Venous Stasis Definition
Stasis dermatitis is a skin condition which develops in people with poor circulation. It occurs in the lower legs. In serve cases, stasis dermatitis can progress into ulcers. People over the age of 50 are most at risk for developing stasis dermatitis, especially if they are very overweight, have heart disease, or frequently sit for long periods of time. Preventing swelling in your lower legs is the best way to avoid getting stasis dermatitis. Stasis dermatitis is skin inflammation that develops in people with poor circulation. It most often occurs in the lower legs because that’s where blood collects.
When the blood collects or pools in the veins of your lower legs, the pressure on the veins increases. The increased pressure damages your capillaries, which are very small blood vessels. It allows proteins to leak into your tissues. This leakage leads to a build-up of blood cells, fluid, and proteins that causes your legs to swell. This swelling is known as peripheral edema.
Commonly, people with stasis dermatitis experience swollen legs and feet, open sores, or itchy and reddish skin. A protein that called fibrinogen may be responsible for the changes you see in your skin. When fibrinogen leaks into your tissues, your body converts it to the active form of that protein, which is called fibrin. As it leaks out, the fibrin surrounds your capillaries, forming what are known as fibrin cuffs. According to the Cleveland Clinic fibrin cuffs can prevent oxygen from entering your tissues. When your cells don’t receive enough oxygen, they can become damaged and die.
Who at Risk of having Stasis Dermatitis?
Stasis dermatitis often affects people with poor circulation. It’s common among adults over the age of 50. Women are more likely to get it than men.
A number of diseases and conditions increase your risk for developing stasis dermatitis, including:
- Varicose veins, which are swollen and enlarged veins that are visible under your skin
- High blood pressure
- Venous insufficiency that occurs when your veins have difficulty sending blood from your legs to your heart
- Congestive heart failure which occurs when your heart doesn’t pump blood efficiently
- Injury to your lower legs
- Kidney failure that occurs when your kidneys can’t remove toxins from your blood
- Numerous pregnancies
- A deep vein thrombosis in your leg, which is a blood clot in your leg vein
- Your lifestyle can affect your risk. You may be at a higher risk of getting stasis dermatitis if you don’t get enough exercise, you’re very overweight, or if you sit or stand without moving for long periods of time.
What’s Causing Stasis Dermatitis?
Poor circulation causes stasis dermatitis. Poor circulation is the result of a chronic, or long-term, condition called venous insufficiency. Venous insufficiency develops when your veins have trouble sending blood to your heart. There are one-way valves inside your leg veins that keep your blood flowing in the right direction, which is toward your heart. For people with venous insufficiency, valves become weak. It will allows blood to flow back toward the feet and pool in your legs instead of continuing to flow toward your heart. This pooling of blood is what causes stasis dermatitis. Varicose veins and congestive heart failure also can cause leg swelling and stasis dermatitis.
Most of the conditions which cause stasis dermatitis develop in people as they get older. However, there are several causes that are unrelated to age, including:
- Deep vein thrombosis in your leg
- Surgery, such as using a leg vein for bypass surgery
- Traumatic injury to your lower legs
What are the Symptoms of Stasis Dermatitis?
- Skin discoloration
You can also experience other symptoms of venous insufficiency, including:
- Calf pain
- Leg swelling
- Calf tenderness
- A dull ache or heaviness in your legs that gets worse when you stand
- In the early stages of stasis dermatitis, the skin on your legs may look thin. Moreover, your skin may also itch, but try not to scratch it. Scratching can cause the skin to crack and fluid to seep out.
- Over time, these changes become permanent. Your skin may thicken, harden, or turn dark brown. This is called lipodermatosclerosis. It may look lumpy. In the final stages of stasis dermatitis, your skin breaks down and an ulcer, or sore, forms. Ulcers from stasis dermatitis usually form on the inside of your ankle.
They are open sores that develop when the veins in your legs do not push blood back up to your heart as they should. Blood backs up in the veins, building up pressure. If left not treated, increased pressure and excess fluid in the affected area will cause an open sore to form.
Most common venous ulcers occur on the leg, above the ankle. But this type of wound can be slow to heal.
When blood pools in the veins of the lower leg, fluid and blood cells leak out into the skin and other tissues. This will cause itchy, thin skin and lead to skin changes called stasis dermatitis. This is an early sign of venous insufficiency.
Who is At Risk of venous ulcers?
