You don’t have an insect bite or an allergic rash, so why has the skin over your leg veins become swollen, tight, and itchy? Persistently itchy leg veins are an early warning sign of chronic venous insufficiency (CVI), a common form of venous disease that occurs when:

• Lower extremity circulation slows
• Blood pools in your leg veins
• Capillaries leak into nearby tissues
• Lower legs and feet start to swell
• Skin tissues receive less oxygen

When the skin tissues over sluggish veins have less oxygen and fewer nutrients, they start to change. The resulting condition, known as venous stasis dermatitis, is more likely to occur near varicose veins, but people without varicose veins can develop it, too. 

Dr. Johnny L. Serrano, our board-certified general surgeon in Glendale, Arizona, discusses how CVI can change your skin and explains why these changes should prompt you to schedule a vein evaluation at Precision Surgery and Advanced Vein Therapy.

How CVI sets the stage for skin changes

Venous insufficiency develops when damage within your leg veins causes a problem — usually inefficient blood flow or inadequate drainage — that leads to poor circulation. If the problem becomes chronic, it can give rise to bothersome symptoms and concerns like:

• Leg pain during activity
• Spider vein emergence
• Varicose vein formation
• Lower leg swelling (edema)
• Abnormal skin changes
• Open wounds (ulcers)

Most CVI cases emerge when weak leg vein valves cause blood to pool, exerting pressure on the surrounding vessel wall until it eventually swells, twists, and distends. CVI can also damage adjacent capillaries, prompting them to leak fluid, blood cells, and proteins into nearby tissues, including your skin. 

Warning signs of venous stasis dermatitis

In normal vascular disease progression, the itchy skin of stasis dermatitis is often preceded by some degree of localized swelling. It may be mild, simply causing an existing varicose vein to become more swollen, or it may be severe, prompting excessive leg swelling that makes your socks and shoes feel uncomfortably tight.

Sometimes, mild lower extremity swelling is simply an early warning sign of the inflammatory skin changes set in motion by stasis dermatitis. Most of the time, this type of mild swelling is closely followed by skin tone and texture changes — and itchiness in the affected area. 

Venous stasis dermatitis symptoms may be mild and intermittent or severe and persistent. What begins as localized skin itchiness and irritation can eventually lead to: 

• Dry, thickened, flaky, or scaly areas of skin
• Red or purplish discoloration (on lighter skin)
• Brown or ashen discoloration (on darker skin)
• Noticeably raised or inflamed varicose veins 
• Persistent leg pain, achiness, or heaviness

Very itchy, highly irritated areas of skin may also eventually develop orange-brown speckles called “cayenne pepper spots.” These spots happen when CVI pressure and swelling cause tiny capillaries to burst beneath your skin. 

When stasis dermatitis goes unchecked

Without intervention, venous stasis dermatitis tends to progress — just as the underlying condition that caused it also continues to advance without care.

Left untreated, stasis dermatitis can lead to ever-worsening skin changes. Oxygen-depleted skin tissues may crack and break open, increasing your infection risk and setting the stage for open, slow-healing wounds called venous ulcers. 

Untreated stasis dermatitis can also lead to long-lasting skin changes like thickening, hardening, or darkening (hyperpigmentation).

Treatment solutions for stasis dermatitis

To prevent the progression of stasis dermatitis, manage CVI, and avoid serious complications, prompt expert care is essential. Stasis dermatitis treatment falls into four general categories:

Itchy skin relief

Applying medicated cream to your dry, itchy skin patches helps reduce localized inflammation to provide immediate relief. Wearing compression garments, which help reduce swelling and improve circulation, can also help alleviate itchy skin. 

Wound care

If your itchy skin has already led to an open sore, you may need to wear a special dressing around the affected area (covered by a compression garment) to promote healing and better circulation. Taking antibiotics can help resolve any suspected infections. 

Circulation support

Getting plenty of exercise, eating a wholesome, low-sodium diet, and elevating your feet when you’re seated can reduce lower extremity blood pooling and improve your circulation.

If you have itchy varicose veins, you may be a good candidate for a minimally invasive vein removal treatment like radiofrequency ablation, endovenous chemical ablation (EVCA), or sclerotherapy. These procedures relieve venous stasis dermatitis by improving blood flow and circulation.

CVI management 

Long-term, Dr. Serrano may also recommend taking steps toward better health management. When you control your body weight, blood pressure, blood sugar, and blood lipid (cholesterol and triglycerides) levels, you can substantially improve your CVI outcome. 

Dealing with itchy leg veins? We can help. Call Precision Surgery and Advanced Vein Therapy today, or use our easy online booking feature to schedule a visit with Dr. Serrano any time.