Dr Vikas Sharma
Do you know what prolonged standing can do to the skin of your legs and feet.
Standing for long hours is an essential part of few of the jobs. But it’s very important to note that the prolonged standing can finally produce certain health hazards which might necessitate a person to leave the same job. Continuous standing at one point for more than 3 hours per day for more than 6 months produces a high ambulatory venous pressure within the calf muscle pump which distends the vessel walls supplying the skin of the calf. The resultant pressure over the blood vessels supplying the skin of lower legs produces gaps in the endothelial cell junctions lining the walls of the vessels thus allowing fibrinogen molecules to escape from blood vessels to form a fibrin sheath around the capillaries thus decreasing the supply of oxygen and nutrients to the skin which are essential for the vitality of skin.
The prolonged standing posture also results in venous stasis which then increases the concentration of various cellular metabolites, increased venous pressure, Leakage of blood constituents into the surrounding tissues and activation of inflammatory cells and fibroblasts which is broadly responsible for the skin changes observed.
These skin changes progress through the following stages:
- Pigmentation (reddish brown-black spots on feet, ankles and lower legs) from haemosiderin deposition
- Areas of inflammatory change and eczema
- Fibrosis and atrophic changes in the skin (lipodermatosclerosis or atrophie blanche)
- Ulceration of the skin
Previously such cases were more seen among bus conductors, army jawans, traffic policemen, sales staff and labourers or security guards who were on long standing jobs , Thanks to the authorities, The School and College Teachers are now also in the list of Occupation related health disorders. Sometime back the only ones found standing in a classroom of any school used to be one or two mischievous students as a measure of punishment for some sort of misbehaviour. But due to the latest instructions by the authorities, school teachers have to take classes in a standing mode.
A very high number of persons who for various reasons are associated with prolonged standing develop Skin Problems like Schamberg’s disease (Pigmentation-reddish brown-black spots on feet, ankles and lower legs from haemosiderin deposition), other types of pigmented purpuric dermatoses, Varicose Veins, Gravitational eczema, Plantar fissures, venous disorders, etc.
The skin problems due to prolonged standing have also been seen in various people unrelated to the occupational jobs mentioned above like even in few housewives who are standing for long hours doing kitchen work.
Prolonged standing also makes a person susceptible to various other disorders :
In genetically predisposed persons: Lichen Planus Hypertrophicus over legs and feet.
Gravitational Eczema: Beware of Newton’s Law of Gravity. Itchy, oozy and crusted skin lesions with redness over legs. Females due to various hormonal changes are more prone to develop gravitational eczema.
Lichen Simplex chronicus over lower leg/foot.
Venous Ulcers: More prone to contact allergies over lower legs and feet.
So you if you don’t want skin problems on your legs and feet which might make you sick plus lose your job so you have to bring in certain modifications to your daily routine. Such modifications should also be brought about by the employers to prevent health hazards to their employees. Movement of legs especially lifting them for a few moments in between, slight walking a few steps, and finally sitting even for 10 minutes after 3 hrs of continuous standing is helpful.
If the skin lesions have started then its important to prevent further progression and complications by following these measures :
Its important that the underlying venous hypertension should be controlled by usage of well-fitted support stockings, or adequate firm bandages, and these must be worn regularly and indefinitely.
Slight Elevation of legs by placing a pillow beneath the feet while sleeping every day is must.
Since prevention is better, So kindly please sit down for a while.
The writer is Chief Consultant Dermatologist, National Skin Hospital, Panchkula
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