Stasis Dermatitis (Varicose Eczema): Causes, Symptoms & Treatment

If the skin around your ankles and lower legs has slowly turned itchy, swollen and darker in colour, and it feels tight, dry or heavy by the end of the day, you may be dealing with stasis dermatitis. It is one of the most common skin problems in adults over 50, and it shows up often in people who stand for long hours, carry extra weight, or have varicose veins. In a hot, humid country like Malaysia, long days on your feet at work, followed by cool air-conditioned offices that dry the skin further, can make the itch and flaking feel worse.

This guide explains what stasis dermatitis (varicose eczema) is, why it happens, how to recognise it, how doctors treat it, and how to care for the fragile skin on your lower legs every day so it stays comfortable and protected.

What Is Stasis Dermatitis (Varicose Eczema)?

Stasis dermatitis and varicose eczema are two names for the same condition. You may also see it called gravitational eczema or venous eczema. The word "stasis" means something has slowed down or stopped, and that is the key to understanding it: the blood in your leg veins is not moving back up to the heart efficiently.

Normally, tiny one-way valves inside your leg veins push blood upward against gravity every time your calf muscles contract. When those valves weaken (a problem called chronic venous insufficiency), blood pools in the lower legs instead. Pressure rises inside the veins, fluid and blood cells leak out into the surrounding tissue, and the skin becomes inflamed, swollen and irritated. Over months and years this low grade inflammation produces the classic itchy, discoloured, scaly skin of stasis dermatitis.

This is why stasis dermatitis is different from other types of eczema: the trigger is not just dry skin or an allergen on the surface, it is a plumbing problem in the veins underneath. That underlying circulation issue is medical and needs a doctor to assess and manage.

Symptoms: What Stasis Dermatitis Looks and Feels Like

Symptoms usually build up slowly and affect both lower legs, though one leg can be worse. Common signs include:

• Swelling (oedema) around the ankles and lower legs, often worse at the end of the day or after standing, and better after sleep or elevating the legs.
• Itching that can be intense, plus a heavy, aching or tired feeling in the legs.
• Discolouration: the skin can look red, but over time it often turns reddish-brown, rust coloured or purple as iron from leaked blood stains the tissue.
• Dry, scaly, flaky skin that may crack, weep or crust during a flare.
• Hardening and tightness of the skin over time (the lower leg can start to feel firm or look narrowed at the ankle).
• Varicose veins, visible twisted veins, often appear alongside it.
• Open sores or ulcers, usually near the inner ankle, in more advanced cases. These are venous leg ulcers and need medical care.

On darker skin tones, the redness may be harder to see and can look more grey, brown, purple or simply darker than the surrounding skin. The changes in colour, along with swelling, itch and warmth, matter more than looking for classic "red" inflammation. Because the discolouration can be permanent, it is worth getting checked and treated early rather than waiting.

What Causes Stasis Dermatitis?

The root cause is chronic venous insufficiency: leg vein valves that no longer close properly, allowing blood to pool in the lower legs. Anything that raises pressure in the leg veins or weakens those valves increases your risk. Common causes and risk factors include:

• Varicose veins and other vein damage.
• Standing or sitting for long periods, common in jobs like retail, factory work, teaching, nursing, security and hospitality.
• Being overweight or obese, which adds pressure on the leg veins.
• A history of deep vein thrombosis (DVT) or blood clots in the legs, which can damage valves.
• Older age: vein valves naturally weaken over time, so it is most common after 50.
• Multiple pregnancies, which increase pressure on the pelvic and leg veins.
• Previous leg surgery or injury, and a family history of vein problems.
• A sedentary lifestyle, since calf muscle movement is what pumps blood back up the legs.

Stasis Dermatitis vs Cellulitis: Know the Difference

Stasis dermatitis is often confused with cellulitis (a bacterial skin infection), because both can cause red, swollen, warm lower legs. Getting the right diagnosis matters, so this table can help you and your doctor tell them apart. Always see a doctor if you are unsure, especially if you feel unwell.

Cellulitis is a medical emergency that needs prompt antibiotic treatment. If your leg becomes suddenly hot, painful, and increasingly red, or you develop a fever, see a doctor the same day.

How Stasis Dermatitis Is Treated

Because the root cause is a vein and circulation problem, treatment has two goals: improve the blood flow (medical) and calm the skin (medical plus daily care). A doctor will usually recommend a combination of the following:

• Compression therapy: medical compression stockings or bandages gently squeeze the lower legs to help blood move back up and reduce swelling. This is a core treatment and should be fitted and guided by a healthcare professional, especially to make sure your arterial circulation is healthy enough for compression.
• Leg elevation: raising the legs above heart level for periods through the day helps drain pooled fluid and reduce swelling.
• Treating the underlying vein disease: for some people a doctor may recommend procedures to close or remove faulty veins, which can improve the skin over time.
• Topical steroids (corticosteroid creams): prescribed by a doctor for short courses to bring down inflammation and itch during a flare.
• Treating infection or ulcers: if the skin is infected or an ulcer forms, the doctor will manage this with appropriate dressings, antibiotics or wound care.
• Daily moisturising (emollients): regular moisturising is a recognised part of managing the dry, itchy skin, done alongside the medical steps above.

Yagishi products are part of that daily moisturising and gentle cleansing step. They support the skin barrier and comfort. They do not treat the vein problem, so keep up with your doctor's compression and other treatment.

