Month: August 2022

Stasis dermatitis, also called gravitational dermatitis, venous eczema, and venous stasis dermatitis, happens when there is venous insufficiency, or poor circulation in the lower legs.  Venous insufficiency happens when the valves in leg veins that help push blood back to the heart weaken and leak fluid. This allows water and blood cells to pool in the lower legs.

Venous insufficiency can be caused by aging, but it can also signal a serious underlying medical condition, such as heart or kidney disease.

Who gets stasis dermatitis and why?

Stasis dermatitis most frequently affects people with poor circulation, usually people over the age of 50. Women are more likely to get it than men.

Not everyone with venous insufficiency develops stasis dermatitis, but poor circulation increases risk.

Other risk factors include:

• varicose veins
• high blood pressure
• obesity, vein surgeries
• multiple pregnancies
• a history of blood clots in the legs
• congestive heart failure
• kidney failure
• certain lifestyle factors such as getting little physical activity or having a job that involves hours of sitting or standing

What are symptoms of stasis dermatitis?

Stasis dermatitis can affect the feet or lower legs on one or both sides. It can appear on other parts of the body, but this is uncommon.

Besides ankle swelling, early signs include orange-brown speckles of discoloration sometimes called cayenne pepper spots. These spots develop when pressure and swelling cause capillaries, the smallest blood vessels, to burst.

Other symptoms of stasis dermatitis include:

• redness in lighter skin tones that may appear brown, purple, gray or ashen in darker skin tones
• itching
• scaling
• dryness
• a heavy or achy feeling after long periods of sitting or standing
• increased risk of developing contact dermatitis

If stasis dermatitis goes untreated, swelling can move beyond the ankle to the calf and skin can become shiny. Open sores, called venous ulcers, can form on the lower legs and tops of feet. These ulcers can bleed, ooze and leave scars once they’ve healed.

Severe stasis dermatitis can cause permanent skin changes, including thickening, hardening, darkening or a bumpy, cobblestone-like appearance.

How is stasis dermatitis treated?

Treatment for stasis dermatitis includes identifying and treating its root cause as well as controlling its various symptoms.

Physicians typically diagnose stasis dermatitis by examining the skin but may also run tests to check blood flow and to help identify the root causes of poor circulation.

Treatment can include:

• compression stockings to reduce swelling
• elevating legs above the heart every two hours to reduce swelling
• avoiding foods high in salt
• supplemental vitamin C and rutin, a plant pigment and antioxidant, to help keep blood vessels flexible and healthy
• for red or darker-colored, itchy skin, dermatologists may prescribe a topical corticosteroid to calm inflammation
• topical or oral antibiotic if skin is infected

What do the ecz-perts have to say?

“Recognizing stasis dermatitis early may help reveal a life-threatening condition and prevent the skin condition from progressing from swelling, redness and itching to open, oozing ulcerations that are vulnerable to infection,” notes Dr. Jenny Murase, associate clinical professor of dermatology at the University of California, San Francisco.

Who gets seborrheic dermatitis and why?

Seborrheic dermatitis can affect people of any age, though it’s most common in infants and adults between the ages of 30 and 60. Among adults and teens, the condition is more common in males.

In infants, the condition usually clears on its own and doesn’t come back. In adults, however, seborrheic dermatitis usually follows a pattern of flaring and clearing that can last for years.

An inflammatory reaction to excess Malassezia yeast, an organism that normally lives on the skin’s surface, is the likely cause of seborrheic dermatitis. The Malessezia overgrows and the immune system seems to overreact to it, leading to an inflammatory response that results in skin changes.

Certain medical conditions can increase people’s risk of developing seborrheic dermatitis, including psoriasis, HIV, acne, rosacea, Parkinson’s disease, epilepsy, alcoholism, depression, eating disorders and recovery from a stroke or heart attack.

Common triggers for seborrheic dermatitis include:

• stress
• hormonal changes or illness
• harsh detergents, solvents, chemicals and soaps
• cold, dry weather
• some medications, including psoralen, interferon and lithium

What are the symptoms of seborrheic dermatitis?

Infants with seborrheic dermatitis most often have a form called cradle cap, which appears on their scalps as scaly, greasy patches. They can also develop seborrheic dermatitis on their bottoms, where it can be mistaken for diaper rash, a form of contact dermatitis.

In teens and adults, seborrheic dermatitis forms where skin is oilier. In addition to the scalp, redness, swelling and greasy scaling can develop on the sides of the nose and in and around the eyebrows, on the mid-chest, upper back and in the armpits and groin area.

How is seborrheic dermatitis treated?

Following a skincare routine can help keep symptoms under control. Wash affected areas daily with a gentle, zinc-containing cleanser (2% zinc pyrithione) and follow up with a moisturizer. Healthy lifestyle habits, like managing stress and getting plenty of sleep, can also improve skin.

Treatment for seborrheic dermatitis is aimed at removing scales, reducing itch and calming the inflammation that’s causing redness and swelling.

In infants, using an emollient such as mineral oil or petroleum jelly to gently loosen scales is usually all that’s needed. Care can be more complicated for adults, who often need ongoing treatment and self-care to help prevent flare-ups.

Dermatologists usually begin treating mild cases with a topical antifungal cream or medicated shampoo, such as a prescription anti-fungal shampoo or over-the-counter dandruff product.

If the condition is more severe, intermittent use of a topical corticosteroid or calcineurin inhibitor may be required.

What do the ecz-perts have to say?

“Seborrheic dermatitis isn’t contagious and is not an allergy, although some allergies can mimic it,” said Dr. Peter Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University’s Feinberg School of Medicine. A correct diagnosis, he added, requires careful evaluation by a dermatologist.

Seborrheic dermatitis can also overlap with atopic dermatitis, especially in infants. “We see this overlap in young adults, as well, usually in those with more severe atopic dermatitis,” Lio said. They can develop a condition that some call head and neck dermatitis that seems to be very closely related to seborrheic dermatitis and is treated similarly.”