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Trophic changes in the skin. How to treat trophic ulcers with varicose veins? Experts offer three ways

A trophic ulcer is a non-healing injury to the skin. It is often accompanied by complications, such as the development of infections.

Before the development of an ulcer, there is a long period of trophic changes in the skin with varicose veins. Vessels and skin are exposed to stress and tension for many weeks and months.

Ultimately, the surface of the skin becomes whitish, an unhealthy shade and shine appear. Such symptoms are considered a critical point.

After this, the ulcer begins to progress rapidly. In the worst case scenario, the damage reaches bone tissue, irreversible consequences can occur, and even deaths are recorded.

There are two types of treatment for varicose ulcers - conservative and surgical. Surgery comes to the rescue in the most difficult cases, when action is needed immediately, and there is no time for drug therapy.

If the ulcerative processes have not gone too far, it will be possible to limit ourselves to conservative methods. Traditional methods refer to conservative treatment approaches.

For mild lesions they can be relatively effective. Let's take a closer look at how to treat ulcers from varicose veins.

Conservative treatment

First of all, the patient undergoes diagnostics. Doctors must determine the cause, nature of the disease and prepare a treatment plan.

The cause of a trophic ulcer is indeed most often varicose veins. He is responsible for more than half of the recorded cases.

But ulcerative processes can be triggered by arterial diseases, diabetes, and serious damage to the back/nervous system. Doctors should also find out the type of microorganisms that are growing in the wound. Some of them may be resistant to broad-spectrum antibiotics.

Conservative treatment can be local or general. By general we mean taking medications, giving injections, and so on.

The local one is aimed directly at the ulcer; ointments, creams, and bandages are used for this. General and local treatment are combined; they go hand in hand in the patient’s recovery process.

We give an approximate course of local treatment. First of all, the wound is cleaned of pus, for example, using vacuum therapy or simply washed with a sponge, and then dead tissue is removed with chymotrypsin.

The ulcer and the surface around it should be treated with a one percent solution of iodopirone. If the wound is located on the foot and the nails are close to it, then they also need to be treated with a solution.

This is done due to the possibility of fungus existing on the nails. Please note that the patient may not notice the presence of fungus. If there is intolerance to drugs containing iodine, you can replace iodopyrone with prontosan.

Then the trophic ulcer is smeared with Argosulfan cream. The top is wrapped with a bandage. The active ingredient in the ointment is silver sulfathiazole.

It has high antimicrobial activity. In addition, Argosulfan accelerates wound healing and reduces pain. The dressing should be changed every day.

Local procedures must be supplemented and enhanced by taking medications. The most prescribed are venotonics, antibiotics, anticoagulants, anti-inflammatory drugs, vitamins, and immunomodulators.

Among venotonics, Detralex or Phlebodia 600 are regularly prescribed. The drugs improve the general condition of vascular tissues and lymphatic drainage.

A popular anti-inflammatory drug is Ambene-N. If the examination reveals the presence of microorganisms in the wound, then antibiotics based on penicillin, doxycycline, and tetracycline can be prescribed.

Surgical intervention

Unfortunately, conservative treatment methods cannot always guarantee complete recovery. In this case, more intensive procedures are necessary.

They are aimed at eliminating the cause of varicose veins. Modern methods allow you to avoid a scalpel and general anesthesia.

Two common methods are considered highly effective and reliable - laser coagulation and sclerotherapy. But there are other new procedures, for example, cryogenic exposure, hyperbaric oxygenation. In terms of effectiveness, they are in no way inferior to classical operations.

Laser therapy (EVLT) does not leave any incisions, the rehabilitation period is only a couple of hours. Accurate identification of damaged areas is carried out using ultrasonic equipment. Laser flashes burn out diseased blood vessels with a thermal impulse. Over time, they become overgrown with connective tissue and dissolve.

Sclerotherapy is also a modern treatment method. A thin needle and medications are inserted into the damaged veins.

The drug glues the walls of blood vessels, due to this it is possible to eliminate the cause of ulcerative processes. The rehabilitation period in the same way is only a few hours. Contraindications for sclerotherapy include heart problems, pregnancy, and diabetes.

Classical surgery is used mainly for very extensive skin lesions. To eliminate the injury, plastic surgery involving skin grafting is performed.

The skin is taken from the patient's thighs or abdomen. It is perforated and applied to a clean ulcer. The flap usually takes 7-10 days to take root. In addition, surgery is used for necrectomy, neurolysis, and adjustment of venous and arterial blood flow.

Intensive treatment methods are highly effective. But they are not always used, since conservative treatment can usually cope quite well with even a trophic ulcer.

Traditional methods

Traditional methods should be classified as conservative treatment. Regardless of your level of confidence in such methods, it is strongly recommended that you undergo an examination by a doctor.

Trophic ulcer is an extremely dangerous complication. Even if for some reason you avoid conventional medications, the doctor must decide how to treat trophic ulcers with varicose veins. Perhaps the doctor will approve herbal medicine or another traditional method. Otherwise, the patient risks his health and even his life.

A remedy with a golden mustache shows a good healing effect.

One leaf of the plant is thoroughly washed under warm water and torn into small pieces, about one to two centimeters.
Place the pieces in an enamel pan and begin to squeeze until the juice appears.
The mixture is applied to the ulcer and covered with gauze and bandage. The bandage is applied at night and removed only in the morning.
The pus must be washed with hydrogen peroxide.

Another option is camel thorn (tatar).

To do this, take dry tartar leaves and grind them into fine crumbs.
It is sifted through a sieve and then stored in a jar in a dark place.
The wound should be treated with pharmaceutical rivanol and sprinkled with camel thorn powder.
The ulcer is bandaged at night and the medications are allowed to act until the morning.

Potassium permanganate is diluted in warm water in medium concentration (until a pale pink color appears). The ulcer should remain in it for half an hour.
Then you should dilute the calendula, 100 milliliters of calendula per liter of water. In the same way, keep the wound in the solution for another half hour.

The third and final bath will be a solution with eucalyptus. After this, the ulcer is bandaged.

Please note that a trophic ulcer is not always caused by varicose veins.

Therefore, the result may be minimal or completely absent. This once again emphasizes the importance of consulting a professional doctor.

Conclusion

Conservative treatment is usually divided into two types - local and general. By local we mean the removal of dead tissue, disinfection, and sterilization of the wound. General treatment includes taking various medications. The patient is most often prescribed venotonics, antibiotics, anti-inflammatory drugs, and painkillers.

Varicose dermatitis develops as a complication of venous diseases, in which pathological changes occur in the valve apparatus and vascular walls. The main cause is considered to be impaired blood flow and stagnation of blood in the vessels of the lower extremities, which is why dermatitis is called stagnant or venous. Another name for it is varicose eczema.

Venous dermatitis is usually diagnosed in middle-aged and elderly people. Both sexes are susceptible to it, but women suffer more often. The disease is fraught with serious complications that can lead to disability, so it is necessary to start treatment as early as possible.

Reasons

The most common causes of stasis dermatitis include the following pathologies:

Varicose veins.
Chronic venous insufficiency.
Thrombosis of superficial and deep veins.
Endocrine diseases (diabetes mellitus).
Leg injuries in which veins were damaged.
Infectious diseases.

Symptoms

The manifestations of varicose dermatitis are individual for different patients, but there are a number of common signs, and first of all these are changes in the skin of the legs.

The skin on the lower legs becomes inflamed, becomes red-purple and hot to the touch.
The inflammation is accompanied by severe itching, which is constantly present, which is very exhausting for the patient.
Swelling of the legs occurs, sometimes quite severe.
Bubbles form on the skin, which break open to form crusts.
Wet areas appear on the legs.
The skin becomes dense, rough, flaky, and brownish spots can be seen on it.
An advanced disease becomes chronic, ulcers and areas of necrosis form.

Stages

Varicose dermatitis has a long-term chronic course, although rapid progression is not excluded. Before the appearance of trophic ulcers, several stages of the disease pass through:

At an early stage, by the end of the day, slight swelling and heaviness in the legs regularly appear.
Veins begin to protrude on the lower extremities, a red-violet vascular network appears under the skin in the area of the legs, and pain intensifies in different parts of the legs.
Swelling of the subcutaneous tissue increases and does not go away well, which is associated with impaired lymph outflow. The skin becomes bluish, denser, dry, itching appears, and pain intensifies.
Sensitivity in the lower extremities is impaired, and convulsions occur. Areas with pronounced pigmentation, flaky brownish spots, and blisters filled with light liquid appear on the legs, which open and form a weeping surface. In place of the opened and dried blisters, gray-yellow or hemorrhagic crusts appear, after which areas of hyperpigmentation remain.
At the last stage, single or multiple venous ulcers are formed, which, if left untreated, increase in size and can fester if infected.

Treatment

Treatment of varicose dermatitis will be more effective if started in the early stages. First of all, the cause is determined and treatment of the underlying pathology begins. The goal of therapy is to prevent the progression of the disease, avoid severe complications, and relieve symptoms that cause great discomfort to the patient.

strengthen vascular walls;
improve venous blood flow in the lower extremities;
restore lymph outflow;
heal damaged skin.

