Hemosiderin staining is the medical term that describes brown discoloration in the lower calf and around the inner ankle, and occasionally on the outer ankle. Because of the ugliness of the stain on the surface of the skin, people naturally want to know how to treat it and if it will go away.
What is Hemosiderin Staining?
Hemosiderin staining is connected to high pressure in the vein's circulation. With a vein condition, blood pools in the lower legs due to vein reflux. This pooling of blood causes pressure to build up and press against the vein walls. The veins eventually become leaky, and blood leaks into the tissues. When this happens, the blood breaks down hemoglobin inside the blood breaks down into something called hemosiderin. Hemosiderin is what gives blood its red/brown color. The hemosiderin is viewed by the local tissue as a foreign particle and the cells in the tissue will then actually ingest it. They bring it into the cell and sequester it thinking that it's something foreign.
And the result is that that small brown particle is now residing inside the cell but those cells don't die. Those cells live as long as you do. Those are called macrophages and they are what causes the brown pigment in the skin to appear.
Interestingly, this is the exact same process that happens when you actually have a tattoo. A tattoo operates with basically the same biology, and the same sequence of events. Tattoos, like hemosiderin staining, do fade slowly with time but they're more or less permanent.
Can Hemosiderin Staining Be Treated?
With vein treatment, the pooling of the blood is resolved. Hemosiderin staining can improve or lighten with time, but it rarely goes away completely. That being said, I have seen several patients actually have their staining nearly disappear, but it's something that I don't promise people ahead of time to expect. In the instances where it has happened, it is very uncommon and typically takes years. With treatment, it's more realistic for the stain to lighten up and so change from being a dark brown to a light brown or tan after a few months.
So with the question of whether or not skin staining can be treated, the answer is yes. Treatment will improve it, but will not necessarily resolve it. It also takes a long time, so the best course of action is to prevent it. Prevention involves timely treatment of a vein condition.
When skin staining then starts to appear, sometimes it progresses very quickly. I suggest keeping an eye on what's going on around your inner ankle. If you notice a small red patch developing, that's a sign that the staining process is in full swing. When that happens, don't wait to schedule treatment. Once it gets started, it's very difficult to make it completely go away.
Be aware that, to start treatment, the insurance process involves a protracted waiting period. It is best to get evaluated before the skin staining begins, or as quickly as possible once you notice the first signs.
