Exploring the aetiology and management of venous eczema

Many older people living at home or in residential settings in the community suffer from inflammation of the skin of the lower legs, or venous eczema. Management of this condition may depend on the background of the professional who carries out the initial assessment. Those with a tissue viability background may plan their care based on an assessment of the patient for suitability for compression, to reverse the venous hypertension which may be a causative factor of the eczema. On the other hand, professionals with a background in dermatology may base initial care plans on the use of emollients and topical steroids to reduce inflammation. This article examines the evidence base for our understanding of what causes venous eczema, questions whether current management of the condition is truly evidence-based, and argues for a more pro-active approach to both assessment and management of venous eczema.