For this purpose, a set of measures is being developed, including:

drug therapy;
wearing compression stockings;
treatment with folk remedies;
if therapy is ineffective - surgical intervention.

Lose weight if you have excess weight.
Lead an active lifestyle and walk more. While walking, the calf muscles contract, thereby pushing blood upward.
Include foods containing rutin in your menu. These are chokeberry, buckwheat, sweet pepper and others.
At every opportunity, try to keep your legs elevated.
If the skin is constantly inflamed, you need to choose clothes that would not injure the affected areas.
Shoes should be comfortable, heels no higher than 4 cm.
Legs affected by varicose dermatitis should not be washed with regular soap. For this purpose, you need to purchase a special detergent without alkali.

Medicines

To treat varicose eczema, drugs of different groups are used. These are tablets and external agents (ointments, gels).

Venotonics

Necessary for strengthening the vascular wall, reducing swelling, improving tissue trophism, relieving pain and heaviness in the legs.

For oral administration:

Tablets based on diosmin and hesperidin: Detralex, Venarus, Phlebodia.
Preparations with troxerutin: Troxevasin, Troxerutin, Ginkor fort.
Herbal remedies based on horse chestnut and grape leaves.

Venozol;
Troxerutin;
Troxevasin;
Venorutin;
Ginkor gel.

Heparin-based ointments and gels

These remedies relieve inflammation, prevent the formation of blood clots, normalize blood flow, and remove congestion:

Hepatothrombin;
heparin ointment;
Lyoton gel;
Venobene.

Moisturizers

At the early stage of the disease, creams are used that moisturize the skin well and prevent it from drying out. They should contain vitamins, panthenol, and natural fats.

Anti-inflammatory

Anti-inflammatory ointments are prescribed for the treatment of varicose eczema:

Hormonal ointments

In acute forms of venous dermatitis, short courses of hormonal therapy are indicated. External products based on steroid hormones relieve inflammation and itching, eliminate skin flaking. They need to be applied to the affected areas in a thin layer. The most commonly used:

Fluorocort;
Flucinar;
hydrocortisone ointment;
Lorinden;
Celestoderm;
Advantan.

Antiexudative

Wound healing ointments with zinc, naphthalene, and tar should be applied to the skin for ulcers. The most famous and effective:

For the treatment of trophic ulcers the following is used:

Other means

For venous dermatitis, other remedies may be needed, for example, sedatives and antipruritics. Constant severe itching not only irritates, but also forces people to scratch the affected areas. To prevent this from happening, the following drugs are prescribed.

External antipruritics include diphenhydramine ointment and Fenistil gel.

Sedatives are necessary during the acute period of the disease. These can be tinctures of valerian and hawthorn.

For severe pain, drugs from the group of tranquilizers can be used.

In case of a complicated form of the disease with tissue necrosis and exudate, water-soluble ointments with antibacterial activity are prescribed:

For venous dermatitis, wearing compression stockings is indicated. They improve lymph flow and soften fibrous tissue.

If therapeutic methods fail to relieve symptoms, surgical treatment may be required, before which a thorough examination is carried out to take into account all possible risks.

Folk remedies

Traditional medicine offers a large number of recipes for venous dermatitis. All of them are available to most people and can be used in combination with other treatment methods.

Garlic with honey

A tincture is prepared based on garlic. Chop the garlic, pour in liquid fresh honey, leave for a week. Take the prepared mixture one teaspoon before meals three times a day. The course of treatment is two months. For 350 grams of honey you will need 250 grams of garlic.

Cabbage leaf

Wear a cabbage leaf bandage on your leg for two weeks. To soften the fresh leaf, you need to beat it off a little, apply it to the sore spot, and secure it with a bandage. After 2-3 days, remove the bandage and tie another sheet.

Cool aloe compresses relieve inflammation and moisturize the skin. You can make a water infusion or simply apply cut leaves with pulp to the damaged areas.

Kalanchoe

To treat varicose eczema, use an alcohol tincture. Fill a half-liter container to the top with crushed leaves of the plant and fill it with vodka or alcohol diluted to 40 degrees. Leave for a week in a cool, dark place. Then mix the tincture, strain and rub on your feet.

Chestnut

Horse chestnut fruits are poured with vodka (half a liter of vodka per 50 grams of fruit) and placed in a dark, cool place for a week. I drink the tincture daily, twice ten drops.

Conclusion

The unaesthetic appearance of the legs is not the biggest problem that varicose dermatitis entails. The disease, if left untreated, can cause harm to health and result in disability, so do not delay going to the doctor when the earliest symptoms appear.

How to treat trophic ulcers with varicose veins? Experts offer three ways

The article will discuss one of the complications of varicose veins - trophic ulcer. The complication is considered extremely dangerous and severe.

If it is neglected, it cannot be avoided without intensive intervention. If severe trophic changes in the skin with varicose veins are visible, then the use of plastic surgery is necessary.

If the varicose ulcer has not grown too much, then the ulcers can be treated with laser therapy, sclerotherapy, or limited to conservative treatment.

General information

A trophic ulcer is a non-healing injury to the skin. It is often accompanied by complications, such as the development of infections.

Before the development of an ulcer, there is a long period of trophic changes in the skin with varicose veins. Vessels and skin are exposed to stress and tension for many weeks and months.

Ultimately, the surface of the skin becomes whitish, an unhealthy shade and shine appear. Such symptoms are considered a critical point.

After this, the ulcer begins to progress rapidly. In the worst case scenario, the damage reaches bone tissue, irreversible consequences can occur, and even deaths are recorded.

For mild lesions they can be relatively effective. Let's take a closer look at how to treat ulcers from varicose veins.

Conservative treatment

First of all, the patient undergoes diagnostics. Doctors must determine the cause, nature of the disease and prepare a treatment plan.

The cause of a trophic ulcer is indeed most often varicose veins. He is responsible for more than half of the recorded cases.

Conservative treatment can be local or general. By general we mean taking medications, giving injections, and so on.

Then the trophic ulcer is smeared with Argosulfan cream. The top is wrapped with a bandage. The active ingredient in the ointment is silver sulfathiazole.

It has high antimicrobial activity. In addition, Argosulfan accelerates wound healing and reduces pain. The dressing should be changed every day.

Local procedures must be supplemented and enhanced by taking medications. The most prescribed are venotonics, antibiotics, anticoagulants, anti-inflammatory drugs, vitamins, and immunomodulators.

Among venotonics, Detralex or Phlebodia 600 are regularly prescribed. The drugs improve the general condition of vascular tissues and lymphatic drainage.

Surgical intervention

Unfortunately, conservative treatment methods cannot always guarantee complete recovery. In this case, more intensive procedures are necessary.

They are aimed at eliminating the cause of varicose veins. Modern methods allow you to avoid a scalpel and general anesthesia.

Classical surgery is used mainly for very extensive skin lesions. To eliminate the injury, plastic surgery involving skin grafting is performed.

Intensive treatment methods are highly effective. But they are not always used, since conservative treatment can usually cope quite well with even a trophic ulcer.

Traditional methods

Traditional methods should be classified as conservative treatment. Regardless of your level of confidence in such methods, it is strongly recommended that you undergo an examination by a doctor.

A remedy with a golden mustache shows a good healing effect.

One leaf of the plant is thoroughly washed under warm water and torn into small pieces, about one to two centimeters.
Place the pieces in an enamel pan and begin to squeeze until the juice appears.
The mixture is applied to the ulcer and covered with gauze and bandage. The bandage is applied at night and removed only in the morning.
The pus must be washed with hydrogen peroxide.

Another option is camel thorn (tatar).

To do this, take dry tartar leaves and grind them into fine crumbs.
It is sifted through a sieve and then stored in a jar in a dark place.
The wound should be treated with pharmaceutical rivanol and sprinkled with camel thorn powder.
The ulcer is bandaged at night and the medications are allowed to act until the morning.

Potassium permanganate is diluted in warm water in medium concentration (until a pale pink color appears). The ulcer should remain in it for half an hour.
Then you should dilute the calendula, 100 milliliters of calendula per liter of water. In the same way, keep the wound in the solution for another half hour.

The third and final bath will be a solution with eucalyptus. After this, the ulcer is bandaged.

Therefore, the result may be minimal or completely absent. This once again emphasizes the importance of consulting a professional doctor.

Conclusion

Venous dermatitis and eczema with varicose veins on the legs

Varicose veins disappeared in 1 week and no longer appear

Varicose eczema is also called erythema, stasis dermatitis, scaly skin of the lower extremities. It refers to chronic skin diseases and develops against the background of impaired venous circulation or deep vein thrombosis. Venous dermatitis on the legs affects the skin exactly above the veins and in close proximity to them, spreading to the ankles and lower legs. Most often, this disease manifests itself in women, overweight people, and those suffering from cardiovascular diseases. In treatment, it is important to normalize venous blood flow and control symptoms.

