Support Stockings

It's not your father's Oldsmobile

It’s Not Your Father’s Oldsmobile

OK, so I know I am dating myself with this video.  Seems like that was just a commercial on TV.  Alas, it was 1988, 28 years ago.  I was 15 and apparently really paying attention to car commercials at that time.  Ironically, my first car was a 1973 Chevy Impala.  An Oldsmobile would have been a big step up, but I digress….

When people have venous disease or poor circulation, they need to wear support stockings to encourage blood to flow back to the heart from the legs in a natural way.  The support stockings come in various strengths known as mmHg.  This stands for millimeters of mercury, which is a measure of how much pressure will be exerted on the legs to encourage blood flow back to the heart.  The higher the strength, the more effective they are.  However, in people with arterial disease, we can’t have it too strong or it will cut off healthy blood flow.

IF HOSE ARE OBTAINED WITHOUT A PRESCRIPTION THEY GENERAL ARE NOT AS MEDICALLY EFFECTIVE.  In Fairmont you can obtain prescription strength hose at a medical supply store such as Fairmont Home Medical  ( Marion Square) or Rider Pharmacy ( Merchant Street).

Steps to get your stockings….

  • Take your prescription to one of the above locations. Call ahead and make sure they will have someone available to measure you.  YOU MAY NEED AN APPOINTMENT!
  • Go and have your legs measured in the MORNING when your legs are their smallest.
  • They will order your hose. It may take a FEW WEEKS to get them. 
  • Many insurance companies will not pay for your hose. However, Dr Rosenberger would be happy to fill out whatever forms needed, if you have a medical problem requiring stockings. 

When I say support stockings, most people sigh.  However, they are not nearly as bad as they used to be.  First of all, there are a number of more cosmetically acceptable options including ones that look like dress socks for men and ones that look like panty hose for women.  Plus, they have super cute fluorescent ones for exercise that are quite stylish for athletes.  The next complaint is that they are hard to get on.  There are a number of devices to aid in applying these.

Support stockings aren’t so bad anymore, AND as I mentioned they are quite popular for young athletes. So wearing them makes you young, cool and hip ( I promise! )  When I ran the Disney Marathon probably 1/4 of the runners were wearing supports stockings.  It’s not your father’s Subaru.  Here’s what’s hiding under my boring black pants at the office…

Cool New Support Stockings

If you find these blog posts helpful, please share them on facebook, twitter or your social media preference using the buttons above.  Also, you can email them to a friend.

If you would like to receive these posts in your email inbox Subscribe to our Site by clicking on this link.

What’s this rash on my legs?

Stasis Dermatitis

Stasis dermatitis is a common rash seen on the lower legs of patients who have swelling in their legs.  It can be seen on both legs, or if a patient has more swelling in one leg compared to the other, can be worse on one leg.

Notice the rash sharply stops where the patient's socks prevented swelling. This is NOT a tan line.

Notice the rash sharply stops where the patient’s socks prevented swelling. This is NOT a tan line.

Sometimes, even before we detect varicose veins, spider veins or extensive swelling in the legs, the legs are swelling off and on every day.  I admit that I often have to loosen my tennis shoe laces at the end of the workday if I am not wearing support hose.  I am 43, relatively healthy and exercise on a regular basis.  Most people’s legs swell sometimes, so let’s agree on that premise.  Everyone tries to tell me that their legs NEVER swell.  Legs swell because the blood is not flowing back to the heart correctly.  This is very common.

When blood doesn’t flow back correctly, the blood leaks slightly out of the blood vessels and into the surrounding skin.  When blood enters the skin, it often irritates the skin causing the legs to itch and sometimes be red.  This itchy rash on the lower legs is called STASIS DERMATITIS.  Even after the rash fades, the skin may have a tan bronze discoloration.  This discoloration is an iron stain in the skin from the blood that is leaking into the skin.  It can take months and months for the tan bronze discoloration to fade.

Some patients never have itching, but if you look closely in the photo below you can see the pinpoint dots of blood in the skin.

Pinpoint red dots from red blood cells extravasating in the skin.

Pinpoint red dots from red blood cells extravasating in the skin.

Treatment for stasis dermatitis, involves prevention and treatment.

