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December 12, 2025Many people, especially those over 50, suddenly notice that the veins in their lower legs appear very prominent, almost as if they are “popping out.” Others may observe redness in the skin or discoloration resembling bruises, without recalling any trauma. It is also possible to develop intense itching and flaking of the skin.
These symptoms can indicate a form of dermatitis related to blood circulation. This condition is called stasis dermatitis or stasis eczema and is most commonly seen around the ankles and lower legs. Essentially, it is an inflammation caused by insufficiency in the veins located close to the skin.
As Dr. Markos Michelakis, Dermatologist and Venereologist (Aesthetic Dermatology – Dermatologic Surgery), explains, stasis dermatitis usually appears on the legs because blood tends to accumulate there. “When blood ‘pools’ in the leg veins, pressure inside them increases as they struggle to push blood back to the heart, which is their normal function. This effort causes fluid to leak from the veins into surrounding tissues and damages nearby capillaries.”
These changes are responsible for the characteristic symptoms of dermatitis. In its early stages, symptoms may include swelling (edema), especially around the ankles (which improves when lying down and worsens with standing), persistent redness that gradually darkens, peeling and dryness, itching, varicose veins, and/or pain that intensifies when standing.
As the condition progresses, stasis dermatitis can cause fluid leakage (exudate), persistent ulcers (ranging from small skin cracks to large wounds), skin infections (e.g., cellulitis, fungal infections), and scarring after wounds heal.
“These symptoms are usually temporary if proper treatment is followed,” Dr. Michelakis notes. However, when stasis dermatitis becomes chronic, permanent skin changes may develop, including:
Lipodermatosclerosis: The skin thickens, becomes firm, and may turn dark brown due to the formation of scar tissue in fat and other tissues.
Atrophie blanche (white atrophy): The skin thins, appearing patchy white, with surrounding capillaries.
Lichenification: The skin develops a “mosaic” appearance as plaques merge. Lichenification is linked to chronic itching and scratching.
Stasis dermatitis is more common in women than men and is usually caused by conditions that slow the return of blood from the legs to the heart. This may be due to prolonged standing, a sedentary lifestyle (e.g., office workers who do not exercise), prolonged immobility (e.g., after injury or surgery), pregnancy (more common in women with multiple pregnancies), or difficulty walking.
Certain health conditions also increase the risk, including obesity, hypertension, varicose veins, blood clots in leg veins, kidney failure, and congestive heart failure. Stasis dermatitis is also more frequent in patients with poorly controlled diabetes.
Treatment primarily involves addressing the underlying cause when possible. For example, obese patients should lose weight, diabetics should manage blood sugar, and hypertensive patients should control their blood pressure. Surgical correction of varicose veins may also be required.
It is crucial that patients avoid scratching the affected skin, no matter how intense the itching, as scratching can break the skin, cause exudate, and increase the risk of infection.
Patients should also avoid sitting or standing for long periods, elevate their legs above heart level several times a day (e.g., lying on a couch with legs on the armrest or sleeping with legs on pillows), and wear graduated compression stockings if prescribed by their doctor. Loose clothing that does not irritate the skin can also help.
“Depending on the case, the dermatologist may prescribe topical ointments and creams to treat stasis dermatitis,” Dr. Michelakis adds. “These products combat dryness, provide topical antibiotics for secondary infections, relieve itching, and may include corticosteroid creams. In any case, the patient must also address the underlying venous insufficiency, so collaboration with a vascular specialist is often necessary.”
If left untreated, stasis dermatitis can lead to chronic lower leg ulcers, osteomyelitis (a serious bone infection), skin abscesses, and permanent scars.
Regarding prevention, “It is not always easy because stasis dermatitis is often a result of chronic health problems such as congestive heart failure,” the specialist emphasizes. “However, even losing a few kilograms and exercising regularly (e.g., daily walking) can improve blood circulation and reduce body fat. Office workers should take frequent breaks (at least once per hour). Moisturizing the skin of the legs is essential, and reducing salt intake may also help.”
aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/stasis-dermatitis
https://www.healthline.com/health/stasis-dermatitis-and-ulcers
https://www.webmd.com/skin-problems-and-treatments/eczema/venous-stasis-dermatitis
https://www.aad.org/public/diseases/eczema/types/stasis-dermatitis/self-care
mayoclinic.org/diseases-conditions/edema/symptoms-causes/syc-20366493
https://nationaleczema.org/eczema/types-of-eczema/stasis-dermatitis/
