The key to managing stasis eczema is the control of the venous insufficiency, the aim being to remove the dependent oedema. If this is done, the eczema itself will respond to hydrocortisone cream or slightly stronger topical steroid creams. However care must be taken when using such steroids as they have the effect of causing skin atrophy, and any skin breakage in patients with venous insufficiency is undesiarable. Any brown-red hyperpigmentation however will not be affected by treatment, therefore treatment should cease once the eczema dissipates. Leg elevation is the only complete way of reducing venous pressure in the leg.
Maximal effectiveness is acheived with the leg above the heart.
Prolonged standing or sitting with legs and feet in a dependent position should also be avoided. Exercise and mobility of the lower limb is pivotal in improving venous flow. Movement encourages venous flow via the venous calf pump, in particular with dorsiflexion of the foot. Diuretics are another therapeutic modality which may be used. These are useful in ridding the body of excess fluid.