Randy Jacobs, M.D. Patient Education
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Stasis Dermatitis
Stasis Dermatitis: What is it?
Stasis
Dermatitis is a chronic rash stemming from poor circulation (low oxygen) of the
legs due to internal varicose veins or poor circulation for other reasons. This
includes poor heart function and any type of blockage to the circulation.
Normally, your heart pumps fresh oxygenated blood to your legs and feet. The
blood is supposed to go down, and is then supposed to return for reoxygenation.
Stasis dermatitis usually occurs in swollen legs with poor circulation. In stasis
dermatitis, the blood is unable to return to the heart for fresh oxygen. The
result: Blood tends to pool at the feet, ankles, and lower legs. Because of
this, there is low oxygen to the tissues, and thus, stasis dermatitis develops.
This condition is worse in diabetics. Also, if the affected areas are injured,
or if a person applies continuous pressure to the area, the skin suffocates and
an ulceration or "pressure sore" may develop. Pressure sores require
therapy above and beyond that of stasis dermatitis.
How Is Stasis Dermatitis Treated?
Think
about it: Anything that helps circulation will also help stasis dermatitis.
Anything that prevents circulation will also make stasis dermatitis worse.
Think about your legs and what you do with them. Are you helping circulation or
are you hindering circulation?
Avoid Allergic Items
Sensitive
skin on the legs can become itchy when exposed to allergic type substances such
as perfumes, dyes, conditioners, powders, anti-perspirants,
hair sprays, grasses, plants, fragranced products, shampoos, unrinsed laundry detergents, fabric softener sheets, bleach, please double rinse your laundry!
Avoid dog or cat hairs, carpets, chemicals, Aloe Vera, PABA, detergents,
acrylic nails, polishes, nickel, elastic, latex, and other allergic substances.
Soap Is Your Big Enemy!
Another factor is the use of soap. Excessive soap
will actually make stasis dermatitis worse. Soap is bad for stasis dermatitis.
Dial, Zest, Lever, Safegaurd, Ivory, gels, and Irish Spring are among the
worst. Soap removes your good skin lipid oils, which are cholesterol, ceramide, and free fatty acids, needed to hold in moisture.
If your oils are removed, the skin develops cracks, fissures, and dry
inflammation. Soap should not be used on dry or sensitive skin. Most of us use
far too much soap. Actually, plain water is often just enough to cleanse the
skin. If you can't live without soap, it's OK to use a gentle cleanser for your
face, feet, armpits, and groin, but not on your legs! Use Gentle Face and Body
Cleanser to cleanse your legs. This special gentle cleanser cleans without
stripping your good skin oils: Cholesterol, ceramide, and free fatty acids.
Stasis Dermatitis Can Be Treated
By the Four E's:
Emolliation Exercise Elevation Elastic Hose
Emolliation : A Fancy Word For Bathing and
Moisturizing
Persons
with dry skin may bathe or shower once daily:
1.
Use no soap on dry or sensitive skin areas. You may use mild Gentle Face and
Body Cleanser soapless cleanser, instead of soap
2.
After bathing, thoroughly lubricate your skin using one of the methods
described in this educational sheet. Ask the receptionist for the little ABC
Dry Skin Booklet.
3.
After your bath, you should not towel dry. Wipe off the water with your hands,
then, apply a thin film of True Moisture® Replenishing Cream to your legs and
entire body. This film will seal in your new moisture. You are now well
emolliated.
4. For shampoo, use fragrance free True Moisture® Gentle
Shampoo.
Exercise: Keep your leg muscles working to increase circulation. Your calf muscles are
very important as they help pump blood back to your
heart.
When you use your calf muscles, you are actually helping to bring fresh oxygen
back to your leg tissues. The more oxygen the better!
Elevation: When not walking, you should keep your legs elevated. You may want to purchase
a small plastic stool to take with you. Don't ever let your legs dangle as in
an airplane or long car trip. Do not stand in one position for very long.
Common sense will show you that circulation will improve the more you keep your
legs elevated and the more you move your leg muscles. If possible, try a
regular walking program.
Elastic Hose: Dr. Jacobs can prescribe special elastic hose called Jobst Stockings available
at your pharmacy. The elastic hose prevents blood from pooling and helps return
blood to the heart for fresh oxygen.
Doctor, please give me other
helpful hints.
In
addition to the three E's, Dr. Jacobs may also have you apply special medicated
ointments, or apply special leg wraps (Ace wraps vs. Cellophane occlusion vs.
Unna Boot) to bring your skin back to health. An Ace Wrap is an elastic bandage
available from your pharmacy. Cellophane can be purchased at the grocery store.
An Unna boot is a zinc impregnated wrap available from your pharmacy. The wraps
can be changed. Ask your pharmacist about them.
Please Be Patient
Finally,
be patient. You need to be consistent and closely follow the four E’s. Stasis
dermatitis can take months to improve. If you do not see improvement after two
months, please check yourself to see if you are following the doctor's advice.
If you are following the advice given in this information sheet and are not
better, Dr. Jacobs may recheck your condition or refer you to a vascular surgeon
to evaluate your circulation.
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