skin disorders
Stasis Dermatitis
Treatment of Stasis Dermatitis
Measures to prevent blood from pooling in the legs Measures to relieve dermatitis For ulcers, special dressings or an Unna paste boot For infection, antibiotics The cause of the chronic swelling is treated. Long-term treatment is aimed at Treatment by keeping blood from pooling in the veins around the ankles. When sitting, the person should elevate the legs above the level of the heart. Properly fitted prescription support stockings (compression stockings) also prevent pooling of blood and decrease swelling. Department store "support" stockings are not usually adequate. For dermatitis that has started recently, and if there are no ulcers, a corticosteroid cream or ointment applied to the affected areas can help. If the disorder worsens, as evidenced by increased warmth, redness, oozing, or small ulcers, a more absorbent dressing, such as a hydrocolloid dressing, can be used. In stasis dermatitis, the skin is easily irritated. Antibiotic creams, first-aid (anesthetic) creams, wool alcohols, witch hazel,lanolin, or other chemicals should not be used because they can make the disorder worse. Ulcers are best treated with compresses and dressings made withzinc oxidepaste. Special moisture-absorbing hydrocolloid or hydrogel dressings also may be used. Some people may need an Unna paste boot, which is a woven stretch wrap filled with a gelatin paste that contains zinc. The wrap is applied to the ankle and lower leg where it hardens, similar to but softer than a cast. The boot limits swelling and helps protect the skin from irritation, and the paste helps heal the skin. At first the boot is changed every 2 or 3 days, but later it is changed only once or twice a week. After the ulcer heals, an elastic support should be applied before the person rises in the morning. Regardless of the dressing used, reduction of swelling (usually with compression) is essential for healing. Antibiotics applied to the skin are useful for treating some open or irritated areas of skin and ulcers. Antibiotics given by mouth are used to treat cellulitis. Sometimes, skin from elsewhere on the body may be grafted to cover very large ulcers. 