Venous stasis, also known as stasis dermatitis, gravitational dermatitis, or venous eczema, is a chronic inflammatory skin condition caused by the pooling of blood in the legs. It commonly affects individuals with chronic venous insufficiency, a condition in which veins have difficulty returning blood from the limbs to the heart.

Common symptoms include leg swelling, skin discoloration, varicose veins, itching, dryness, and scaling. Treatment typically involves wearing compression stockings or bandages to reduce swelling and pain. In more severe cases, surgical procedures may be recommended.

This condition affects millions of adults over the age of 50, particularly in the United States.

Venous Stasis Symptoms

Venous stasis develops as blood accumulates in the legs due to impaired circulation. This buildup increases pressure in the leg veins, which pushes against the skin and causes various symptoms.

Symptoms often begin gradually and worsen over time. Early signs include:

  • Itchy, dry, or discolored skin (especially near varicose veins)

  • Irritation or soreness of the skin

  • Pain in the legs

  • Swelling around the ankles, particularly in the evening

  • Swelling that improves overnight but returns during the day

If left untreated, the condition can progress and lead to:

  • Darkened skin (hyperpigmentation)

  • Scaly patches across the lower legs and tops of the feet

  • Open wounds or ulcers

  • Hardening of the skin

  • Significant pain

  • Shrinking or thinning of the calf muscles

What Causes Venous Stasis?

Venous stasis is primarily caused by poor blood circulation in the legs, often due to damaged or weakened veins. Chronic venous insufficiency is the most common underlying cause. In this condition, the valves in the veins, which usually help blood move toward the heart, become dysfunctional and allow blood to flow backward and collect in the legs.

Risk Factors for Chronic Venous Insufficiency

  • Age 50 and older

  • Family history of vein problems

  • History of deep vein thrombosis (DVT)

  • Prolonged standing or sitting

  • Pregnancy

Additional Risk Factors for Venous Stasis

  • Lower leg injuries requiring surgery

  • Chronic high blood pressure

  • Congestive heart failure

  • Varicose veins

  • Previous blood clots in the legs

  • Cellulitis

  • Chronic kidney disease

Diagnosis

To diagnose venous stasis, your healthcare provider will examine your skin and review your medical history. Questions will typically focus on cardiovascular health, previous heart issues, stroke, or use of blood pressure medications. Any recent leg injuries or surgeries will also be discussed.

Sometimes, a physical exam is enough. If not, additional testing such as ultrasound, CT scans, or MRI may be done to check for blood vessel damage or rule out blood clots. Allergy testing might also be recommended to exclude allergic reactions.

Treatments for Venous Stasis

While venous stasis cannot be cured, symptoms can be effectively managed through various treatments aimed at improving circulation, reducing swelling, and easing discomfort.

Managing Swelling

Compression therapy is the primary treatment for swelling. This includes wearing:

  • Compression stockings

  • Bandages

  • Applying corticosteroid creams (if prescribed)

Additional strategies:

  • Walking regularly

  • Elevating legs above heart level for 15 minutes every two hours

Improving Blood Flow

Improved blood flow can be achieved through:

  • Compression therapy

  • Leg elevation and walking

  • Using an Unna boot, a medicated compressive bandage that helps reduce swelling and heal wounds

Medications

Depending on your symptoms, your provider may recommend:

  • Blood thinners to prevent clotting

  • Antihistamines for itching

  • Moisturizers to reduce dryness and promote healing

  • Corticosteroid creams for inflammation

  • Tylenol (acetaminophen) for pain relief

Intense Pulsed Light (IPL) Therapy

This light-based treatment targets skin discoloration. Several sessions are usually needed, and some patients may see complete improvement in pigmentation.

Surgical and Minimally Invasive Procedures

Various procedures may help relieve symptoms or correct vein function, including:

  • Phlebectomy – removal of damaged veins through small incisions

  • Sclerotherapy – injecting a solution to collapse veins

  • Thrombolytic therapy (lysis therapy) – breaking up clots using a catheter

  • Stent placement – opening narrowed veins with a stent

  • Endovenous thermal ablation – closing veins with heat (laser or radiofrequency)

  • SEPS (Subfascial Endoscopic Perforator Surgery) – blocking damaged veins to promote ulcer healing

Prevention

Preventing venous stasis focuses on managing risk factors, especially chronic venous insufficiency. Preventive steps include:

  • Avoid prolonged sitting or standing

  • Stop smoking

  • Stay physically active

  • Maintain a healthy weight

  • Moisturize the legs regularly

  • Control blood pressure, blood sugar, and cholesterol

Complications

Venous stasis is associated with several complications:

  • Cardiovascular issues such as high blood pressure and heart failure

  • Contact dermatitis: A common allergic reaction affecting many people with venous stasis

  • Superinfections: Bacteria or fungi can infect open ulcers or broken skin, especially from scratching

Living With Venous Stasis

Without treatment, venous stasis tends to worsen over time. Early diagnosis and consistent treatment can help manage and improve symptoms.

Tips for living well with the condition include:

  • Staying active and exercising regularly

  • Working with a physical therapist if needed

  • Following a heart-healthy, low-sodium diet rich in fruits and vegetables

Managing venous stasis is a long-term commitment, but with proper care, many people experience significant relief and improved quality of life.