Varicose eczema

Varicose eczema is a long-term (chronic) skin condition that causes eczema symptoms on your lower legs.

It usually affects people with varicose veins or other circulation problems. Like varicose veins, it’s more common in women than men, and becomes more likely as you get older, with one in five over-70s affected.

While there’s no simple cure, there’s plenty you can do to improve your skin condition, ease symptoms and avoid flare-ups. Symptoms can also be relieved by treating the underlying cause, if known.

It’s important to treat it because, if left, it can lead to leg ulcers – open sores that take several weeks to heal.

If you have varicose eczema, the skin on your lower legs may be:

• Red and shiny or discoloured
• Swollen
• Dry, flaky and/or itchy
• Weepy
• Discoloured or hardened
• Slightly scarred, with small, white marks

Your GP will be able to diagnose varicose eczema from looking at your legs and asking about your symptoms. They may carry out an ankle brachial pressure index test to assess the blood flow in your arteries.

Your GP may refer you to a vascular consultant, a doctor who specialises in circulation problems, or to a dermatologist, a doctor who specialises in skin conditions, if:

• The blood flow in your legs is very poor
• You also have varicose veins, hardened skin or have had leg ulcers previously
• Your symptoms don’t respond to treatment

Varicose eczema is caused by weak valves in the veins in your legs. This means that fluids from your blood can leak into the surrounding tissue, which causes inflammation in your skin and eczema symptoms.

The most common cause is varicose veins, but other conditions that affect blood flow in your legs are:

• High blood pressure
• Infections, such as cellulitis
• Phlebitis – inflammation of your vein wall
• Previous deep vein thrombosis (DVT) or surgery to your legs
• Obesity

Pregnancy and age can also affect blood flow in your legs.

The aims of treatment are to improve both the condition of your skin and your circulation. Your GP can prescribe:

• Emollients – strong moisturisers that prevent water loss and help protect your skin
• Corticosteroid creams, which reduce inflammation
• Compression stockings, which stimulate circulation, reducing the pressure in your veins
• Paste bandages with zinc oxide, which reduce scaliness and protect your legs
• Wet soaks with potassium permanganate dissolved in water 
to treat weeping

You can also ease your symptoms by:

• Putting your feet up, ideally above the level of your heart, to reduce swelling
• Avoiding long periods of sitting or standing
• Protecting your legs from injury
• Avoiding things that can dry your skin out, such as soap, bubble bath, hot water and alcohol rubs
• Avoiding products containing perfumes or lanolin, which can irritate skin

Varicose eczema is common in people with varicose veins so in some cases, your GP may recommend varicose vein treatment.