming less irritated. They come in a range of strengths from mild preparations such as hydrocortisone 0.5% or 1% to more potent strengths such as betamethasone valerate, hydrocortisone butyrate and mometasone.
Types of Hydrocortisone
Not all hydrocortisone is the same. Hydrocortisone 0.5% and 1% are mild creams sold over the counter – the 1% is simply twice the strength. Hydrocortisone butyrate 0.1% sounds weaker, but the “butyrate” makes it penetrate the skin far better, so Hydrocortisone butyrate 0.1% is a potent, prescription-only steroid. Read the full name, not just the percentage, and check with your doctor or pharmacist if you’re unsure which one you have.
Venous eczema sometimes requires mild steroid creams and sometimes requires potent steroid creams. Using the right cream for your venous eczema is important.
Treatment
Ultimately, once you have developed venous eczema, you will need to consider whether more aggressive treatment is suitable for you, with techniques such as endovenous ablation and/or ultrasound-guided sclerotherapy available under the right circumstances. For some patients, we also recommend treatment with external pneumatic compression devices.
These electronic devices, known as Sequential Pneumatic Intermittent Compression (SPIC), sit over the legs like large stockings and inflate/deflate regularly to encourage blood flow back to the heart. These are useful for people with mobility issues, very sedentary lives, or people with advanced circulation issues.
Unsure of your best venous eczema management techniques? We can help!
If you’re struggling with itchy, swollen legs or want to learn more about a management plan that works for you, get in touch with our friendly team of vein specialists at Delphi Clinic today. We’d love to help.