Chronic Venous Insufficiency Chronic venous insufficiency means that blood and fluid in the veins of the legs do not drain out properly. Because of the buildup of fluid, the legs become swollen. Many factors may cause venous insufficiency. Treatment depends on the cause. Usually the first sign is swelling of the leg -- most often around the ankle. Over time, the leg can become itchy and brownish-red. Initially, the skin may be thin, shiny, and tear easily. However, with time the skin may become very thick and hard. Varicose Veins may occur. Some patients complain of aching or discomfort in the leg after standing for long periods. Ulcers may form -- usually just above the ankle. Sometimes the ulcer can become infected and lead to Cellulitis (skin infection). Previous blood clots in the leg can damage the veins and lead to chronic venous insufficiency. Previous leg injury Cancers in the pelvis or abdomen can prevent blood flow out of the leg. Abnormal blood vessels in the legs can prevent normal circulation out of the legs. Is made by knowing the patient's past medical history, by thorough examination, and by eliminating other diseases as the cause of the problem. Vascular studies -- Doppler venous Ultrasound, or plethysmography (various tests for measuring flow of blood) may be ordered. First, any swelling should be reduced by keeping the legs elevated, by using compression stockings, and by avoiding long periods of sitting or standing. If the skin is inflamed, wet compresses with saline or boric acid should be used 4 times a day for 1 hour each time. A steroid cream can then be used to decrease some of the inflammation (do not use a steroid cream if the skin is infected). In people who have had inflamed skin for a long time, patience and good skin care is extremely important. Cordran, a tape containing steroid cream, can be used for convenience. Zinc oxide ointment can be used to help reduce inflammation. An anti-fungus cream, such as clortrimazole or miconazole, can be used to decrease the risk of infection and help speed healing. Any ulcers need to be treated aggressively. See the section "Venous Stasis Ulcers" for more details. If Cellulitis develops, antibiotics need to be started immediately. Varicose Veins may need to be removed. The goal is to prevent damage to the blood vessels in the legs. People diagnosed with Thrombophlebitis should be started on blood thinners as soon as possible. Legs should be kept elevated to prevent swelling. Avoid long periods of standing or sitting. Stockings can be used to reduce some of the swelling in the legs. Congestive Heart Failure Thrombophlebitis Varicose Veins Lymphedema Kidney failure Arterial insufficiency Felty's syndrome Sickle Cell Anemia Cellulitis Ruptured Baker's cyst Special Information People with chronic venous insufficiency must follow the above advice for their entire life. Some patients with this problem may develop blood clots in their legs that require treatment with blood thinners.