Is it dangerous if eczema spreads from ankles to calves?

Question

Hi doctor.

I am a 34-year-old, and have had eczema on my ankles for many months, mostly dryness and itching. Recently, I noticed the patches slowly spreading upwards toward my calves, with more redness and thick skin in some areas. I have been using Betnovate cream on and off and moisturiser daily, but it keeps coming back. I am getting worried seeing it spread like this.

Is it dangerous if eczema spreads from the ankles to the calves?
Does that just mean it is not well controlled yet?
Could this spreading indicate an infection or another skin problem?
Also, does frequent scratching or prolonged walking make eczema spread to nearby areas?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

Eczema (also called atopic dermatitis or chronic dermatitis) is a long-term inflammatory skin condition. It is quite common for patches to change in size, location, or appear to “spread” when the disease is not fully controlled. In most cases, this is not dangerous, but it usually indicates that the skin inflammation is still active or being repeatedly triggered.

In your situation, eczema starting around the ankles and gradually extending toward the calves can occur for several reasons:

If eczema is not fully controlled, the irritated skin can gradually involve nearby areas. This does not mean the disease is becoming dangerous, but it suggests that treatment and skin-care measures may need adjustment.
Frequent scratching, rubbing from clothing, or prolonged walking can irritate the skin and lead to thickened, darker, and more widespread patches. This process is called lichenification, which occurs when eczema persists for months.
The lower legs, especially around the ankles, are naturally prone to dryness. If the skin barrier remains weak, eczema can slowly extend to adjacent areas.
Using topical steroids like Betnovate (betamethasone) only occasionally may reduce symptoms temporarily, but if the inflammation is not treated adequately or for the correct duration, the eczema can return or appear to spread.
If the affected areas become very red, painful, warm, swollen, oozing fluid, or develop yellow crusts, it may indicate a bacterial infection, which would require medical treatment.

Repeated scratching, friction from socks or shoes, and prolonged walking can worsen inflammation and make eczema extend to nearby skin. For better control

Apply a thick moisturizer at least two to three times daily, especially after bathing.
Avoid harsh soaps and hot water.
Try to minimize scratching (keeping nails short helps).
Wear soft cotton socks and loose clothing to reduce friction.
Avoid using strong steroid creams continuously without medical supervision, especially on large areas.

If you would like, you can follow up with photographs of the affected areas and details about itching severity, scaling, or any discharge, so I can help assess whether this is persistent eczema or another condition and guide you regarding the most appropriate treatment options.

I hope this helps.

Thank you.