Mechanism of disease development

Venous dermatitis is a chronic disease manifested by swelling of the tissues of the lower extremities of a non-inflammatory nature. It is accompanied by itching and excoriation of the skin (injury when scratching), weeping. Often a secondary infection occurs. It develops on the skin in the area of the ankle joints and lower legs. The true cause of varicose eczema is poor circulation and venous stasis, or rather, it is an advanced form of varicose veins.

Thrombosis of the vessels of the lower extremities and disruption of the venous valves leads to a deterioration in the outflow of blood, increased pressure on the walls of the veins and vessels, and their mechanical stretching. At the same time, the permeability of the vascular walls increases significantly, and blood elements enter beyond the bloodstream. Tissues experience hypoxia (oxygen starvation).

Stagnation of blood leads to disruption of tissue trophism and swelling of the legs. The skin becomes bluish, thins, flakes and itches. Wounds and microcracks appear on it - ideal entry points for infection. Inflammation begins, weeping, pustules, and ulcers appear. When they tighten, they decrease in size, many small scars remain, and the tissues become coarser. Read more about leg ulcers due to varicose veins

Causes of venous dermatitis

Chronic non-inflammatory dermatitis of the lower extremities is a consequence of varicose veins. Therefore, the true causes of varicose eczema are:

stagnation of blood in the vessels;
vascular valve dysfunction;
excess pressure in the venous bed;
vasodilation.

Risk factors that may increase your chance of developing eczema include:

vein thrombosis;
leg injuries;
overweight;
old age;
diseases of the endocrine system;
pregnancy;
cardiovascular failure;
various vascular pathologies;
dermatitis and eczema of the skin of an allergic nature.

It is also possible that infectious agents may have a negative impact on the condition of the veins. Toxins produced by viruses or bacteria can also trigger the development of varicose veins and then eczema.

Diagnostic methods

It is impossible to identify this disease visually during examination. Each patient has a different set of symptoms. In addition, the manifestations of the disease change over time. There are no specific diagnostic methods either.

To make an accurate diagnosis, the doctor conducts a physical examination and studies the anamnesis, and conducts a comparative analysis of all signs of the disease. Sometimes additional examination methods and laboratory tests (ultrasound of blood vessels, blood tests, etc.) are necessary.

Symptoms of the disease

Venous eczema develops over a long period. One stage replaces another. Some symptoms accompany the disease constantly, while others are characteristic only of a certain phase. This complicates diagnosis and requires a specific approach to treating the disease at different stages.

Clinical manifestations of varicose eczema:

fatigue and pain in the legs, worsening in the evening;
swelling of the tissues of the lower extremities;
purple, bluish or red tint to the skin in the area where the veins are located;
epidermal pigmentation;
itching and irritation;
open wounds on the skin of the legs;
peeling of the dermis;
formation of ulcers;
blistering rash;
detachment of skin and subcutaneous fat from underlying tissues;
tissue hardening.

The earlier the disease is diagnosed, the greater the likelihood of preventing its progression to a chronic form. But this requires an integrated approach.

Features of treatment

Treatment of venous dermatitis on the legs should be carried out in two directions. Firstly, it is necessary to relieve the unpleasant accompanying symptoms: itching, swelling, peeling, ulceration of the skin. Secondly, it is important to eliminate the true cause of the disease - to treat varicose veins, normalize blood flow through the vessels and restore tissue nutrition. Therefore, complex treatment of varicose eczema does not exclude the combination of various methods of therapy.

Traditional methods of treatment

Venous dermatitis on the legs and varicose veins that provoke its development have been known to mankind for a long time. The treatment methods used by the people were adjusted and supplemented. Therefore, today there are many ways to treat this disease at home. Aloe, chamomile, wormwood, hop cones and other medicinal plants have long been used to treat venous eczema:

Various ointments and infusions are prepared from aloe juice, which have a moisturizing, bactericidal and anti-inflammatory effect. They are often used to treat various skin diseases, including dermatitis, burns and peeling. You can also apply sections of the leaves of this plant to the affected skin or lubricate it with freshly squeezed juice. Aloe also helps with varicose veins
Chamomile decoctions and infusions have a drying and bacteristatic effect. They are recommended for use in weeping forms of eczema.
Turmeric paste perfectly relieves swelling and irritation during allergic skin reactions and severe itching.
Tea tree oil disinfects and soothes the skin. It cannot be used in pure concentrated form. For 50 ml of boiled water or herbal decoction, take 15-20 drops of oil. The resulting solution is used to treat the affected areas several times a day.
Raw grated potatoes help treat skin sores. The pulp from the root vegetable is placed in a gauze bag and applied to the leg for 20-30 minutes a day.
A strong decoction of wormwood or an infusion of wormwood powder in milk is applied to intact skin on the area of veins affected by varicose veins. The procedure is repeated for 4 days, then a break of 10-15 days is taken.
A decoction of hop cones prepared in a water bath is recommended for external and internal use.

Traditional medicine does not deny the possibility of their use. But experts warn that all these methods should be used as an additional or supportive treatment, and in no case as the main and only correct one. Self-medication and ignoring medical recommendations can even lead to disability.

Drug treatment

The main goal of treatment is to improve the condition of the veins and normalize blood flow. At the same time, symptomatic treatment is carried out to relieve skin symptoms such as irritation, swelling, peeling, ulceration, inflammation, etc. The patient is prescribed ointments or emulsions, as well as preparations for internal use. Among them are antihistamines, glucocorticosteroids, anti-inflammatory, antibacterial (in case of secondary infection), diuretics for the drainage of excess fluid from tissues.

The use of ointments for varicose veins and edema restores blood flow in the limbs and gives tangible treatment results.

For topical use, ointments containing zinc, camphor, benzocaine, and menthol are used. In the complex, medications are prescribed to calm the nervous system: drops of hawthorn, valerian. For severe excruciating pain, it is advisable to use tranquilizers. At advanced stages of the disease, treatment is not complete without broad-spectrum antibiotics.

Compression garments

Phlebologists recommend using compression garments for the treatment of varicose veins and venous erythema in the stage of epithelization (remission). Compressing the dilated veins helps normalize the pressure in the vessels and the speed of blood flow. Blood flow from pathologically dilated and damaged veins during compression is redistributed and transferred to healthy vessels. Tissue nutrition and fluid outflow are restored.

Previously, special elastic bandages were used for this. Modern underwear is created taking into account the physiological and anatomical characteristics of a person. The pressure in compression tights or stockings is evenly and correctly distributed to all areas of the skin. The pressure from the shin to the thigh decreases gradually. You just need to choose the right size.

You should select such underwear after consulting your doctor. This method of prevention and treatment has contraindications. It is not recommended to use the compression method for patients with atherosclerosis, arterial pathologies, people with sensitive skin and for dermatitis and eczema in the acute stage.

Therapeutic gymnastics

Moderate therapeutic exercises allow you to control and maintain the condition of the veins, and is an additional way to treat varicose eczema. The main thing is to control the load and not overdo it. Leg exercises for varicose veins will also be useful.

The exercises are very simple - you need to rise on your toes and lower yourself onto your entire foot in different positions:

sitting on a chair;
standing on your feet with support on your hands (you can lean on a chair or table);
standing on your feet, arms down;
standing on your feet, arms raised up;
standing on your feet, arms extended forward.

Slow walking is useful. It is important to ensure that the shoes on your feet are comfortable and do not restrict movement or squeeze. During periods of remission, when the skin is epithelialized and there is no damage on it, it is useful to visit the pool and do fitness.

Physiotherapeutic treatments

Alternative medicine suggests treating many diseases of the blood and veins with leeches. Hirudotherapy often saved and helped many patients. Modern physiotherapy has a whole arsenal of methods and devices for the treatment and prevention of varicose veins and varicose dermatitis. The choice of method should be made by a phlebologist and physiotherapist, since at different stages of the disease some methods are indicated, while others can even be harmful.

electrophoresis;
darsonvalization (improves lymph flow and blood microcirculation);
pulsed magnetic therapy with eddy electric currents;
intermittent pneumocompression;
simultaneous exposure to magnetic and laser fields;
balneotherapy;
hydrotherapy;
oxygen baths;
ozone therapy;
PUVA therapy (irradiation with UV rays);
phototherapy.

The range of physiotherapeutic treatment options is constantly expanding. Some of the listed methods, in combination with proper conservative treatment and the use of folk remedies, can contribute to the rapid restoration of the skin and blood vessels.

Prevention of venous dermatitis on the legs

In order to prevent the disease for people prone to varicose veins and eczema-like skin manifestations, doctors recommend:

avoid skin injury;
in a sitting position, raise your legs on a small bench or stand so as not to load the vessels through which the blood flows;
lead an active lifestyle and walk so that the leg muscles are active and cause blood to circulate through the vessels;
if your skin is too dry, use moisturizing and nourishing creams;
avoid overheating and sweating feet;
it is important to wear high-quality and comfortable clothes made from natural fibers;
choose the right shoes, especially tall models of boots and shoes.

For people with a hereditary predisposition to varicose veins, prevention of varicose veins of the lower extremities is ideal.

It is equally important to follow a diet, give up alcohol and smoking, fatty and fried foods, salty and spicy foods. In the winter-spring period, it is recommended to compensate for the lack of vitamins and minerals with special balanced complexes. Those who have a stationary or standing job need to take breaks and do some exercise for their legs.

