Eczema on the legs or varicose eczema?

Body eczema: hands, feet, arms, back, face, etc

Do you notice itchy red patches on your legs? It may be eczema of the legs. But beware: red patches on the legs can also be a symptom of other illnesses. So how can leg eczema be distinguished from other conditions, and above all, what can be done to treat it effectively? Find out more in this article.

Eczema on the legs: definition

Eczema on the legs is a generic term for an inflammatory skin condition characterised by redness, dry skin with small scales on the surface, itching of varying intensity and sometimes localised swelling. 

Eczema on the legs

In reality, there are different forms of eczema:

  • It can be what is known as  “atopic ", eczema. i.e. linked to a hereditary background that makes the skin more sensitive to environmental factors. In general, the affected area is located in the folds at the back of the knees. 
  • This may correspond to allergic or irritant contact eczema. The body's defence system overreacts.
  • It can also be varicose eczema, which is a very specific form of eczema. Also known as stasis dermatitis, this eczema appears mainly as a result of venous insufficiency, i.e. circulatory problems. Around 37-44% of people with leg ulcers may also have varicose eczema(1). 
Symptoms of leg eczema

Symptoms of leg eczema 

The main symptoms of leg eczema are red patches, intense itching, dry skin and sometimes thickening of the skin. However, a distinction must be made between atopic eczema and varicose eczema.

  • Atopic eczema of the legs is often observed in childhood or in young adults with an allergic background. It manifests itself as red or pink patches, mainly in the folds (such as behind the knees), accompanied by severe dryness and very sensitive, thin skin that itches intensely during inflammatory flare-ups. Unlike varicose eczema, atopic eczema generally does not lead to significant swelling or complications such as ulcers. 
  • Varicose eczema is characterised by red patches, dry skin and intense itching. But over time, the skin can become thick, rough and scaly, with the possible formation of small blisters (vesicles) that ooze out before forming scabs. This form of eczema is also often accompanied by swelling (oedema) of the legs, which can cause feelings of heaviness or burning and make walking or wearing clothes uncomfortable. If left untreated, it can develop into a venous ulcer. Persistent itching and pain can also affect sleep quality and lead to anxiety or depression.

If in doubt or if symptoms persist, it is strongly recommended that you consult a healthcare professional to establish a precise diagnosis and receive appropriate treatment. 

Causes of varicose eczema

Varicose eczema (or venous eczema) occurs when blood circulation in the veins of the legs is somehow blocked or insufficient. Blood has difficulty flowing back to the heart, leading to stagnation in the veins of the legs.

This stagnation of blood in the legs causes an increase in venous pressure, leading to inflammation and fluid leakage into the skin tissues: red patches appear accompanied by itching.

Eczema on the legs: not to be confused with other conditions

Red patches on the leg can be caused by a number of conditions. Some are serious and/or require rapid treatment. A red patch on the leg may, for example, reveal deep vein thrombosis (or phlebitis) or erysipelas (a bacterial infection of the skin). 

Varicose eczema often starts on the lower legs. Eczema on the thigh is rarely associated with varicose eczema, or only at a later stage.

It is possible to have both eczema on the arms, eczema on the legs and other patches of eczema on the skin. In this case, venous insufficiency is rarely the cause - it may be a case of atopic eczema. 

Red patches on the legs can also be caused by contact eczema following the application of a product or dressing to the legs.

Eczema on the legs: what treatment?

The treatment of varicose eczema on the legs involves treating venous insufficiency: wearing compression stockings, elevating the legs and, if necessary, undergoing surgery.

For local relief, whatever the form of leg eczema (atopic, contact or varicose), the doctor prescribes cortisone creams and emollients to be applied daily. 

For confirmed cases of contact eczema, avoiding the allergens involved will be essential to prevent any recurrence or establishment of lesions. 

Treatment of eczema on the legs

Source :  

(1) Payne D. Venous eczema: more than just a rash. Br J Community Nurs. 2023 Jun 2;28(6):298-300. doi: 10.12968/bjcn.2023.28.6.298. PMID: 37261990. 

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