  • When sitting around we need to ELEVATE OUR LEGS, ABOVE THE LEVEL OF THE HEART. Sit in a recliner kicked back or prop legs up on the end of the couch or on pillows.
  • Use topical steroid on active red rash on the legs. Twice a day when rough AND red.  Once a day when rough OR red.  Stop when roughness and redness clears.  Use as needed with the above guidance. This is a chronic problem and will need long term treatment.
  • Wear support stockings as much as possible.

Secondary problems seen with stasis dermatitis may also need to be treated.  These include fungal infection and thickening of the skin.

Next post will focus on the benefits of support stockings and a cute picture of me wearing mine.

If you find these blog posts helpful, please share them on facebook, twitter or your social media preference using the buttons above.  Also, you can email them to a friend.

If you would like to receive these posts in your email inbox Subscribe to our Site by clicking on this link.

 

 dsPostcard 062316 copy

PLAN TO JOIN US FOR OUR UPCOMING OPEN HOUSE AND COSMETIC DAY!

Open House & Cosmetic Day – June 23rd 8AM to 4PM

Four great reasons to join us this day!

Please take some time out of your busy summer schedule and stop in the office for our upcoming Open House on Cosmetic Day! June 23rd!

You can participate in a few ways!

1- Make an appointment for a procedure on this special day for special pricing on BOTOX, Juvederm, Kybella and Latisse!

$100  OFF any two procedures… BOTOX ($200 or more), Juvederm, Kybella.

2-Stop in to learn more about the cosmetic procedures we offer and to have a chance on our great door prize!

3-Purchase ZO products and sun protection products with special pricing and a super great gift with purchase($125 value) with any product purchase of $200 or more.

4-Refreshments!  Need I say more?

What’s this sore on my ear?

Chondrodermatitis Nodularis Helicis

CNH Left Ear Doctor, what is this sore on my ear?  Chondrodermatitis Nodularis Helicis (CNH), I reply.  Yes, it is one of those conditions that dermatologist’s like to name to sound smart.  In reality though, this is a simple and common condition that is often stubborn to treat.  Let’s break it down…

Chondrodermatitis – Inflammation of the cartilage (chondro) and skin (dermatitis)

Nodularis – forming a bump, callus or ulcer

Helicis  – most common on the helix or antihelix (see Diagram) of the ear or other part of the ear that sticks out the most

 

Illustration diagram of ear

I like to describe this to patients as a pressure sore on the ear.  When we lay on the ear at night ( or have a helmet or hat ), it puts pressure on the cartilage, the hard part of the ear.  The pressure causes inflammation of the cartilage which leads to irritation, pain, redness, callus and/or ulcer of the skin overlying the inflamed cartilage.

This is most commonly seen on the sun damaged ear of middle aged and elderly people, so sometimes, the patient may also have a skin cancer or precancer occurring in the area of CNH.  For this reason, often we will biopsy persistent lesions to make sure there is not any additional cancer in the area.

On the part of the ear that sticks out the farthest.

On the part of the ear that sticks out the farthest.

The first objective in treatment is to avoid pressure on the ear by avoiding sleeping on that side, however, as seen in the patient photos, this often leads to a lesion on the new sleeping side.  Another option is a CNH pillow or other similar pillow that would prevent putting pressure or the ear.

The second objective is to avoid infection of the area and encourage healing by gently cleansing and keeping the area moist with Vaseline, Aquaphor or mupirocin antibiotic ointment.

The final objective is to reduce inflammation of the underlying cartilage as well as the skin.  For persistent lesions, or non-ulcerated lesion we sometimes use topical steroids or injections with steroids to reduce the inflammation.

Finally, as previously mentioned, we want to biopsy any persistent lesions to evaluate for cancerous cells within the area.

When the left ear became sore, she started sleeping on the right ear. Then CNH developed on the right ear.

When the left ear became sore, she started sleeping on the right ear. Then CNH developed on the right ear.

If you have a persistently sore spot on your ear, try to avoid sleeping on it. If it does not resolve after a few months, see a dermatologist.

dsPostcard 062316 copy

 

 

 

If you find these blog posts helpful, please share them on facebook, twitter or your social media preference using the buttons above.  Also, you can email them to a friend.

If you would like to receive these posts in your email inbox Subscribe to our Site by clicking on this link.