Varicose Veins/Venous Eczema: Symptoms and Treatments

Varicose eczema: what symptoms?

A patch of red, rough skin appears on the lower legusually above single (not on thighs or knees). This plate has a tendency to peel. Scabs form and above all “the person feels the immediate need to scratch”, explains Dr. Nicolas Néaume, vascular physician and general secretary of the French Society of Phlebology.

“It’s not eczema like any other. It has nothing to do with atopic dermatitis or an allergy,” he specifies. The problem is actuallyvenous origin

Eczema on the ankle, leg: what is the cause?

In this particular case, the eczema is linked to venous insufficiency. The veins in the lower extremities are no longer tonic enough to return blood to the heart. Stagnation in the legs causes the blood to exert too much pressure on the wall of the artery. This expands and over time forms a varicose vein

“The accumulation of blood in the leg increases the pressure in the veins, but also in the skin. An inflammatory process occurs, which explains the urge to scratch,” says the vascular doctor.

In fact, the disease progresses gradually and in several stages. Varicose eczema manifests at stage C4, according to a classification used by vascular physicians:

  • stage C0: the person complains of heaviness in the legs.
  • stage C1: small blood vessels become visible on the surface of the skin.
  • Stage C2: A varicose vein is diagnosed on ultrasound.
  • stage C3: a edema forms: the leg swells
  • Stage C4: The skin changes appearance. It is at this stage that varicose eczema appears, as well as other trophic conditions, that is, related tovenous insufficiencyas the ocher dermatitis† We also talk about stasis dermatitis
  • Stage C5: An ulcer, called an ulcer, forms. At this point she manages to heal.
  • stage C6: thevaricose ulcer can no longer heal, the wound becomes chronic.

Some people with venous insufficiency will only experience heaviness in the legs. But others, in the absence of treatment, will more or less quickly progress to varicose veins or even varicose eczema. “The problem is that we don’t know which patients will reach this advanced stage. Most likely, these are people with a genetic predisposition. Obesity, physical inactivity and occupations that require standing more than six hours a day, such as hairdressers, pharmacists or flight attendants, are aggravating factors.notes Dr. Néaume.

Who to consult?

A vascular doctor (or angiologist) places the diagnosis varicose veinsafter performing a doppler echo† This examination makes it possible to measure the blood flow in the leg, thanks to an ultrasound probe. Sometimes a dermatologist, finding eczema in the leg, refers his patient to a vascular doctor to confirm the venous origin of the problem.

A cortisone cream against inflammation

a cream topical corticosteroids, prescribed by a doctor, will help calm the inflammation. It is applied directly to the skin daily. Thanks to its action, redness and itching will gradually fade. “The eczema will subside within a few months, the time the skin cells regenerate”, explains the vascular doctor. However, the problem will not really be solved.

Treating varicose veins

The basic treatment for varicose veins consists of removing the varicose vein. Intervention is necessary because: “a varicose vein never goes away on its own. It is better to treat it, especially if the patient is at the stage of trophic disorders”, Dr. Néaume insists.

the stripping, a surgical procedure that consists of pulling out the vein, is gradually being phased out. To destroy the diseased vein, the vascular doctor now has two techniques: laser or radio frequency† In both cases, the procedure takes place on an outpatient basis (no hospitalization) and under local anaesthetic: “No more incision is needed. The probe is inserted into the vein with a needle. The patient returns home the same day and on his own feet, without the need for a work stoppage. †

However, venous insufficiency remains a chronic disease. Varicose veins can recur on the same leg or on the other leg. Monitoring is therefore necessary, usually with an ultrasound doppler per year.

What is the risk of complications in the absence of treatment?

Varicose eczema that is left untreated will not heal on its own. On the contrary, it threatens to evolve unfavorably into other pathologies:

  • Ocher dermatitis is part of the trophic disorders (stage C4) that can affect the skin in a person suffering from venous insufficiency. “Normally the skin of the calf turns brown and forms a kind of sock. The skin is actually tattooed by the iron of the blood that stagnates in the leg. This stain will not go away even if the varicose vein is removed. We have no treatment to make it go away.” emphasizes Dr. neaume.
  • varicose ulcer is another possible complication. Broken skin can become infected. This one wound does not heal easily and requires special care. It sometimes happens that a contact dermatitis is added to the ulcer. In this case, the reaction is due to an allergy to the bandage applied to the wound or to the glue holding it together.

What possible prevention?

For prevent the return of varicose veins, to reduce the risk of varicose eczema, you should contact us if you have the slightest doubt. This is the only way to intervene as early as possible. “You should consult if the feeling of heavy legs returns, or in case of cramps, edema and itching”, advises Dr. Néaume.

In prevention, exercise is essential, combined with proper hydration. “Man was made for walking. Staying still, standing, or sitting keeps the blood from getting enough dynamic flow to rise correctly to the heart. Walking at least 30 minutes a day will facilitate venous return.” the vascular doctor remembers. This regular exercise also helps you lose weight, another important point to relieve your legs.

For people who are forced to stand for several hours a day without moving, wearing socks or compression stockings will again venous return and relieves the feeling of a heavy leg.

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