By following these simple prevention tips and following your doctor’s recommendations, you can avoid such serious complications as the formation of trophic ulcers, open bleeding wounds, tissue degeneration and malignancy, blood poisoning, the development of gangrene and subsequent amputation of a limb. It is important to remember that without proper treatment, varicose eczema can develop from a cosmetic defect into a very serious disease, and at the first symptoms and suspicions, immediately consult a doctor.

Are you one of those millions of women who struggles with varicose veins?

Have all your attempts to cure varicose veins been unsuccessful?

Have you already thought about radical measures? This is understandable, because healthy legs are an indicator of health and a reason for pride. In addition, this is at least human longevity. And the fact that a person protected from vein diseases looks younger is an axiom that does not require proof.

Changes in the skin of the legs with varicose veins

Pathological changes in the veins of the lower extremities are considered common, especially among athletes and the elderly. If the blood supply to a certain area of the skin is disrupted, venous pressure increases and varicose veins occur. The dilation of the veins becomes very noticeable, blood vessels appear, and changes in the process of cellular nutrition (trophism) occur. When the disease is not treated for a long time, trophic changes in the skin occur with varicose veins, which are accompanied by damage to the skin. In the affected area, significant increases in skin pigmentation, dermatitis, eczema and trophic ulcers are observed.

When treating trophic changes in the skin using traditional methods in combination with drug therapy, the patient has a better chance of a speedy recovery.

Causes

Predisposing factors for inflammation of the skin on the legs are quite similar to the causes of varicose veins:

carrying heavy objects;
overweight;
diabetes mellitus;
pregnancy and childbirth;
genetic predisposition;
lower limb injuries;
chronic infections;
decrease in the body's defenses;
metabolic disorder (metabolic process) and microcirculation;
disruptions in the functioning of the cardiovascular system;
venous insufficiency;
swelling of tissues.

Symptoms

With trophic disorders, the skin becomes thin, dry and easily injured. Other problems with the skin and condition of the legs also arise:

puffiness and swelling;
burning and pain in the affected area, the skin becomes very hot;
heaviness in the limbs;
necrosis of the epidermis;
the appearance of red itchy spots, which eventually acquire a blue tint;
the skin becomes smooth and shiny;
small bubbles appear, which burst and erosions form in their place;
Liquid begins to seep through the skin.

Trophic ulcers develop both on the top layer of skin and can go deep into the wound. In this case, the person experiences severe pain in the calves or tendons of the legs, and there is a high risk of osteomyelitis (an infectious inflammation of all parts of the bone tissue). The person becomes irritable and restless, and sleep disturbances occur.

Types of trophic changes in the skin of the legs

Against the background of impaired venous outflow in the lower extremities, trophic skin changes occur, which are characterized by a chronic course. And even after successful surgical treatment of the disease, external signs of ulcers and eczema do not disappear. Trophic disorders of soft tissues include:

lipodermatosclerosis;
hyperpigmentation;
microbial eczema;
skin atrophy (exhaustion, loss of vitality);
trophic ulcers.

Lipodermatosclerosis

The process of cellular nutrition is disrupted during periods of constant edema. As a result of disruption of venous outflow, pressure begins to increase in the vessels. Blood components (plasma and cells) pass through the walls of the capillaries, located in the subcutaneous fat layer and skin. Here the destruction of all components occurs, the chronic course of the inflammatory process begins, which subsequently leads to trophism.

Hyperpigmentation

Trophic changes, as a rule, occur in the lower part of the leg and in the area of the inner ankle. The sensitivity of the skin decreases, it becomes dense, darkens, and acquires a brown tint.

Microbial eczema

When venous stagnation occurs, it becomes difficult for local immunity to fight the pathogenic microflora that is present on the skin. Therefore, at the site of inflammation, various infectious agents (streptococci) or fungi begin to actively multiply. The body’s immune system responds to the irritant with an allergic reaction, and venous microbial eczema occurs. In the acute stage of eczema, the patient complains of itchy skin in areas affected by varicose veins and throughout the body. The skin begins to separate in small films, small wounds such as abrasions appear, and therefore the quality of life and moral well-being of the patient decreases.

Skin atrophy

Pigmented skin at the site of lipodermatosclerosis becomes lighter over time, but this is not an indication that everything has returned to normal. On the contrary, the last stage of disruption of the cellular nutrition process occurs - white atrophy. The skin becomes denser, and retracted areas appear in the form of pits. The leg at the site of the lesion may decrease in volume, as if it were tightened with a cuff.

Trophic ulcers

They have a chronic course, do not heal for a long time, but only increase in size. The wound periodically heals, but after a while it opens again. Scratching the wound causes infection. Local medications only in rare cases help healing, and special dressings do not justify themselves at all. In this case, an urgent consultation with a phlebologist and a diagnostic examination is required.

Treatment

Patients with varicose eczema need a comprehensive treatment approach: drug and local therapy, balanced nutrition, a healthy lifestyle, distribution of work and rest. For trophic ulcers, surgery is indicated. After which the ulcers quickly heal. But darkening and thickening of the skin remain forever. Compression garments are recommended for everyone, without exception.

Local therapy

This type of treatment involves the use of special creams, ointments, lotions and baths. They are especially effective in the initial stages of inflammation of the skin with varicose veins. Local preparations moisturize, soften and disinfect the affected area of the skin. It is also necessary to monitor the hygiene of problem areas of the skin. Wash the skin with neutral soap, dry with sterile wipes or cotton wool, and treat with solutions of antiseptic and antimicrobial agents. The use of hormonal drugs helps relieve inflammation and reduce itching.

Drug treatment

Local therapy in combination with oral medications is effective in treating the problem. Drug treatment consists of the following medications:

antihistamines;
antibiotics;
sedatives;
venotonics and vascular drugs.

Surgery

Indications for surgical intervention are advanced forms of skin changes that do not respond to conservative therapy. The patient undergoes vein removal, minimally invasive surgery (operation through pinpoint punctures of tissue) or uses laser treatment methods and sclerotherapy.

Traditional medicine

To begin treating inflammatory skin processes with traditional medicine, you must first consult a doctor. If the patient has injuries and deep ulcers, folk remedies can only worsen the situation. Traditional therapy suggests the use of natural ingredients, vegetable oils, tinctures of medicinal herbs, and plant juices. As a rule, decoctions are prepared from chestnut extract, grape leaves, chamomile and calendula flowers, oak bark, which have disinfectant, anti-inflammatory properties, and also heal wounds. Vegetable oils from almond, coconut or wheat germ moisturize problematic skin after hygiene procedures.

Preventive measures

Preventive measures for a very life-threatening complication of venous pathology are of great importance. Moderate physical activity helps to increase the tone of the muscles and veins of the legs: walking, running, swimming. Massages, contrast showers, and dousing with cool water will also be helpful. You should not constantly sit or lie down, as movement increases microcirculation and promotes wound healing. Wear comfortable shoes that fit your feet, choose clothes exclusively from natural fabrics, especially for eczema and ulcers.

Inflammation of the skin of the legs with varicose veins is chronic, lasts for years and leads to irreparable changes in the skin. If changes in the skin are noticed in time, the doctor will conduct competent and correct therapy, which will stop the inflammatory process and even eliminate small trophic ulcers.

Varicose trophic skin changes: how to treat the disease

What is a trophic ulcer

This term refers to a chronic skin defect, most often in the shin area. Without treatment, ulcers practically do not heal completely and appear again and again, the cause of their occurrence is varicose veins .

According to many experts, the reason for the appearance of varicose veins in a person was his upright posture, as a result - increased loads on the legs.

And indeed, if you look at any four-legged animal, not one of them will have varicose veins. If the walls of blood vessels are weak initially, the risk of varicose veins only increases.

If the disease is not treated in time, the walls of the vessels gradually become thinner, and the elasticity of the skin in the area of the diseased veins decreases.

Tissues cease to receive the required amount of nutrients and oxygen, and the carbon dioxide content, on the contrary, increases. In addition, impaired blood circulation leads to the fact that decay products are not removed from the tissues in a timely manner.

The first sign of trophic changes in the lower extremities is a change in skin color, it becomes darker. In addition, you can notice:

burning and itching;
lymph discharge on the skin;
swelling;
thickening of the skin, the appearance of an unhealthy shine;
dermatitis;
A white spot (dead tissue) appears in the center of the affected area.

Gradually, the ulcer begins to deepen, grow and fester. If there are several trophic formations, they grow together.

Important! Almost all trophic ulcers caused by varicose veins appear in the ankle area.

The development of a trophic ulcer from appearance to healing occurs in four stages:

The appearance and growth of ulcers. In the process, the skin cells around the wound are destroyed.
Purulent discharge.
Scarring. During this period, the body tries to cope with the ulcer on its own.
Restoration of the affected skin area.

The whole process takes on average about 1.5 months. However, the greatest danger of ulcers is in relapses. In advanced cases, tissue damage becomes deeper, reaching the bones.

