Local, topical effects of heparins on the skin still need deeper investigations. The lack of
evidence is mainly due to the lack of large investments in this field. Three main local actions
of heparin on the skin can be defined: (1) the anticoagulant action, (2) the microcirculatorymodulatory
action determining important control of the microcirculation in case of excessive
vasoconstriction or vasodilatation, and (3) the “facilitatory action” on skin permeability, allowing
other drugs to diffuse better and faster into the skin (producing a therapeutic effect). These
aspects have to be evaluated more extensively both in experimental and in clinical conditions
as they may be clinically very important. Recent experimental studies indicate these effects of
locally applied heparin. Therefore, key questions on local heparin administration such as skin
penetration and the action on the local thrombi have a promising answer. These observations
suggest important clinical applications for local liposomal heparin. Both the potentials of local
applications of heparin, particularly with new formulations, and some new aspects in the
management of superficial vein thrombosis can focus on locally applied heparin. Superficial
vein thrombosis is an important clinical condition considering its frequency and the potentially
large use of local heparin in this clinical problem. Results from new studies and observations
presented in this issue of Angiology could be a window for suggesting new significant clinical
applications and therapeutic solutions.
