Varicose eczema and Medical intervention

I don't know if anyone here in the audience has had phlebitis and whether they had an ultrasound scan but I think now if you have been told, or you suspect you have got phlebitis, you should have an ultrasound scan.

Varicose eczema this is a condition that affects the skin, usually just above the ankle. Now this is a term that is misleading, you might think well varicose eczema, it's a skin problem and indeed I see many people who are treated with creams, often steroid creams. These conditions are very itchy, they can drive you mad and they can keep you awake and cause a lot of distress, and there's no doubt that there is inflammation of the skin and there's no doubt that if you put steroid cream on you will feel better, the itching will go, your leg will feel better and it will give you some relief. 

But varicose eczema is not principally a skin condition, it's due to this problem called reflux and what this indicates is that the skin is being damaged by this faulty vein circulation.  It looks like eczema but it actually indicates that there's damage to the skin and that that skin is vulnerable and at risk of ulceration, so this condition is often the precursor of a leg ulcer.  Not tomorrow, not the day after, it takes time, but the skin is vulnerable and at risk and this should be treated to prevent an ulcer.  It's not a skin condition,it shouldn't really be treated with steroids, in fact steroids, if you put them on long-term, they actually thin the skin and they make the skin more vulnerable, more liable to ulceration.

So varicose eczema should be treated by a vein specialist or a vascular surgeon, not a dermatologist, not with skin creams. Deep vein thrombosis well, this is the fear of most people, in fact it's not very common as a complication of veins, it's only recently that we are confident now to be able to say that varicose veins are a risk factor for deep vein thrombosis, there's now good evidence in the medical literature to support that.  It doesn't mean you're going to get one inevitably but, if you have an additional risk factor, varicose veins will contribute. So, for example, if you were to go into hospital and have major surgery, say a hip replacement or a major operation for bowel cancer, and you had bad varicose veins, it would slightly increase your risk of a deep vein thrombosis.  If you were to go on a long-haul flight with bad varicose veins, it would add to your risk.

It doesn't cause it but it is a risk factor,and anyone under those circumstances coming out of hospital after surgery, stepping off a plane after a long-haul flight who has one leg more swollen than the other, this should ring alarm bells, have I got a deep vein thrombosis.