One of the most severe consequences of trophic skin lesions is cancer and gangrene, which in the final stages leads to amputation of the limb. Therefore, at the first symptoms, you should consult a doctor and do not try to cope with the disease on your own.

Types of treatment for trophic ulcers with varicose veins

The type of treatment for trophic leg ulcers depends on the stage of the disease and the individual characteristics of the patient. Of all the directions, three of the most famous can be distinguished:

Conservative treatment.
Surgical intervention.
Traditional medicine.

At the same time, doctors are skeptical about traditional methods of treatment. This is primarily due to the fact that too much time must pass to achieve the effect of the same herbal medicine. Additionally, herbs and poultices will not help cure ulcers in their advanced stages.

Ulcers need to be treated only together with the underlying disease. Since varicose veins are not the only cause of trophic changes in tissues, a complete diagnosis of all body systems will be required.

Conservative treatment

Conservative treatment includes drug therapy, washing of ulcers and their subsequent treatment. To achieve the desired effect, a set of measures is used:

Treatment aimed at improving blood flow and dissolving blood clots.
Cleansing the ulcer from pus.
Wearing therapeutic underwear.
Therapeutic gymnastics and massage.

To treat trophic changes in the skin with varicose veins, regular wound treatment with antiseptic agents is required. This is necessary to prevent suppuration.

In addition to antiseptics, wound healing and anti-inflammatory ointments are used. Also, do not forget about drugs aimed at strengthening veins and small vessels.

Infectious diseases make treatment difficult, so it is important to maintain immunity during this period. To do this, you need to take a complex of vitamin preparations, as well as carefully monitor your health.

Surgical treatment

The most effective method of treating trophic ulcers. It includes any options for surgical interventions, including plastic surgery with transplantation of healthy skin to the affected area. In addition to transplantation, the affected areas of the veins are removed.

Before any surgery, ozone therapy is first performed to cleanse the ulcer of bacteria. Recovery after skin graft surgery is quick, and the patient feels no pain the very next day.

Extreme measures include amputation of limbs. This can happen if the patient does not follow the doctors’ recommendations after surgery.

If you ignore further therapy using topical medications, the ulcer will return again. If treatment is delayed, the risk of skin cancer only increases.

Traditional methods

Despite the achievements of modern pharmacology, herbal medicine is still popular. Sometimes doctors themselves recommend herbal treatment, but only in combination with the main therapy.

Most often, homemade ointments and compresses, herbal baths are used, and sometimes patients take decoctions or tinctures orally. This treatment is effective only in the initial stages of the disease, here are some simple recipes:

Before using ointments and compresses, the skin must first be disinfected. All bandages used must be sterile to avoid introducing infection into the wound.

Important! Most folk recipes contain allergenic components. Before using ointments, you should first test their effect by applying a small amount to the crook of your elbow or wrist. If nothing happens within 24 hours, the product can be used.

Preventive measures

Preventing trophic changes in the skin and subcutaneous tissue due to progressive varicose veins is much easier than treating the consequences. Therefore, it is important to take measures not only against the appearance of ulcers, but also to try to prevent the appearance of varicose veins. What you can do:

And the main thing in preventing the disease is regular visits to a phlebologist for preventive examinations. Then it will be possible to detect the disease in the early stages and quickly treat it without serious consequences and costs.

Conclusion

Complications from trophic ulcers caused by varicose veins are too serious to neglect timely treatment and prevention. An integrated approach to the treatment of ulcers and the underlying disease will quickly restore health to the legs and veins.

One of the most serious consequences of varicose veins is trophic changes in the skin on the legs. Ulcers are difficult to heal, and their treatment takes time; if you miss the moment, there is a high risk of losing your leg. This is why it is so important to treat varicose veins in the early stages, even before the formation of non-healing wounds.

Patients who develop trophic changes in the skin due to varicose veins in the form of ulcers are at particular risk. The likelihood of developing deep ulcerative lesions and infection is very high, which can lead to a serious general condition. Trophic changes in the skin of the lower extremities can accompany many other diseases, the course of which is out of control.

Causes and clinical picture of trophic disorders

The most common “culprits” of problems with the nutrition of the tissues of the affected area are the following diseases:

varicose veins in the legs;
diabetes mellitus, type 2;
obliterating atherosclerosis;
infectious processes of a chronic nature;
cardiovascular failure with edema.

Predisposing factors of the pathological process can be the following body conditions:

overweight;
late pregnancy and the postpartum period;
traumatic injuries.

The first signs of disruption of soft tissue trophism in the area of the affected area are indicated by a change:

skin color (redness or darkening);
elasticity of the skin (it becomes thinner, shiny, peeling);
itching, burning and pain in the legs;
swelling;
the appearance of bubbles with transparent contents.

If the first symptoms of venous insufficiency or other problems with blood vessels and innervation of the legs were ignored, deep damage to the skin and subcutaneous tissue in the form of ulcers with purulent contents may subsequently occur.

The appearance of various types of disturbances in the trophism of the outer integument and underlying tissues requires close attention of specialists and immediate treatment of the underlying disease and its consequences.

Edema of the lower extremities of venous or cardiac origin provokes a change in the permeability of the vascular wall, as a result of which the liquid part of the blood penetrates into the subcutaneous tissue and causes gradual destruction of cellular structures. The skin thickens and becomes painful.

Due to lack of oxygen, adipose tissue cells are replaced by connective tissue, and chronic inflammation develops. The lack of therapeutic measures over time leads to trophic disorders in the form of ulcers.

Darkening of the skin is one of the initial signs of developing trophic changes in the form of ulcers. Pigment spots appear due to the destruction of blood cells penetrating from the vascular bed into the surrounding tissues. Pigmentation is most often located on the inner surface of the legs.

Congestion in the veins creates favorable conditions for the development of an infectious inflammatory process on the skin. Bacterial pathogens (streptococcus, staphylococcus) provoke the development of an allergic skin reaction against the background of weakened immunity.

These phenomena lead to the development of eczematous lesions. The patient is bothered by itching, which intensifies at night and in stressful situations. Due to scratching, the inflammatory process progresses, which manifests itself as a pustular lesion with the formation of an ulcer.

In places of increased pigmentation, the cover gradually becomes lighter, which occurs as a result of atrophic processes. A sharp compaction of the skin layers leads to the formation of depressions and irregularities, visually the leg decreases in volume.

The terminal stage of trophic disorders is called white atrophy.

Violation of the integrity of the epithelial layer leads to the formation of a skin defect with the formation of an ulcer. Penetration gradually develops, affecting the deep layers of the skin, as well as subcutaneous fatty tissue and muscles.

Modern examination methods will help to identify the condition of veins and arteries:

duplex scanning of blood vessels;
ultrasound examination;
computed tomography of veins;
X-ray method with the introduction of contrast agents into the vascular bed.

To identify the nature of the infection, it is necessary to do a bacteriological analysis of the purulent contents from the wound surface. The results obtained will allow us to select etiological treatment with local drugs.

A clinical blood test will show the degree of the inflammatory process (the number of leukocytes and ESR), as well as the severity of the allergic reaction to eczema (eosinophil content).

Health measures have a pronounced effect with a complex effect directly on the lesion and the entire body. Recovery usually does not occur quickly: it takes a long time for the ulcer to epithelize, so you need to be patient and persistently follow the advice of specialists.

To get rid of skin damage due to venous disease, you will need to reconsider your lifestyle:

tidy up your diet;
adhere to the work and rest regime;
get rid of bad habits;
use an elastic bandage for problem areas.

Drug treatment improves venous circulation and metabolism in soft tissues, affects the causative agents of the infectious process in the areas of ulcer formation.

To normalize venous blood flow and tissue trophism, the following means are needed:

venotonics (Detralex, Phlebodia, Troxevasin, Venoruton);
drugs to improve capillary blood circulation (Pentoxifylline, Nicotinic acid, Capilar, Aescusan);
medications that stimulate trophic processes in affected tissues (Actovegin, Solcoseryl);
broad-spectrum antibiotics (cephalosporins, fluoroquinolones, semisynthetic penicillins);
antihistamines (Fenkarol, Cetrin, Claritin);
antioxidants (Tocopherol acetate, Succinic acid, Mexidol).

The duration of the course is determined by the attending physician.

Treatment periods can be long (for venotonic drugs). Antibiotic therapy is carried out in conjunction with intestinal probiotics and antifungal agents.

Ointments and creams applied directly to the lesion have a positive effect when the first signs of the disease appear.

To cleanse the wound surface of necrotic masses, Iruksol ointment is recommended. Chloramphenicol (an antibacterial agent in the drug) suppresses the activity of pathogenic microflora.

Local drugs actively inhibit the activity of microorganisms:

A modern way to fight infection is Branolind tissue wipes, which have an effective disinfectant and anti-inflammatory effect.

To wash the ulcer and free it from necrotic tissue, the following disinfectant solutions are used, which can be used to soak the dressings:

Potassium permanganate;
Hexamidine (3%);
Hydrogen peroxide (3%);
0.25% silver nitrate;
Dioxidine;
Miramistina.

Ointments have wound healing properties:

In cases where it is urgently necessary to relieve the inflammatory process, corticosteroid-based products are used (Celestoderm, Lorinden A, Sinaflan). These ointments are not recommended for long-term use, as they can cause a decrease in adrenal function.

