Stasis dermatitis and ulcers

Chronic venous insufficiency (CVI) is a long-term (chronic) condition in which the veins have problems sending blood from the legs back to the heart. This may be due to damaged valves that are in the veins. 

Some people with CVI develop stasis dermatitis. Blood pools in the veins of the lower leg. Fluid and blood cells leak out of the veins into the skin and other tissues. This may lead to itching and inflammation that cause more skin changes. The skin may then break down to form open sores.

You may have symptoms of CVI including:

• Dull aching or heaviness in the leg
• Pain that gets worse when you stand or walk
• Swelling in the leg

At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown coloring of the skin.

The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.

Over time, some skin changes become permanent:

• Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
• A bumpy or cobblestone appearance of the skin
• Skin turns dark brown

Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.

The diagnosis is primarily based on the way the skin looks. Your health care provider may order tests to examine the blood flow in your legs.

Stasis dermatitis can also be related to heart problems or other conditions that cause leg swelling. Your provider may need to check your general health and order more tests.

The treatment goals for stasis dermatitis are:

• To treat the underlying vein condition
• Reduce swelling, itching, or pain
• Help ulcers heal

Your provider may suggest the following to manage the CVI that causes stasis dermatitis:

• Use elastic or compression stockings to reduce swelling
• Avoid standing or sitting for long periods of time
• Keep your leg raised when you sit or raise it 3 to 4 times a day for about 15 minutes each time.
• Lose weight if you are overweight.
• Walk or exercise regularly.

Your provider may also recommend certain procedures to treat varicose veins. These may include:

• Injection into the vein with a solution (sclerotherapy)
• Laser treatment
• Small cuts to remove the veins (phlebectomy)
• Use of heat to destroy the vein (ablation) 

Treatments for skin changes due to stasis dermatitis your provider may suggest include:

• Skin moisturizers to treat dryness
• Unna boot (compressive wet dressing, used only when instructed) 
• Topical steroid creams or ointments
• Oral antibiotics
• Good nutrition
• Wound care for open sores or ulcers

Some skin treatments can make the problem worse. Talk to your provider before using any lotions, creams, or antibiotic pointments.

Things to avoid:

• Topical antibiotics, such as neomycin
• Drying lotions, such as calamine
• Lanolin
• Benzocaine and other products meant to numb the skin

Stasis dermatitis is often a long-term (chronic) condition. Healing is related to the successful treatment of the cause, factors causing the ulcer, and prevention of complications.

Complications of stasis ulcers include:

• Bacterial skin infections
• Infection of bone
• Permanent scar
• Skin cancer (squamous cell carcinoma)

Contact your provider if you develop leg swelling or symptoms of stasis dermatitis.

Watch for signs of infection, such as:

• Drainage that looks like pus
• Open skin sores (ulcers)
• Pain
• Redness

To prevent this condition, control the causes of swelling of the leg, ankle, and foot (peripheral edema).

Venous stasis ulcers; Ulcers - venous; Venous ulcer; Venous insufficiency - stasis dermatitis; Vein - stasis dermatitis

Alli, A. Orthotic management of neuropathic and dysvascular feet. In: Murphy DP, Webster JB, Lovegreen, W, eds. Atlas of Orthoses and Assistive Devices. 6th ed. Philadelphia, PA: Elsevier; 2026:chap 27.

Dains JE, Flynn JA, Silbert-Flagg J, Solomon BS, Stewart RW. Skin, hair, and nails. In: Dains JE, Flynn JA, Silber-Flagg J, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 11th ed. St. Louis, MO: Elsevier; 2027:chap 9.

Hafner A, Sprecher E. Ulcers. In: Bolognia JL, Schaffer, JV, Cerroni L. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 105.

Yosipovitch G, Nedorost ST, Silverberg JI, Friedman AJ, Canosa JM, Cha A. Stasis dermatitis: An overview of its clinical presentation, pathogenesis, and management. Am J Clin Dermatol. 2023 Mar;24(2):275-286. Epub 2023 Feb 17. PMID: 36800152; PMCID: PMC9968263. pmc.ncbi.nlm.nih.gov/articles/PMC9968263/.

Updated by: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/17/2026.