Risk factors for venous ulcers can include:
- History of blood clots in the legs
- Varicose veins
- Blockage of the lymph vessels, which causes fluid to build up in the legs
- Family history of venous insufficiency
- Older age, being female, or being tall
- Sitting or standing for a long periods.
- Fracture of a long bone in the leg or other serious injuries, such as burns or muscle damage.
Care Your Wound!
We will show you how to care for your wound; read this tips:
- Ask your provider to tell you how often you need to change the dressing.
- Always keep the wound clean to prevent infection.
- Keep the dressing and the skin around it dry. Don’t get healthy tissue around the wound too wet. This can soften the health tissue, causing the wound to get bigger.
- Before applying a dressing, cleanse the wound.
- Protect the skin around the wound by keeping it clean and moisturized.
- Wear a compression stocking over the dressing.
To treat a venous ulcer, blood flow to your legs needs to be improved.
- Put your feet above your heart as often as possible.
- Wear compression stockings every day as instructed because they help prevent blood from pooling, reduce swelling, help with healing, and reduce pain.
- Take a walk or exercise every day to improve blood flow.
- Take medicines as directed to help with healing.
If ulcers DO NOT heal well, your provider will recommend certain procedures or surgery to improve blood flow through your veins.
How to Prevent Venous Ulcers?
Lifestyle changes will help prevent venous ulcers. The following measures will help improve blood flow and aid healing.
- Exercise as much as you can because staying active helps with blood flow.
- Quit smoking; it is bad for your blood vessels.
- If you have diabetes, keep your blood sugar level under control.
- Eat healthy foods and get plenty of sleep at night.
- Lose weight if you are overweight.
- Manage your blood pressure and cholesterol levels.
When to Worry?
You should see your doctor if you notice leg swelling or any symptoms of stasis dermatitis, especially if the symptoms include: pain, open wounds or ulcers, pus-like drainage or redness.
How to Diagnose Venous Stasis Dermatitis?
To diagnose stasis dermatitis, your doctor will examine the skin on your legs. Your doctor may order a venous Doppler ultrasound. This is a non-invasive test that uses sound waves to check the blood flow in your legs.
How to Treat Stasis Dermatitis?
There are several things that you can do at home to treat stasis dermatitis which include:
- Wear compression stockings
- Avoid standing and sitting for long periods of time
- Prop up your feet when sitting
- Wear loose-fitting clothing to avoid irritating your skin
- Consult your doctor about the types of skin creams and ointments you can use.
You should avoid using the following products:
- Calamine and other lotions that dry your skin
- Topical antibiotic ointments such a neomycin
- Benzocaine and other numbing medications
Your doctor may tell you to put wet bandages on your skin and prescribe topical steroid creams and ointments. If your skin becomes infected, your doctor may prescribe antibiotics. Surgery may be recommended to correct varicose veins if they become painful.
Treating conditions that cause venous insufficiency can also help control your stasis dermatitis.
What Are the Possible Long-Term Complications?
If left untreated, stasis dermatitis can cause:
- Permanent scarring
- Chronic leg ulcers
- Osteomyelitis, which is a bone infection
- A bacterial skin infection, such as abscesses or cellulitis
How to Prevent Stasis Dermatitis?
Stasis dermatitis is the result of a chronic illness, such as congestive heart failure, so it’s difficult to prevent if you’re already ill. But you can reduce your risk by preventing the swelling in your legs, or peripheral edema, that causes it. Moreover, you can lower your risk by exercising. Exercise is a great way to improve your circulation and reduce your body fat. Also, Limiting the amount of sodium you consume will help.
How does venous insufficiency cause Edema?
The veins in the legs are responsible for transporting blood up to the veins of the torso, where it is then returned to the heart. They have valves that prevent the backward flow of blood within them. Venous insufficiency is incompetence of the veins that occurs because of dilation, or enlargement, of the veins and dysfunction of their valves. This happens in those who have varicose veins. Venous insufficiency will lead to a backup of blood and increased pressure in the veins, thereby resulting in edema of the legs and feet. Edema of the legs can occur with an episode of deep vein thrombophlebitis (DVT), which is a blood clot within an inflamed vein. In this situation, the clot in the deep vein blocks the return of blood, and consequently causes increased back-pressure in the leg veins.