In situations where conservative therapy does not have the expected effect, the issue of surgical treatment of ulcers with trophic disorders is decided.

One of the ways to restore venous circulation is to remove the dilated venous node. An alternative to this effect is sclerotherapy of the affected vein and laser surgery.

To cope with trophic disorders of the skin and underlying tissues, the necrotic area with the ulcer is excised. This accelerates regeneration processes and stimulates repair.

Compresses and lotions based on the following medicinal plants can produce a therapeutic effect:

chamomile;
calendula;
St. John's wort;
sage;
oak or white willow bark.

Oil from sea buckthorn and rose hips has a pronounced regenerating effect.

Herbal remedies from the arsenal of alternative medicine should be used with great caution and only after consultation with your doctor.

The appearance of trophic disorders with ulcers on the skin is a prognostically unfavorable sign, which indicates the ineffectiveness of previous treatment for varicose veins.

Therapy tactics include a complex effect using systemic drugs and local agents. If conservative treatment is ineffective within several months, a decision is made on the need for surgical intervention.

Prevention of trophic ulcers consists of timely treatment of varicose veins and compliance with recommendations for lifestyle correction.

Patients with a tendency to trophic disorders of the skin of the legs should wear clothes made from natural fabrics and regularly carry out hygiene procedures. Women should avoid wearing high-heeled shoes.

Trophic disorders of the lower extremities should be treated intensively and in a timely manner: this will avoid decompensation of the condition and trophic disorders of the skin and subcutaneous tissue with the formation of ulcers.

What are the trophic changes in the skin with varicose veins?

Trophic changes in the skin with varicose veins most often occur if a sick person does not approach the treatment of his illness with full responsibility, namely: does not visit a phlebologist at the right time, does not follow precautions well, refuses medications and self-medicates.

The development of trophic ulcers is based on many processes:

Serious injury that can cause damage at the site where the ulcer will form.
Slow blood circulation and poor transmission of nerve impulses to blood vessels and tissues.
Diabetes mellitus and its many complications.
Serious damage to the nerve column.
Chronic eczema, dermatitis and severe allergies.
Burns and frostbite of varying severity.
Various diseases of the lymph nodes and acute lymphedema.
Thrombophlebitis and stage 4 varicose veins.
Antiphospholipid antibody syndrome (APA) and various autoimmune diseases.

With serious trophic disorders, the affected skin becomes very thin, and the patient may receive various injuries, but these are not the worst manifestations of varicose veins:

severe swelling and swelling;
unpleasant itching, burning and unbearable pain in the affected area, the affected area of skin is much hotter than the whole body;
heaviness in the legs, especially after long physical work and long walking over long distances;
epidermal necrosis;
bright red spots appear that are very itchy and over time change their color to dark purple;
the affected skin is smooth on palpation and also slightly shiny;
small bubbles form, which burst over time, and as a result of this process, erosion begins;
through the skin pores, light yellow pus is secreted.

Trophic ulcers can form not only on the first layer of the skin, but can go far into the depths of bleeding wounds. A sick person experiences terrible pain in the tendons and calves of the lower extremities. The risk of inflammation of the bone marrow and soft tissues, which is caused by mycobacteria, increases.

Trophic changes in the skin are divided into several stages, which differ in the method of elimination and symptoms. The most important point in the further formation of a trophic ulcer is the presence of an initial stage, when obvious symptoms have not yet appeared, but there is a tendency to trophic changes.

If a person has discovered several lumps in the area of the calf muscles and/or legs that are very itchy, as well as various neoplasms in the form of severe swelling, this indicates that he has begun stage 1 of varicose veins. The most commonly observed symptoms are:

feeling cold;
cramps of the lower extremities during sleep;
the color of the skin changes.

The appearance of dark red and blue spots indicates that the initial stage is coming to an end. The first stage comes to an end when the scab in the middle of the ulcer is destroyed by the action of dark brown pus. The first stage develops differently for everyone: up to several weeks or 1-2 days.

When the trophic ulcer is fully formed, varicose veins smoothly move to the next stage, at which edema and other very unpleasant processes begin to form. In the middle of a trophic ulcer, tissue necrosis begins. An open wound secretes abundantly lymph and other products of dead tissue, which emit a bad odor.

At this stage of formation, with a thorough examination of the material, the doctor identifies new colonies of pathogenic microorganisms. The ulcer continues to grow and develop, and this leads to the following ailments:

thrombosis;
erysipelas;
nocardiosis.

The result of the development of the second stage of varicose veins is the inability to step on damaged feet and the formation of new trophic ulcers.

As a rule, it lasts about 2 weeks, but sometimes this period can last 20-21 days. The bottom and walls of the trophic ulcer are updated daily with new abscesses. In many African countries, varicose veins at this stage are successfully treated with the help of Tsetse flies, which feed on dead tissue without affecting the remaining areas of the skin. The swelling gradually subsides, the viscous pus gradually ceases to be released, and the wounds begin to scar.

A trophic ulcer becomes covered with a thick layer of skin, and pus begins to secrete under it. This stage of varicose veins occurs 60-70 days after the onset of the disease. At the last stage of varicose veins, the patient develops terrible scars.

Because the blood flow in the legs is disrupted, trophic changes appear on the skin, which can become acute or chronic. And even after a completely successful surgical intervention, obvious signs of acute eczema and trophic ulcers remain on the patient’s skin. There are several types of trophic changes in tissues:

trophic ulcers;
skin atrophy;
bacterial eczema;
varicose dermatitis;
hyperpigmentation.

Due to constant swelling, the process of nutrition of epidermal cells, venous outflow is disrupted, and pressure rises in the blood vessels. The composition of the blood (its liquid part, red blood cells, leukocytes and platelets) slowly passes through the walls of the veins, which are located in the skin and subcutaneous fat layer.

As a result, all components begin to deteriorate, and a long-term inflammatory process gradually develops, which over time can lead to a slow delivery of nutrients to the cells and subsequently to tissue necrosis.

Most often, trophic changes occur in the ankle area and in the very lower part of the lower leg. A sick person exhibits these symptoms:

The sensitivity of the skin decreases.
The skin becomes denser.
It darkens, gradually acquiring a light brown tint.

Hyperpigmentation is not so scary; it is important to pay attention to external changes in the skin of the extremities in time and take action.

When blood stagnates in the veins, it is very difficult for the immune system to cope with pathogenic microbes that multiply on the patient’s skin in record time. For this reason, fungus and globular streptococcus actively develop at the sites of inflammation. The immune system responds to these irritants with severe allergies and the sick person begins to develop bacterial eczema.

When eczema worsens, the skin becomes very itchy, not only in the areas affected by the dangerous disease, but throughout the body. Small films separate from the skin, wounds develop that are very similar to abrasions, for this reason the patient’s well-being and quality of life sharply decrease.

Skin covered with pigment spots, in places where lipodermatosclerosis appears, gradually acquires a lighter shade, but this does not mean that varicose veins have stopped growing. This is associated with the progression of white atrophy. Over time, the skin becomes denser upon palpation, and small pits appear. The lower limb in the affected area may decrease in size.

They increase in volume very quickly, do not heal for a long time, and sometimes become chronic. Periodically, the trophic ulcer heals a little, but after a while it begins to bleed again and secrete light yellow pus. When scratching, pathogenic bacteria enter the trophic ulcers. In this case, the sick person urgently needs to make an appointment with a qualified phlebologist and undergo a thorough examination.

The following preventive measures are of great importance for trophic changes in the skin from varicose veins of the lower extremities and pelvis:

Slow walking (preferably barefoot on the grass).
Medical massage using massage or baby cream, as well as healing balms and essential oils.
Pouring with cool water.
Contrast shower.
Swimming in the pool with or without sports equipment.
Buy comfortable shoes made from genuine leather.
Stop smoking pipes and cigars.
Do not drink alcohol.
Closely monitor the levels of glucose and bad cholesterol in the blood.
Completely exclude from the diet cakes, pastries, chocolate (especially milk and white), buns, pies, cookies, sweet carbonated water, juices, fruit drinks, factory-produced nectars and other confectionery products.
Wear elastic bandages, compression stockings or knee socks. These products prevent the appearance of edema and provide tone to the blood vessels.

Various inflammations of the skin of the lower extremities and pelvis with varicose veins very often become chronic, leading to serious consequences. If trophic changes in the skin are diagnosed in time and appropriate treatment is carried out, then it is possible not only to eliminate the inflammatory process, but also to get rid of trophic ulcers.

Varicose trophic skin changes: how to treat the disease

According to many experts, the reason for the appearance of varicose veins in a person was his upright posture, as a result - increased loads on the legs.

And indeed, if you look at any four-legged animal, not one of them will have varicose veins. If the walls of blood vessels are weak initially, the risk of varicose veins only increases.

If the disease is not treated in time, the walls of the vessels gradually become thinner, and the elasticity of the skin in the area of the diseased veins decreases.

