Eczema is the skins way of showing that it is being irritated.
In venous eczema, the underlying venous reflux (“hidden varicose veins”) are causing inflammation in the skin capillaries, which causes the skin to react - forming venous eczema.
Venous reflux is the basis of most venous diseases of the legs and so, although it will be described briefly here, if you want to understand it better, please see The College of Phlebology's text book “Understanding Venous Reflux - The Cause of Varicose Veins and Venous Leg Ulcers
In normal leg veins, valves keep the blood flowing upwards on movement, and prevent it falling back down the legs when standing still. In people with venous disease, the valves have stopped working and the blood falls backwards down the veins - called venous reflux.
As the blood falls back from the heart and down the veins, it hits the capillaries at the ankle (the lowest part of the venous system) causing them to be inflamed.
Of course this is only a very small inflammation, and when it first occurs, it has hardly any effect. However, over days, months and years, the constant inflammation every time the person stands up starts to have an effect, and the capillaries start getting thickened and the surrounding tissue becomes inflamed. Over time, this inflammation spreads through the tissues of the lower leg, making the subcutaneous fat hard and swollen - and then the skin red and itchy. This is venous eczema.
Unfortunately many doctors and nurses do not understand this process and the hot, red and itchy patches of the lower leg are often misdiagnosed as “Phlebitis
If you have followed how venous eczema is caused from the brief description above, it will be clear to you that the cure will be to stop the venous reflux.
It is a very sad reflection on how badly veins and venous conditions are understood that most doctors and nurses still give antibiotics or steroid creams for this condition, being fooled by the redness into thinking that it is either infection or a simple eczema with no underlying cause.