Stasis Dermatitis: Pictures, Causes, and Treatment

What is stasis dermatitis?

Stasis dermatitis usually affects the ankles and lower legs, where blood and fluid can pool when leg veins do not move blood back toward the heart efficiently. Increased pressure in these veins contributes to swelling and inflammation in nearby skin. It is a form of eczema, but it has a different underlying driver from childhood atopic dermatitis.¹

It can affect one leg or both. The rash may improve and flare again because the venous problem often needs ongoing management. Stasis dermatitis itself is not contagious.

What does stasis dermatitis look like?

• Itchy, dry, flaky or scaly skin, often near the ankles.
• Inflamed patches that can look red, purple, gray or darker brown, depending on skin tone.
• Ankle swelling, heaviness or aching that may worsen after prolonged standing.
• Brown staining, visible enlarged veins, or skin that gradually becomes firm and tight.
• During a stronger flare, weeping, crusting, blisters or breaks in the skin.

The amount of visible redness does not reliably measure severity on every skin tone. Report pain, warmth, swelling, drainage and changes from your usual skin color. Longstanding venous disease can lead to ulcers, which are open wounds requiring their own care plan.²

What causes venous eczema?

One-way valves and the calf muscles help return blood up the legs. When that system is impaired, pressure can remain high in the lower-leg veins. A previous deep vein thrombosis, damaged veins or varicose veins may contribute. Swelling is an important clue, although swollen legs can also have other causes.^{1, 3}

Repeated scratching and irritating skin products can make an already inflamed area worse. Some people also develop contact allergy to a cream, dressing or other treatment. A rash that worsens in the exact area where a product touches the skin deserves review.

Who is more likely to develop it?

Stasis dermatitis is most often seen in adults, especially with increasing age and chronic leg swelling. A history of varicose veins, a blood clot in the leg, leg injury or surgery, and long periods of limited movement can be relevant. It is much less typical in children; a child with a leg rash needs an age-appropriate assessment rather than assuming the cause is venous disease.³

How is it diagnosed, and could it be cellulitis?

A clinician examines the skin, swelling and leg circulation, and asks about previous clots, operations, medications and other medical conditions. An ultrasound may be needed to assess the veins or check for a clot. Recurrent treatment-related reactions may warrant patch testing for contact allergy.³

These patterns overlap. Eczema can become infected, and a photograph cannot safely rule out cellulitis or a blood clot.^{3, 6}

How is stasis dermatitis treated?

Treat the swelling and venous problem

Your clinician may recommend fitted compression stockings or wraps, regular movement and leg elevation. Before starting medical compression, the team should assess whether it is suitable, including the arterial blood supply when indicated. Do not choose a strong compression level on your own.^{1, 4, 8}

Ask for help if bending or hand strength makes stockings difficult to put on. A fitting review, a stocking aid or a different prescribed system may make the plan more workable. Do not roll the stocking into a tight band. Vein treatment or specialist referral may be appropriate for some people.⁴

Calm the inflamed skin

A topical corticosteroid may be prescribed for an active flare. The strength, treatment area and duration should be clear. Antibiotics are used when an infection warrants them, not automatically for every itchy or red leg. An ulcer needs a wound-care plan, rather than simply more eczema cream.³

Make daily care practical

1. Clean gently. Use lukewarm water and a mild fragrance-free cleanser when needed. Avoid scrubbing, exfoliating tools and hot water on inflamed skin.
2. Moisturize the dry, intact skin. Smooth a fragrance-free cream or ointment over the lower legs after washing and again when dry. Use your wound clinician’s instructions for open areas.
3. Build movement into the day. Short walks or seated ankle movements, if appropriate for your mobility, help avoid long uninterrupted periods of sitting or standing.
4. Elevate during breaks. Follow the position and timing recommended for you. Support the legs comfortably rather than putting pressure directly on a sore spot.
5. Check both legs. Notice new sores, drainage, increased pain or a sudden change in swelling. If reaching the ankles is difficult, ask someone to help with skin checks and application.

Keep the routine going after the rash improves. Ongoing swelling can bring symptoms back, and brown discoloration may persist even when inflammation is better controlled.⁵

Where does moisturizer fit?

For a broader comparison of lower-leg rashes, see eczema on the legs. If dryness and a fine network of cracks are the main features, read about asteatotic eczema.

When do leg symptoms need urgent attention?

Get urgent medical assessment for sudden pain or swelling in one leg, rapidly spreading warmth or skin-color change, fever, increasing tenderness, or a new draining wound. A leg that becomes cold, pale or blue, numb, or severely painful also needs urgent care.

Call emergency services for leg pain or swelling together with chest pain or shortness of breath, which can signal a clot in the lungs.⁶

What to bring to your appointment

Bring a medication list, the names or labels of creams and dressings, and photographs showing how the swelling or rash changes through the day. Ask what each part of the plan is treating: inflammation, dryness, swelling, venous disease or a wound.

Explore the Eczema Resource Center, types of eczema guide, and eczema symptoms and pictures guide.

Frequently asked questions

Medical sources and references

1. DermNet. Venous eczema.
2. NHS. Varicose eczema.
3. American Academy of Dermatology. Stasis dermatitis: Diagnosis and treatment.
4. NHS. Varicose eczema: Treatment.
5. American Academy of Dermatology. Stasis dermatitis: Self-care.
6. NHS. Deep vein thrombosis (DVT).
7. Janßen and colleagues. Intermittent Pneumatic Impulse Compression in the Treatment of Stasis Dermatitis. Journal of Clinical Medicine, 2025. Clinical photograph, Figure 2.
8. NHS. Venous leg ulcer: Diagnosis and circulation assessment before compression.