The first sign of trophic changes in the lower extremities is a change in skin color, it becomes darker. In addition, you can notice:

burning and itching;
lymph discharge on the skin;
swelling;
thickening of the skin, the appearance of an unhealthy shine;
dermatitis;
A white spot (dead tissue) appears in the center of the affected area.

Gradually, the ulcer begins to deepen, grow and fester. If there are several trophic formations, they grow together.

Important! Almost all trophic ulcers caused by varicose veins appear in the ankle area.

The development of a trophic ulcer from appearance to healing occurs in four stages:

The appearance and growth of ulcers. In the process, the skin cells around the wound are destroyed.
Purulent discharge.
Scarring. During this period, the body tries to cope with the ulcer on its own.
Restoration of the affected skin area.

The whole process takes on average about 1.5 months. However, the greatest danger of ulcers is in relapses. In advanced cases, tissue damage becomes deeper, reaching the bones.

Conservative treatment.
Surgical intervention.
Traditional medicine.

Conservative treatment includes drug therapy, washing of ulcers and their subsequent treatment. To achieve the desired effect, a set of measures is used:

Treatment aimed at improving blood flow and dissolving blood clots.
Cleansing the ulcer from pus.
Wearing therapeutic underwear.
Therapeutic gymnastics and massage.

To treat trophic changes in the skin with varicose veins, regular wound treatment with antiseptic agents is required. This is necessary to prevent suppuration.

In addition to antiseptics, wound healing and anti-inflammatory ointments are used. Also, do not forget about drugs aimed at strengthening veins and small vessels.

Before any surgery, ozone therapy is first performed to cleanse the ulcer of bacteria. Recovery after skin graft surgery is quick, and the patient feels no pain the very next day.

Extreme measures include amputation of limbs. This can happen if the patient does not follow the doctors’ recommendations after surgery.

If you ignore further therapy using topical medications, the ulcer will return again. If treatment is delayed, the risk of skin cancer only increases.

Despite the achievements of modern pharmacology, herbal medicine is still popular. Sometimes doctors themselves recommend herbal treatment, but only in combination with the main therapy.

Before using ointments and compresses, the skin must first be disinfected. All bandages used must be sterile to avoid introducing infection into the wound.

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A trophic ulcer occurs on the skin due to decreased tissue nutrition due to impaired circulation and death of neurons. Deterioration of trophism leads to necrosis and rejection of dead cells at the affected area. Treatment of trophic ulcers on the leg is particularly difficult due to changes in oxidative reactions in the area of inflammation and difficulty in cell regeneration, a decrease in local and general immunity.

In 95% of cases, the process forms on the lower extremities and is characterized by a long progressive course and a tendency to relapse.

In most cases, the appearance of trophic ulcers is caused by complications of primary diseases that cause changes in blood vessels, soft tissues or bones. Due to decreased blood circulation and hypoxia, microcirculation disorders and metabolic disorders (acidosis) occur in this area. The affected area becomes necrotic, easily injured and infected with pathogenic microflora. Common causes leading to trophic changes in the skin include:

Venous diseases. In 70% of cases, varicose veins, thrombophlebitis and postthrombophlebitis syndrome become factors in the formation of non-healing wounds on the extremities.
Obliterating atherosclerosis. When cholesterol plaques are deposited on the inner wall of the arteries of the extremities, a blockage of the vessel occurs.
Diabetes. Endocrine disease causes damage not only to the veins, but also to peripheral nerves, bones and joints.
Hypertension. A persistent increase in pressure leads to vascular ischemia.
Congenital malformations of the vascular system. These may be Parkes-Weber-Rubashov syndrome, hemangiomas.
Injuries. Caused by bandaging, squeezing, bedsores, burns or frostbite, and radiation.
Dermatoses. Eczema and allergic skin lesions of a chronic nature.
Autoimmune pathologies. Lead to disruption of systemic blood flow, for example, to Raynaud's disease.

As a rule, ulcers form in the lower leg area, on the sole, and less often on the toes. A photo of a trophic skin lesion is presented below.

Classification and symptoms of trophic ulcers

Violation of trophism in the limb is accompanied by signs that you should pay attention to and immediately begin treatment to prevent the development of ulcers. As a rule, this is heaviness in the legs, pain or loss of sensitivity, swelling of the calf area. Next comes burning and itching, the skin becomes rough, red, and acquires a purple tint.

Classification of trophic ulcers occurs according to several criteria:

according to the severity of the current;
according to morphological characteristics;
by size;
by origin.

According to etiology, trophic wounds are divided into the following types.

Atherosclerotic ulcers

Damage of atherosclerotic origin is located on the outer part of the foot, big toes, and sole. The defect is a consequence of damage to the arteries by cholesterol plaques during obliterating atherosclerosis, which causes stenosis of the veins in the legs or completely blocks the blood flow. Pathology is caused by hypothermia, constant compression of the feet by tight shoes, and violation of the integrity of the skin. The wound is usually small, round in shape with ragged, dense edges and suppuration in the center. The skin around the ulceration is pale, with a yellowish tint. The condition develops more often in older people; deterioration of trophism is indicated by:

difficulty climbing stairs due to pain;
intermittent claudication syndrome;
coldness of the extremities.

If left untreated, small wounds initially form on the foot, gradually increasing in size.

Venous

This type of lesion is formed due to circulatory disorders due to varicose veins or thrombophlebitis, the location is the inner surface of the lower leg. Reduced blood flow causes a lack of oxygen and nutrients, symptoms develop gradually:

At first, a person is bothered by a feeling of heaviness in the legs and swelling, and cramps appear at night.
Over time, the skin begins to itch and swell, and a red-purple network of veins clearly appears on it.
Gradually, the veins merge into a dark spot, the dermis thickens, becomes unnaturally smooth and shiny.
Light-colored, peeling scabs form.

If treatment is not started, a purulent wound forms that constantly gets wet. First, inflammation engulfs the epithelial layer, the progression of the disease leads to damage to muscle tissue, and subsequently the pathological process affects the Achilles tendon. In the advanced stage, the periosteum is damaged and destroyed.

In the video, home methods for treating trophic ulcers:

Diabetic

High blood sugar affects blood vessels and nerve endings. As a result of malnutrition, deep trophic ulcers form in the tissues, which are very difficult to cure even with medications. Sometimes non-healing wounds occur due to trauma to the corns, and due to the lack of innervation, a person loses sensitivity and does not feel the damage. In diabetes mellitus, the areas of greatest friction are predominantly affected - the phalanges of the toes and feet. Self-medication for diabetic ulceration is unacceptable; delayed help leads to gangrene and amputation.

Neurotrophic

The occurrence of wounds is associated with disruption of nerve conduction after injuries to the spine or brain. Ulcers form on the sole, in the area of greatest pressure - on the heel or near the toes. Their sizes are often small, but the tissues are affected deeply, to the bone. The pus that accumulates inside emits an unpleasant odor. Due to the death of nerve endings, sensitivity in the area of damage is reduced or absent, so patients can walk.

Hypertensive

The defect is rare; it affects older people, often women. The second name for the type of ulcer is Martorell syndrome. The cause is arterial hypertension, when prolonged spasm leads to atrophy of small vessels of the extremities. Initially, bluish or pigmented plaques appear on the outer surface of both legs. Then, suddenly or after a minor injury, crusty ulcers form. Progression of changes in the skin is slow, but the wounds are very painful and often become infected.

Pyogenic

The type of ulcers is called infectious, since they develop when pathogenic microflora is introduced due to scratching and poor hygiene in cases of folliculitis, eczema, pyoderma, and microtrauma. The wound is oval, shallow, with a flat bottom and thick purulent contents. The edges are roll-shaped and soft, bluish-reddish in color, the skin around is inflamed. Patients, as a rule, are representatives of asocial groups.

Possible complications

Trophic ulcers gradually grow, increasing the area and depth of tissue necrosis. Wounds are difficult to treat, and prolonged course and improper care can lead to complications of the disease:

erysipelas;
bleeding;
lymphangitis (inflammation of the lymphatic vessels);
phlegmon;
osteomyelitis;
purulent arthritis;
sepsis (infection in the blood);
gangrene.

The consequence of an ulcer can be amputation of a limb. In some cases, untimely assistance ends in the death of a person.

Diagnostics and therapy

Treatment of trophic ulcers of the leg and foot is prescribed after a comprehensive examination of the patient, during which the type and etiological factor of the lesion are determined. The nervous system is examined to determine the presence of hypertension or diabetes mellitus. Attention is paid to the condition of the vessels, lymph and bones on the affected leg, for this purpose instrumental methods are used:

Doppler sonography shows veins and blood flow;
X-rays reveal the stage of the disease.

Macroscopic examination includes bacteriological and cytological tests.

The choice of treatment tactics in each specific case is influenced by the results of the examination:

localization and depth of skin lesions;
changes in microcirculation in tissues;
presence and type of infection;
type of underlying disease.

Depending on the degree of damage and prognosis, conservative or surgical measures are indicated. In the initial stage, the doctor allows traditional methods of therapy to be supplemented with traditional medicine.

