Significant changes in the skin of the lower leg may be a sign of vein disease, most commonly superficial and deep vein insufficiency (when superficial veins with broken valves become dilated) or arterial occlusive disease (when narrow arteries disrupt blood flow), though other conditions may be at fault. Skin changes may include:
- Darkening of the skin, typically to a reddish-brown, dark-brown or rust color
- Rashes, manifesting as tiny, usually itchy bumps around the lower calf or ankle
- Cellulitis or similar skin infections
- Painful, hard, dark-red or brown plaques (lipodermatosclerosis) around the lower calf and/or ankle
- Venous ulcers around the inner or outer ankle
- Thin, easily torn skin
- Loss of hair on lower legs and feet (also a sign of arterial disease)
These changes may also be accompanied by aches and pains and/or heavy, tired legs.
The inflammatory changes caused by chronic venous insufficiency often leads to skin rashes that cause intense itching and redness. If this rash is due to vein disease it is usually referred to as venous eczema or venous stasis dermatitis. This usually affects the lower legs with patches of numerous tiny red bumps that may coalesce into diffuse red rashes covering the lower legs and ankles. The rash is usually very itchy and is often misdiagnosed as an infection of the skin called cellulitis.
Chronic venous insufficiency also frequently leads to a darkening of the skin called hyperpigmentation. Chronic inflammation damages the tiny blood vessels called capillaries. Fluid and red blood cells leak out, causing swelling and skin discoloration, respectively. The substance in red blood cells that carries oxygen is called hemoglobin — an iron-based pigment. When leaky capillaries allow red blood cells to escape into the skin and subcutaneous tissues, this iron-based pigment is deposited in the skin, causing the brownish, rust-colored discoloration that starts around the ankle and progresses up the lower leg in a gaiter distribution.
More advanced skin changes lead to lipodermatosclerosis, a dark-red or brown, plaque-like thickening of the skin that can be painful. This is usually associated with scarring and fibrosis of the underlying subcutaneous tissues and causes the tissues below the calf to shrink and become hardened. Patients may notice a caliber change in the diameter of their lower legs and narrowing of the lower legs from the lower calf down to the ankles.
Because of these symptoms, venous insufficiency is often misdiagnosed as a dermatological problem. This can prevent its true cause from being discovered, which allows the condition to get worse over time. If the vein disease is left untreated, the patient risks developing an ulcer or open wound on the skin.
If you are experiencing these symptoms, contact us today to schedule an appointment. The proper diagnosis and treatment of the skin changes on your legs caused by vein disease can prevent the progression of symptoms, and allow proper blood flow to return to the area.