Lipodermatosclerosis is inflammatory skin condition of legs, due to inflammation of fat layer beneath skin with underlying cause of “chronic venous insufficiency”. As it results in subcutaneous fibrosis, it is also known as sclerosing panniculitis and hypodermitis sclerodermaformis.
- All contributing factors for chronic venous insufficiency like venous valves, venous flow obstruction, venous pump, and lifestyle disorders etc.
- Commonly affecting middle-aged or elderly people, more common in women and associated with immobility and high body mass index( obesity)
- Chronic venous insufficiency symptoms; leg pain, leg swelling, heaviness, skin hardening, skin colour change, venous eczema and ulcers
- Acute phase; mimic cellulitis commonly involving medial aspect of leg
- Chronic phase; along with symptoms of acute phase narrowing of distal lower limb due to subcutaneous fibrosis leading to tapering of legs above the ankles like inverted champagne bottle
Note: Venous ulcer is commonly accompanying and might be of very poor prognosis because of chronic inflammation and fibrosis.
- Physical examination
- Doppler study
- Biopsy if required to differentiate from other similar disease conditions
- Physical activity to improve venous pump
- Obesity reducing program if associated
- Medicines for pain and inflammation etc.
- Application in venous eczema
- Intraregional injection
- Compression therapy and foot elevation to reduce oedema and pain
- Ultrasound therapy and ultraviolet therapy to reduce pain and hardness
Surgical: If Venous insufficiency is the cause and need to be handled by vascular surgeon
If underlining cause for lipodermatosclerosis is CVI, it will not be resolved until or even it takes little more time after resolving CVI hence treatments are aimed to counteract the primary cause;
- Short term goals to pacify symptoms like dryness, Pain, Irritated and inflamed skin;
- Dhara : Process of pouring medicated liquid with specific temperature for specified duration are done either as per the requirement or sequentially
- ksahaya dhara; Herbal decoction
- Taila dhara: medicated oil
- Ksheera dhara: medicated milk
- Leach therapy (Jalaukaavacharana): Nontoxic leeches are used to suck the blood from the affected area, it is pain less procedure and specially indicated in people sensitive to pain like Children, Elderly, and Females.
- Along with removing stagnated blood it release as chemical known as Hirudinto our body. It is a powerful anticoagulant which is found in salivary glands of leech helps in blood thinning, avoid or dissolve the blood clots
- Localized congestion or blood stasis is relived
- Improved microcirculation will helps in reducing the fibrosis
- Skin regains its normal functions
- Long terms goals to resolve;
- Venous stasis (Anything obstructing or slowing flow of venous blood)
- Vein damage (Intrinsic or extrinsic)
- Regulating blood coagulation (Biochemical imbalance between circulating factors)
- Reduce stasis and fibrosis
- Bloodletting therapy: To reduce venous stasis and deactivate blood coagulation
- Leach therapy (Jalaukaavacharana): As explained above
- Venipuncture (Siravyadha): About 100 to 300 ml of blood is removed at once, just like how blood is drawn during blood test or donating blood
- Physiological blood thinner;physiologically, sudden blood volume loss is compensated by draining body fluids into blood to avoid hypovolemic shock, which is a natural blood thinner and reduces blood viscosity being diluted by body fluids to improve circulation through maintained blood volume
- Internal medication: Specially formulated Dr. Ural’s syrup and tablets are having multidimensional effects in eradicating the cause from root levels,
- By purifier and thinning blood, helps to mobilise stagnated blood in veins towards heart as well as enhance optimal function by stimulating collateral circulation
- By enhancing liver function it optimise quality of blood production and removal of toxins due to stasis
- In Ayurveda blood vessels are originated from blood tissues (UpaDhatuof Rakta). Structural and functional rectification of veins are facilitated by optimized functions of blood
- Ayurveda concept of tissue (Dhatu) nourishment, Mamsa(Muscle tissue) is successive Dhatu nourished after Rakta, once the formation Rakta is optimum thus naturally it nourish Mamsa to regain its strength and stability in veins i.e., tunica media (muscular) layer of vein and elastic valves regain their strength enabling the function of valves and vein.
- Improves microcirculation helps in reducing inflammation of fat layer thus facilitate process of reducing fibrosis.
- Oil application: Specially formulated Dr. Ural’s oil is advised to apply very gently (very less pressure) towards heart direction (upwards) for 15 mints / day and leave it for minimum 3 hours
- Helps to improve cutaneous circulation and reduce blood stasis
- Improve elasticity of veins
- Strengthen the vein, valves of vein and skin surface
- Reduce strain and heaviness of muscles
- Reduces fibrosis helps in softening and misting skin naturally
- For prevention and to accelerate healing Diet, lifestyle, Yogasana and Pranayama are advised as per the individual need depending on their Prakruthi, Occupation, and Age, severity of varicose vein, venous ulcers, lipodermatosclerosis and associated comorbidities.