What to know about eczema on the shin

The most common type of eczema in older adults is asteatotic eczema (AE). AE also commonly occurs in people in their 20s. Other names for AE are xerosis and eczema craquelé.

AE is likely to be a benign condition. A person may experience AE on any part of their skin, but people typically find it on:

• the front or side of their lower legs (shins)
• their back or arms

Symptoms

A person’s AE symptoms can include skin inflammation along with:

• dryness, which is more pronounced in dark skin tones
• redness in lighter skin tones
• darker brown, purple, or ashen gray discoloration in darker skin tones
• scaling
• itchiness
• cracking, which may occur in patterns, as eczema becomes more severe

Risk factors

People develop AE when they lose water from their skin or when their skin is more likely to be dry. People are more likely to have AE if they:

• live in dry or cold climates, especially during winter
• often take long, hot baths
• use degreasing agents
• experience a lot of skin friction
• experience exposure to radiation
• use indoor heating systems

Doctors believe that people with AE tend to be those who have the following:

• malignancy, or the presence of cancerous cells in the body
• hypothyroidism, a condition in which an individual’s thyroid gland does not produce enough thyroid hormones
• malnutrition, which can occur when a person’s diet does not include enough nutrients

Doctors also believe some types of medications may cause AE, such as:

• diuretics
• retinoids
• antineoplastics agents

Treatments

Doctors will tell a person to treat their AE with skin hydration methods such as:

• using skin lotions with high oil content rather than high water content
• applying emollients, or medical moisturizers, twice per day, just after bathing
• using topical corticosteroid medication on their skin
• applying topical agents such as pimecrolimus cream

Prevention

People can reduce their AE symptoms by:

• bathing less frequently
• using as little soap as possible when bathing
• using different types of soap
• using a humidifier in dry places

Discoid eczema (DE) can affect a person at any age. It is more common in:

• middle-aged people
• men
• people with other kinds of eczema

People may experience DE on their:

• arms or hands
• legs, including their shins
• torso

Other names for DE are nummular eczema and nummular dermatitis.

Symptoms

A person’s DE symptoms can include:

• round, raised lesions or skin spots
• very itchy skin
• a burning sensation on the skin
• oozing and crusting of lesions
• inflamed skin around the lesions that may appear red, pinkish, or brown, depending on a person’s skin tone
• scaly skin around the lesions

Risk factors

Doctors do not know the exact causes of DE. However, DE can have the following triggers:

• dry skin
• sensitive skin
• scrapes, chemical burns, or insect bites
• reactions with other kinds of eczema

DE on a person’s legs or shins can be a symptom of insufficient lower body circulation.

Treatments

A doctor can treat a person’s DE effectively with the right methods. They will recommend that a person:

• use topical corticosteroids on their skin two times per day
• apply topical antibiotics with the topical corticosteroids
• receive light treatment, or phototherapy, 2–3 times per week
• take medication to help clear any secondary infections

Prevention

Dermatologists will instruct people with DE to use skin self-care methods, which can help people clear their skin and prevent DE flare-ups. Dermatologists recommend that people:

• apply moisturizer frequently, including applying it to damp skin within minutes of bathing
• limit baths or showers to 20 minutes and use lukewarm water
• use mild, fragrance-free, or hypoallergenic skin care products
• use a humidifier in dry places
• wear loose-fitting, soft clothing made of breathable fabrics

Varicose eczema (VE) is a common type of eczema. It affects a person’s lower legs and ankles. It rarely occurs elsewhere on the body.

This type of eczema develops in people with insufficient blood flow in the lower body. It is more common in women and usually affects people over 50.

VE may indicate a serious underlying condition. A person is more likely to develop VE if they:

• have varicose veins
• have high blood pressure
• have kidney failure
• have obesity
• have had vein surgery
• have had multiple pregnancies
• have a history of blot clots in the legs
• have congestive heart failure
• sit or stand for long periods in their job
• do not engage in much physical activity

Healthcare professionals may also refer to VE as venous eczema, gravitational dermatitis, or stasis dermatitis.

Symptoms

A person’s VE symptoms can include:

• ankle swelling
• orange-brown spots of skin discoloration
• redness in lighter skin tones
• brown, purple, gray, or ashen discoloration in darker skin tones
• itching
• skin scaling or dryness
• aching after sitting or standing for long periods

If a person does not receive treatment for VE, they may develop shiny skin and open sores that bleed or ooze.

Treatments

To treat VE, doctors will recommend that a person:

• wear compression stockings to reduce swelling
• avoid high salt foods
• raise their legs above their heart every 2 hours
• take supplements such as vitamin C
• use topical corticosteroids or antibiotics if they have a secondary skin infection

Some types of eczema on a person’s shin are not a symptom of a serious condition. However, some forms of shin eczema, such as VE, may indicate that an individual has a life threatening condition.

People with eczema symptoms on their shins should always seek professional healthcare advice. Doctors can find out whether people have more serious health conditions and prescribe effective treatments.

Asteatotic, discoid, and varicose eczema can all develop on a person’s shins. Multiple causes and triggers can lead to uncomfortable symptoms. However, many effective treatments are available for eczema on the shin.