It's Spring, and with warmer weather comes the allure of wearing shorts, capris, and for women, dresses. For many, however, the thought of exposing ankles, calves, or feet with brown splotchy skin discoloration is embarrassing. If you are one who has skin discoloration and tries to hide your legs from public view, I explain why this is happening and what can be done about it.
For the vast majority of people, it is not a dangerous condition but it is unsightly. People don't like looking at something that appears abnormal. I see brown skin discoloration every day. It is very common, especially if the splotches are located around the inner ankle, that it is most likely due to a vein condition. I also see the brown areas appearing on calves, shins, and feet which for many people, is due to other causes, the most common being Schamberg's Disease.
A vein circulation condition results in vein reflux. In normal vein circulation, there are valves in the veins that close as the heart pumps the blood back against gravity to the heart, preventing it from backflowing. Vein reflux is when the valves in the veins of the legs are stretched and weakened and are no longer able to prevent blood from pooling in the lower legs. As blood pools in the lower legs, the veins become stretched and blood eventually leaks out into the skin. The body reacts by attacking the blood cells in an attempt to break them down and move them out. In that process, a molecule called hemoglobin is left behind. Hemoglobin is brown and is deposited permanently in the skin. As a result, the brown coloring remains.
Interestingly, skin staining from vein reflux is a process similar to getting a tattoo. When you get a tattoo, the artist injects color into the cells in the skin. Those cells grab onto the color and absorb it into the cell, staining them the color of the ink. As with a tattoo, getting rid of the stain is extremely difficult and in most cases, the coloring is permanent. With skin staining from a vein condition, vein treatments can lighten it, but typically don't make it go away.
That being said, every person is different. I have seen cases in my clinic with patients whose skin discoloration was markedly reduced after treatment. If left untreated, though, the skin discoloration worsens over time. The real issue then is to seek treatment and stop the progression of the skin stain. I advise people to get treated sooner rather than later because of the worsening of the staining that will always occur if untreated.
Something that is unknown to most medical providers and patients is that skin staining around the lower inner calf and ankle indicates a high risk for a skin sore in the future. These skin sores due to a vein condition don't heal on their own and are very difficult to take care of without vein treatments.