Operation

Surgical intervention for a trophic ulcer is carried out to remove the source of inflammation - necrotic tissue and pus - in severe cases it involves amputation of the limb. Radical treatment includes procedures:

Curettage, otherwise the cleansing of the wound cavity from pus and dead tissue, with a special instrument - a curette.
Layer-by-layer excision is used in severe cases with deep wounds. After the intervention, skin plastic surgery is required.
Vacuuming is carried out using a device that sucks out foreign inclusions; at the same time, the inflamed surface is irrigated with an antiseptic solution.
VAC therapy is an effective method that represents a local effect on the area of low pressure damage. Innovative treatment technology reduces the contamination of the wound with bacterial flora, removes its contents, maintains environmental humidity, and increases blood circulation. The procedure stimulates granulation, reduces the size of the damage, reducing the risk of complications.
Catheterization is required during a protracted course of the disease, especially with ulcers of hypertensive and venous origin.
Virtual amputation is a resection of the metatarsophalangeal joint while preserving the anatomical structure of the foot.
Percutaneous suturing of the arteriovenous ostium (fistula) to disconnect the vessels. The operation is often performed for hypertensive ulcers at the edges of the injury.

Laser energy helps fight non-healing ulcers. Low intensity radiation - LILI therapy - has an anti-inflammatory, biostimulating and analgesic effect without side effects under highly sterile conditions. Patient reviews of the laser technique are mostly positive.

Drug course of treatment

Treatment of trophic wounds with medications is used after surgery or as an independent course for mild and moderate stages of the disease. Therapy is carried out in stages, the choice of drugs is determined by the degree of development of the pathological process.

In the treatment of trophic ulcers of the lower extremities with weeping wounds, the following is used:

Antibiotics. Broad-spectrum drugs are suitable.
Non-steroidal anti-inflammatory drugs. Medicines based on diclofenac or ibuprofen: Diclofenac, Voltaren, Ibuklin.
Antiplatelet agents. These include "Reopoliglyukin" or "Pentoxifylline". Medicines are indicated to prevent blood clots and are prescribed intravenously.
To prevent allergies, Suprastin or other antihistamines are needed.

At the local level, healing of the ulcer surface requires measures to remove pus, infection, and dead tissue. Treatment includes:

Cleansing with antiseptic solutions: Chlorhexidine, Furacilin, potassium permanganate.
Application of anti-inflammatory local agents that can fight purulent processes - “Levomekol”, “Streptolaven”.
A special adsorbent coating is applied. During the treatment period, hydrogel dressings with silver are effective: “Coloplast Physiotul-AG”, “Atrauman AG”, etc.

If necessary, a blood purification procedure is performed - hemosorption.

During the cell division and healing phase, scars begin to form. The time has come to use gels, creams or ointments that stimulate tissue regeneration - Solcoseryl or Ebermina. Also at the second stage, the following is used for treatment:

Ointment with silver sulfathiazole - "Sulfargin" - is prescribed due to its antibacterial and wound-healing effects.
“Tocopherol” is recommended for eliminating toxins and restoring cell membranes.
Modern wound dressings: Voskopran, Allevin, Geshispon - provide protection and create a microenvironment that accelerates tissue recovery.

In case of diabetes mellitus, the treatment of trophic ulcers includes a mandatory reduction in glucose levels and the organization of dietary nutrition, otherwise it is impossible to achieve a positive result.

After completing the local course of therapy, patients need to take venotonic drugs, immunomodulators and vitamins for a long time.

Home methods

Folk remedies for the treatment of trophic ulcers of the lower extremities are allowed to be used in the initial stages, but only in combination with medications and on the recommendation of a doctor. The following recipes are used at home:

The wound is treated with an antiseptic solution: a Streptocide tablet is crushed into powder and sprinkled on the painful area.
Three layers of gauze soaked in blue iodine are applied to the ulcer. The top is covered with cotton wool and bandaged. After 12 hours, the bandage is removed and the gauze is changed. The course of treatment lasts until the wound begins to dry out and heal.
Propolis (25 g) is finely crushed, butter (200 g) is melted and the powder is poured into it. The mixture is simmered over low heat for 10 minutes, then filtered into a sterilized glass jar through gauze, and after cooling, stored in the refrigerator. The wound and the area around it are treated with an antiseptic, placing a thick layer of mass on a napkin and pressing it to the wound, covering it with cellophane and bandaging it. The compress is kept for a day, this treatment continues until healing.

Prevention

The occurrence of trophic changes in the skin of the extremities is associated with the underlying disease, so the main preventive measure remains treatment of the primary disease at an early stage. It is important to take good care of the skin of the legs and prevent injury in areas with poor circulation. Patients need to choose comfortable shoes and wear elastic bandages for varicose veins, and perform physical therapy exercises.
A trophic ulcer causes suffering and serious complications. Therapy for injuries takes a long time, often leaving large scars on the skin. Therefore, people at risk need to pay increased attention to their health, eliminate bad habits, and follow all doctor’s recommendations for disease prevention.

Localized muscle atrophy:
There are congenital and are designated in these cases as dysplasia. The pectoral muscles and the muscles of the eminence of the thumb are especially often affected.
Purchased local muscle atrophy always result from a neuromuscular disease. They are accompanied - depending on the etiology - by paresis, loss of reflexes, fasciculations and/or sensory disturbances.

If atrophy distributed symmetrically, this always raises suspicion of myopathy (or spinal amyotrophy). For example, in progressive muscular dystrophy there is relatively isolated atrophy of the quadriceps femoris or biceps brachii muscles. If atrophy is localized in the distal limbs, most likely we are talking about Steinert's myotonic dystrophy or polyneuropathy (with impaired sensitivity and loss of reflexes in the distal limbs).

Unilateral acquired isolated muscle atrophy are always the result of damage to either a root, or a plexus, or a peripheral nerve (the characteristic distribution of the process of atrophy and sensory disturbances is decisive for the topical diagnosis) or prolonged inactivity of the muscle (for example, atrophy of the quadriceps muscle with arthrosis of the knee joint, as well as with sarcoma of the hip). Focal atrophies of individual muscles or muscle groups, isolated and sometimes symmetrical, can slowly progress over many years. This is a sign of focal damage to the ganglion cells of the anterior horns, either due to ischemia in the area of the blood supply of the sulcocommissural artery, or for no apparent reason. The calf muscles are often affected.

With progressive muscular dystrophy Sometimes, in significantly atrophied muscles, areas with intact muscle fibers are identified, which look like nodules. They should be distinguished from the muscle roll formed by a rupture of the short head of the biceps brachii muscle and noticeable on the flexor surface of the shoulder.

Contractures of individual muscles due to connective tissue degeneration of tissues lead to their shortening. They develop, for example, with myopathies, especially with muscular-dystrophic processes, after muscle ischemia (Volkmann's forearm flexor contracture; retraction of the tibial bed muscles - extensors of the foot and fingers - with anterior tibial artery syndrome) and after frequent infectious diseases (quadriceps femoris contracture in young children, especially after deep injections of antibiotics).

Calcifications in muscles they are formed as part of universal calcification, diffusely - with trichinosis, widespread calcifications are found with “neurotic” myositis and during mechanical influences, for example, in the abductor muscles of the thigh with the so-called “cavalryman’s legs”.

Trophic skin disorders

Generalized skin changes Almost always serve as a sign of a dermatological disease:
For a neurologist, only “premature aging” of the skin with progeria (Werner’s disease), which is often accompanied by short stature, early gray hair, sometimes muscle atrophy, premature calcification of the arteries and other organ changes characteristic of old age, is of clinical significance.
as well as a number of neurocutaneous diseases, such as ichthyosis in Sjögren-Larsson syndrome.

Localized skin changes are of great importance in the practice of a neurologist:
On the one hand, they can be a sign of a disease of the peripheral nervous system:
- with lesions of peripheral nerves, the skin becomes dry, smooth, the papillary pattern is enhanced, and hyperkeratosis is sometimes observed;
- with herpes zoster (herpes), after the blisters disappear, segmental skin atrophy, livedo or white spots in the rash area are often observed;
- with leprosy, white spots are detected on the skin, pain sensitivity is impaired in their area;
- with syringomyelia. polyneuropathies, as well as diabetes and scleroderma, ulcers form. When identifying a trophic ulcer, differential diagnosis with rare sensory radicular neuropathy or vascular disorders is necessary. The location and accompanying symptoms are decisive for diagnosis.

On the other side, skin changes accompany a number of phakomatoses, being diagnostically important, pathognomonic signs for some of them:
- café-au-lait spots, if there are more than five of them, indicate Recklinghausen’s neurofibromatosis;
- white areas depigmentation serve in children as an early sign of tuberous sclerosis of the brain, which is also characterized by
- adenoma of the sebaceous glands (Pringle's nevus), located in the midline of the face - especially on the forehead, bridge of the nose or cheeks, which can protrude significantly above the skin in the form of a tumor and be covered with acne; - sometimes a nevus is localized on the face in the zone of innervation of one or several branches of the trigeminal nerve, characteristic of the third phakomatosis - encephalofacial angiomatosis of Sturge-Weber. In addition, skin changes are observed in a number of neurocutaneous syndromes, the listing of which is beyond the scope of this book.