Daily Leg Skin Care for Stasis Dermatitis

The skin on affected lower legs is dry, thin and easily irritated, so a gentle, consistent routine matters. Here is a simple approach:

• Cleanse gently, without stripping. Skip harsh, heavily fragranced or strongly antibacterial soaps that dry the skin. Use a mild, fragrance-free, sulfate-free cleanser and lukewarm (not hot) water. A gentle goat milk cleanser such as the Yagishi Pure Goat's Milk Body Wash with Ceramide cleans while staying close to your skin's natural pH.
• Moisturise generously, twice a day. Apply a thick, fragrance-free moisturiser to the lower legs, especially right after showering while the skin is still slightly damp, to lock in water. A ceramide moisturizer like the Yagishi Body Lotion helps rebuild the barrier and reduce moisture loss. If you want to compare options, see our guide to the best body lotions for dry skin.
• Do not apply anything to open sores or ulcers. Broken skin and ulcers need medical dressings, not lotion. Leave those areas to your doctor or nurse.
• Elevate your legs when resting, and move your calves regularly if you sit or stand a lot at work.
• Try not to scratch. Scratching breaks the skin and raises the risk of infection. Moisturising, a cool compress and treating the itch with your doctor help more.

If you also have patches of eczema elsewhere, our guide to discoid eczema explains another common type and how gentle skin care helps.

How to Prevent Complications

The main complications of stasis dermatitis are skin infection and venous leg ulcers, both of which come from the combination of fragile skin, swelling and poor circulation. To lower your risk:

• Wear your compression stockings as prescribed and keep swelling down.
• Keep the skin well moisturised so it is less likely to crack and let bacteria in.
• Avoid scratching, and keep nails short and clean.
• Stay active and manage your weight to ease pressure on the leg veins.
• Elevate your legs daily and avoid standing still for very long stretches.
• Check your lower legs regularly for new sores, weeping, spreading redness or increasing pain, and act early.

When to See a Doctor Urgently

See a doctor promptly, or seek same-day care, if you notice any of these:

• An open sore or ulcer on the lower leg or ankle that will not heal.
• A sudden hot, swollen, painful leg, which could signal a blood clot (DVT) or infection.
• Spreading redness, warmth, fever or feeling unwell, possible signs of cellulitis.
• Skin that is weeping, crusting or oozing pus.
• Itch and discomfort that are not improving despite moisturising and self care.

Even without an emergency, it is worth seeing a doctor for a first proper diagnosis, because managing the vein problem early gives the skin the best chance to settle.

Frequently Asked Questions

Is varicose eczema the same as stasis dermatitis?

Yes. Varicose eczema, stasis dermatitis, gravitational eczema and venous eczema all describe the same condition: eczema on the lower legs caused by poor blood flow in the leg veins.

Will stasis dermatitis go away on its own?

It usually does not fully go away by itself, because the underlying vein problem remains. With treatment (especially compression and leg elevation) plus good skin care, symptoms can improve a lot and flares become less frequent. Managing it is ongoing rather than a one time cure.

Can moisturiser help stasis dermatitis?

Yes, as part of the plan. Regular fragrance-free moisturising keeps the dry, itchy skin more comfortable and helps protect the barrier so it is less likely to crack and get infected. It does not fix the circulation, so it works alongside medical treatment, not instead of it. Never apply moisturiser to open ulcers.

Is stasis dermatitis dangerous?

The eczema itself is not dangerous, but it is a warning sign of venous insufficiency and it can lead to complications like skin infections and venous leg ulcers, which are more serious. That is why it is worth taking seriously and getting medical care.

What is the best cream for varicose eczema?

During a flare, a doctor may prescribe a topical steroid to calm inflammation. For everyday care between flares, a thick, fragrance-free moisturiser with ceramides helps maintain the skin barrier. There is no single "best" cream for everyone, so follow your doctor's advice for the medicated part.

Does standing all day cause it?

Standing (or sitting) for long hours does not cause it directly, but it raises pressure in the leg veins and worsens pooling, which contributes to it over time. Taking breaks to move your calves, elevating your legs and wearing compression can help if your job keeps you on your feet.

Can younger people get stasis dermatitis?

It is most common after 50, but younger adults can develop it, especially with varicose veins, obesity, a history of DVT, or multiple pregnancies. If you have persistent itchy, swollen, discoloured lower legs at any age, see a doctor.

Should I use compression stockings?

Compression stockings are a core treatment, but they must be the right type and pressure for you, and your arterial circulation should be checked first. Get them recommended and fitted through a healthcare professional rather than guessing.

Key Takeaways

• Stasis dermatitis and varicose eczema are the same lower-leg condition, caused by poor vein circulation (venous insufficiency), not just dry skin.
• Look for swelling, itch, heaviness, and brown, red or purple discolouration around the ankles, sometimes with hardening skin or ulcers.
• It is often confused with cellulitis; sudden hot, painful, one-sided redness with fever needs urgent care.
• Treatment is medical: compression, leg elevation, treating the veins, and topical steroids for flares, plus daily gentle skin care.
• Care for the skin daily by cleansing gently without stripping and moisturising the lower legs twice a day, but never apply products to open ulcers.
• See a doctor for diagnosis, and urgently for non-healing sores, spreading redness, fever or a sudden swollen painful leg.

Disclaimer: This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Stasis dermatitis and varicose eczema involve an underlying circulation problem that should be assessed by a doctor. Yagishi products are daily skin care to support comfort and the skin barrier, not a treatment for venous disease, and should not be applied to open wounds or ulcers. Always consult a qualified healthcare professional about your symptoms and before starting any treatment.