Venous insufficiency is a problem that localized to the legs, ankles, and feet. One leg might be more affected than the other (asymmetrical edema). In contrast, systemic diseases that are associated with fluid retention generally cause the same amount of edema in both legs, and can also cause edema and swelling elsewhere in the body. The response to therapy with diuretic drugs in patients with venous insufficiency tends to be unsatisfactory. This is because the continued pooling of fluid in the lower extremities makes it difficult for the diuretics to mobilize the edema fluid. Elevation of the legs during the day and the use of compression stockings may alleviate the edema. Some patients require surgical treatment to relieve chronic edema that is caused by venous insufficiency.
Chronic Venous Insufficiency Stages
Chronic Venous Disease (CVD) refers to other chronic conditions which caused by veins that become diseased or abnormal. These problems can include:
- Leg Swelling and Leg Pain
- Varicose veins and spider veins
- Leg skin changes
- Chronic venous insufficiency
- Leg ulcers
- Vascular Malformations
Varicose veins are dilated, thickened, elongated and twisted blood vessels that don’t control blood flow as they should. In some cases, they can be small spider veins and appear thread-like. In other cases, they may appear as large grape-like clusters under your skin.
What are the Symptoms of Chronic Venous Insufficiency Stages?
- Leg heaviness
- Aching pain
- Easily tired legs
- Swelling in the legs
- Darkening of the skin
- Numbness in the legs
- Itching or irritated rash on the legs
Treatment of Chronic Venous Insufficiency Stages
There are several procedures that can be used alone or in combination to treat varicose veins. These may include:
- Microsclerotherapy: it is similar to sclerotherapy, but uses different solutions and injection techniques. It is effective in treating spider veins.
- Sclerotherapy: a doctor injects the veins with a solution that causes the vein to close and the blood is directed through healthier veins. This is a common treatment option; however, it may require multiple treatments. It is very useful for treating small and medium sized varicose veins.
- Surgical vein stripping: the varicose vein is removed through small incisions at the groin, knee and ankle. It can treat larger varicose veins.
- Laser surgery: the heat from a laser beam destroys spider vein; however, it does not harm the skin. It is often less effective than sclerotherapy for varicose veins in the legs. It causes side effects, such as bruising, blistering and discoloration.
- Endovenous thermal ablation: a thin tube is inserted into the vein. Then, the surgeon applies heat through the tube, causing the vein to collapse. A scar results and the blood is forced through nearby healthy veins. This procedure is used to treat larger varicose veins.
- Ambulatory phlebectomy: the doctor removes larger varicose veins in the legs through a series of tiny skin punctures. Local anesthesia is used. There is little scarring.
- Coil embolization: a catheter is first places into a large vein in the leg or calf; then, a small coil is inserted into the catheter and guided into the vein; alcohol is then injected. The alcohol is an irritant to the vein lining and causes it to close and scar. Again, the blood is rerouted to nearby health veins. This procedure requires local anesthesia.
- Endoscopic perforator vein surgery: it is used for advanced varicose veins that have caused leg ulcers. The doctor makes a small incision and inserts a thin video camera to see and then close veins near the skin that lead to the deep veins in the legs.
What are the possible Complications?
Left untreated, varicose veins is expected to enlarge and worsen. As a result, the symptoms will become more severe. Additional health problems can result. This may include:
- Sores or skin ulcers.
- Severe venous insufficiency: a severe pooling of blood in the veins that slows the return of blood to the heart.
- Ongoing irritation, swelling and painful rashes on the legs.
Diet for Chronic Venous Insufficiency
Besides basic factors like staying mobile and quitting smoking, a healthy diet can be used to help manage CVI. Proper eating habits will help you maintain a healthy weight; however, it can also help through a few other means.
Keep considering the following dietary changes to help manage your risk of CVI:
- Eat more fiber
Straining during bowel movements compresses blood vessels and can lead to damage or swelling. This is one way hemorrhoids can form. Fiber ensures the smoother passage of stool that requires less strain. It is easier on your veins.
- Try chestnuts
Horse chestnut seeds are known to reduce the swelling and itching of CVI. Since herbal remedies can interact with medications, be sure to inform your doctor if you are taking or planning to take any.
- Eat more flavonoids
Flavonoids are a collection of chemicals which have been associated with certain cardiovascular benefits. The ones relevant to CVI can reduce vascular inflammation risk and improve the functions of certain blood vessels. Flavonoids can be found in numerous healthy foods such as grapes, green and white tea, citrus, kale, broccoli, peas, soy, celery, hot peppers, and red, blue, and purple berries.