\n<\/p>\n
There are two major aims of treatment: Eliminate persistent gravitational eczema and prevention of recurrance.[7]<\/span><\/sup>\u00a0These goals can be achieved via a range of approaches:<\/p>\n \u00a0<\/p>\n Lifestyle adjustments like elevating legs alongside compression therapy, are foundational as they can effectively manage venous hypertension, to alleviate persistent gravitational eczema and reduce the likelihood of its recurrence.<\/p>\n It\u2019s crucial to recognize all topical products utilized by the patient, as certain self-treatments can be detrimental, such as the use of household antiseptics.<\/p>\n Direct exposure to irritants should be minimized. Typical irritants include extremes of temperature, alkaline or acidic substances, wool, and excessive moisture. To shield against the irritating effects of wool, the Wound Healing Research Unit recommends applying a layer of tubular gauze bandage.[7]<\/span><\/sup>\u00a0Bandaging has the added benefit of protection against unconscious scratching, and ones that contain ichthammol, zinc or tar can give a soothing effect. Using a compression bandage initially, followed by an elastic stocking in the later stages is also found to be helpful.<\/p>\n \u00a0<\/p>\n Topical treatments, such as creams or ointments, offer relief. Consistent use of emollients creates a protective layer on the skin, guarding against dryness, irritants, and maceration from wound fluids, while also reducing scaling. Emollients should be applied regularly to the surrounding skin, following the direction of hair growth to minimize the risk of folliculitis. Preferably, all topical therapies should be in the form of ointments rather than creams, as studies have shown ointments to have a more potent and longer-lasting effect.[7]<\/span><\/sup><\/p>\n Astringents like potassium permanganate can help alleviate the oozing associated with severe eczema and also possess some antibacterial properties. Treatment typically involves immersing the affected leg in a solution for 15\u201320 minutes or, if not feasible, applying gauze soaked in the solution.[7]<\/span><\/sup><\/p>\n Topical steroids play a vital role in effectively managing severe gravitational eczema. Examples are, Triamcinolone 0.1% or Cutivate or another class II steroid topical applications.[8]<\/span><\/sup> It is important to continue their application for at least 2 weeks, as premature discontinuation often results in recurrence.[7]<\/span><\/sup>\u00a0While each component alone may not be highly effective, when used together, their effects are significantly amplified.<\/p>\n Systemic therapy, like oral medications, may be considered for severe cases. Staphylococcus aureus<\/em> is a bacterium that commonly inhabits and infects eczematous skin, exacerbating gravitational eczema through various means, including the release of exotoxins.[7]<\/span><\/sup>\u00a0Therefore, antibiotics targeting S. aureus<\/em>, such as flucloxacillin, play a crucial role in the management.<\/p>\n \u00a0<\/p>\n Surgical interventions target underlying venous issues, addressing the root cause for long-term management. Vein Stripping can be done in an open vein surgery, where the affected veins are removed through small incisions.[10]<\/span><\/sup> Minimally invasive procedures such as endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) are used to close off diseased veins using heat. Endovenous laser ablation method is proven effective to treat chronic venous insufficiency, leading to over 80% success rate at healing venous eczema within 6 months period.[9]<\/span><\/sup>\u00a0<\/sup>Sclerotherapy is another procedure used, where a solution is injected into the affected veins to irritate the vein walls, causing them to collapse and eventually be reabsorbed by the body.[10]<\/span><\/sup><\/p>\n<\/div>\nConservative Treatments<\/u><\/strong><\/h3>\n
Medications<\/strong><\/span><\/h3>\n
Advanced Treatments<\/u><\/strong><\/h3>\n