Venous stasis, also called stasis dermatitis, venous eczema, or gravitational dermatitis, is a chronic skin condition caused by poor blood circulation in the legs. It is most commonly seen in older adults and individuals with chronic venous insufficiency (CVI), a condition in which the veins struggle to return blood to the heart.

This condition can cause discomfort, discoloration, swelling, and, in severe cases, open wounds or ulcers. Although it is not curable, early diagnosis and proper treatment can help manage symptoms and prevent complications.

Recognizing Symptoms

Venous stasis symptoms typically develop slowly and worsen over time. The earliest signs often appear near the lower legs and ankles. Common early symptoms include:

  • Itching or tingling around the ankles

  • Dry, flaky, or reddish skin

  • Swelling that worsens throughout the day

  • Skin irritation or sensitivity

  • Mild pain or heaviness in the legs

As the condition progresses, more severe symptoms may appear, such as:

  • Hyperpigmentation (dark brown discoloration of the skin)

  • Scaly, thickened patches

  • Leaking fluid or weeping skin

  • Hardened, tight skin texture

  • Open sores or venous ulcers

  • Shrinking or thinning of the calves

These symptoms may affect one or both legs, depending on the severity of the underlying venous issues.

What Causes It?

Venous stasis results from chronic venous insufficiency, where blood collects or “pools” in the lower limbs due to weakened or damaged vein valves. These valves normally prevent blood from flowing backward, but when they fail, pressure builds in the veins and leads to fluid leakage into surrounding tissue.

Other contributing factors and conditions include:

  • Deep vein thrombosis (DVT) – blood clots that damage vein structure

  • Varicose veins

  • Long periods of standing or sitting

  • Previous leg surgeries or injuries

  • Congestive heart failure

  • High blood pressure

  • Obesity

  • Pregnancy

  • Chronic kidney disease

  • Family history of vein disease

  • Cellulitis or other skin infections

Over time, this chronic pressure and inflammation damage the skin and increase the risk of ulcers and infections.

Risk Factors

Certain individuals are more likely to develop venous stasis, especially those with conditions or lifestyles that impact blood flow. Key risk factors include:

  • Age over 50

  • Female gender (due to hormonal changes and pregnancy)

  • Sedentary lifestyle

  • History of blood clots or leg trauma

  • Smoking

  • High BMI or obesity

  • High blood pressure or cardiovascular issues

  • Family history of varicose veins or vein disease

Prolonged sitting or standing without movement—common in many jobs—can significantly contribute to venous problems.

Diagnosis Process

Diagnosing venous stasis typically involves a combination of:

  • Physical examination – to observe skin texture, discoloration, and swelling

  • Medical history review – assessing past leg injuries, surgeries, heart issues, and lifestyle habits

  • Imaging tests, such as:

    • Ultrasound – to evaluate blood flow and detect valve dysfunction

    • CT or MRI scans – if deeper vein assessment is needed

  • Allergy testing – to rule out contact dermatitis or other skin-related conditions

  • Blood tests – to check for signs of infection or inflammation

The diagnosis is mainly clinical, but tests help confirm the severity and rule out other causes like cellulitis or arterial ulcers.

Managing Swelling

Swelling is one of the most prominent and troublesome symptoms of venous stasis. Management usually includes:

  • Compression therapy:

    • Compression stockings or bandages improve circulation and reduce swelling

    • Stockings should be worn during the day and removed at night

  • Leg elevation:

    • Elevate legs above heart level for 15 minutes every 2 hours

  • Physical activity:

    • Walking and gentle exercises stimulate blood flow

  • Anti-inflammatory creams:

    • Topical corticosteroids may be prescribed for inflammation and itching

  • Skin care routines:

    • Regular moisturizing prevents dryness and scaling

    • Avoid harsh soaps or irritants

Proper compression use is essential and may require professional guidance for sizing and application.

Improving Blood Flow

Enhancing blood circulation is central to managing and slowing disease progression. Techniques include:

  • Continued use of compression garments

  • Daily physical activity, especially walking or stretching

  • Calf strengthening exercises – such as ankle pumps and toe raises

  • Avoiding prolonged sitting or standing

  • Weight loss, if applicable

Unna boots may be prescribed for more advanced cases. These medicated compression bandages are infused with calamine and zinc oxide, offering support and promoting wound healing.

Medications

A variety of medications may be used to treat different symptoms associated with venous stasis:

  • Topical corticosteroids – reduce inflammation and itchiness

  • Moisturizers and barrier creams – improve skin hydration and protect from further damage

  • Antihistamines – reduce itchiness caused by histamine response

  • Analgesics – like acetaminophen or NSAIDs to relieve pain

  • Antibiotics – in cases of infection

  • Blood thinners – if there's a risk or history of clots

It's important to follow dosage instructions carefully and consult your provider about possible side effects.

Intense Pulsed Light Therapy

Intense pulsed light (IPL) therapy is a cosmetic procedure used in some cases to treat discoloration caused by chronic venous stasis. The treatment involves:

  • Use of laser light at controlled wavelengths

  • Targeting pigment changes and damaged blood vessels

  • Typically 3–6 sessions required

  • Non-invasive and minimal downtime

While not medically necessary, it can help improve the skin’s appearance and boost self-confidence for some patients.

Surgical and Minimally Invasive Options

If conservative treatments aren’t effective, some individuals may benefit from procedures that address underlying venous insufficiency:

  • Sclerotherapy – injection of a solution to collapse dysfunctional veins

  • Phlebectomy – physical removal of small varicose veins through minor incisions

  • Endovenous ablation – using heat via laser or radiofrequency to close damaged veins

  • SEPS (subfascial endoscopic perforator surgery) – clips off faulty perforator veins

  • Venous stenting – to hold open narrowed or blocked veins

  • Thrombolytic therapy – breaks up existing clots

These options vary in invasiveness and are typically outpatient procedures.

Preventive Strategies

While venous stasis cannot be completely prevented, especially in individuals with existing vein problems, there are steps to reduce the risk or delay progression:

  • Exercise regularly to promote circulation

  • Avoid prolonged inactivity, especially sitting or standing

  • Elevate legs frequently

  • Maintain a healthy weight

  • Use compression garments proactively

  • Manage blood pressure, cholesterol, and diabetes

  • Avoid smoking

  • Wear supportive footwear

Simple lifestyle changes—like taking walking breaks and stretching—can go a long way in maintaining vein health.

Potential Complications

If left untreated, venous stasis can lead to several complications:

  • Venous ulcers – open, slow-healing wounds

  • Cellulitis – bacterial infection of the skin

  • Contact dermatitis – allergic reactions from medications or dressings

  • Skin fibrosis – thickening and hardening of the skin

  • Superinfections – due to bacteria entering through skin cracks or ulcers

  • Disability or limited mobility – due to pain or leg heaviness

Complications can become chronic, painful, and even disabling without appropriate care.

Living With the Condition

Managing venous stasis requires long-term lifestyle adaptations, but many people live well with it through consistent care.

Key management tips:

  • Wear compression stockings daily

  • Monitor for changes in skin color or wounds

  • Attend regular check-ups

  • Keep legs moisturized and clean

  • Eat a heart-healthy, low-sodium diet

  • Follow a structured exercise plan, possibly guided by a physical therapist

Support groups and counseling may also help individuals cope with emotional or cosmetic concerns associated with the condition.