Stasis dermatitis
Why do I have stasis dermatitis?
Stasis dermatitis (also called venous eczema, or varicose eczema) is common in older adults. It shows up as dry, itchy, flaky skin on the shins, ankles, and tops of the feet.
As we age, the veins in our legs weaken and become leaky, making it harder to pump blood back to the heart. This causes fluid to pool in the legs (swelling). Swelling stretches the skin and creates tiny gaps that let irritants in, leading to eczema.
Treatment focuses on:
Compression and leg elevation – to reduce swelling.
Moisturizing – to protect and repair the skin.
Topical medicines – to calm redness and itching.
Stasis dermatitis is a chronic condition that can flare. Triggers include dry weather, cold air, harsh soaps, fragrances, stress, poor diet, or allergens like dust or pet dander. Illness can also worsen it.
How do I treat stasis dermatitis?
Compression stockings – Wear daily to reduce swelling.
Leg elevation – Keep feet above heart level while sleeping. Slip a pillow under your fitted sheet so it stays in place.
Exercise – Walking or swimming helps improve circulation.
Hydrocortisone ointment (not cream) twice daily calms redness and irritation.
For stubborn areas, apply hydrocortisone and wrap with plastic wrap for 30 minutes to boost absorption.
⚠️ Overuse of steroids can cause thinning skin, stretch marks, or easy bruising.
Moisturizing:
Apply moisturizer every morning, night, and as often as needed.
Thick ointments like Vaseline or Aquaphor are most effective but greasy.
If you prefer lighter options, use CeraVe moisturizing cream or Vanicream moisturizing cream—they hydrate well without a sticky feel.
What do I do if my legs have open sores or are weeping?
Vinegar soaks: Mix 2 tablespoons white vinegar with 2 cups warm water. Soak a washcloth or paper towel in the solution and place it on the affected skin for 10–15 minutes daily.
Moisturize and protect: After soaking, gently pat dry and apply Vaseline over the sores to keep the skin moist and help healing.
How do I prevent stasis dermatitis?
Moisturize daily—morning, night, and as needed. Thick ointments like Vaseline or Aquaphor work best; creams such as CeraVe or Vanicream are good for daily use without a greasy feel.
Wear compression stockings daily.
Elevate your legs at night (feet above heart level). Use a pillow under the fitted sheet to keep it in place.
Exercise regularly, including walking or swimming.
Go fragrance-free for 1 month (continue if it helps): use fragrance-free washes, shampoos, moisturizers, and laundry products to reduce irritation.
Additional tips and tricks for stasis dermatitis:
Not every tip works for everyone, but through trial and error, you may find these strategies helpful:
Cool-mist humidifier: Dry climates and indoor heating reduce humidity and dry out skin. Run a cool-mist humidifier overnight in the bedroom or in main rooms during the day.
Antibiotic ointment or honey: Apply over-the-counter antibiotic ointment or Manuka honey twice daily to areas of broken skin. Prescription mupirocin works better than non-prescription options. If skin is red, oozing, or worsening, you may need a prescription oral antibiotic.
Antihistamines for itch: These can sometimes improve sleep and reduce scratching.
Cetirizine (Zyrtec) in the morning and evening
Diphenhydramine (Benadryl) about 30 minutes before bedtime
Bleach baths: Adding diluted bleach to bathwater makes it similar to a chlorinated pool. This reduces bacterial overgrowth and often decreases itching, especially before bedtime. Safe for all ages and skin types.
Avoid irritants and triggers:
Rough or scratchy clothing (especially wool)
Harsh soaps or detergents
Tobacco smoke
Stress (emotional, physical, or relationship stress often triggers flares)
What if my stasis dermatitis isn’t getting better?
Most people improve with the steps above. If over-the-counter treatments aren’t enough, stronger prescription topical medications or custom compression stockings may help. Consult a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
DISCLAIMER
The statements expressed and content of this website are not intended to be a substitute for professional medical advice. Readers should seek their own professional counsel for any medical condition or before starting or altering any treatment, exercise, or dietary plan. Please see our full disclaimer here.