Ankle Discoloration: A Symptom of Vein Disease

Do you or someone you know have foot or ankle discoloration, such as brown freckle-like spots on feet and ankles? Have you noticed swelling or indents from socks that worsen later in the day in the area of ankle discoloration, like brown spots on ankles? You could have venous disease.

This is a common condition where abnormal veins result in poor blood flow as blood pools in the blood vessels by the ankles. This stretches the skin from blood stasis in the leg veins. Medically this is called chronic venous insufficiency cvi which is a blood circulation issue resulting from venous reflux.

Patients will often see bulging veins and spider veins on the leg with the vein disease. Common symptoms include itching and redness, called venous stasis dermatitis. In some patients there are venous stasis ulcers. These are skin ulcers in areas of dark pigmentation, including dark dry patches of skin on the ankle bone, and skin discoloration that are hard to heal.

Left untreated there can be more blood flow issues with skin changes, dark spots and other symptoms of dermatitis. Thus one should think of chronic venous insufficiency when they notice they have ankle discoloration and consider seeing a vein or vascular specialist to seek an ankle discoloration diagnosis.

Why Brown Discolored Ankles?

Areas of darker skin color in the lower leg, ankle, or foot, such as brown freckle-like spots on feet and ankles, are thought to be due to Hemosiderin deposits. Hemosiderin deposits are a brownish pigment caused by the breakdown of blood hemoglobin, the iron content in red blood cells. Foot and ankle discoloration usually starts with Stasis Dermatitis and is usually a symptom of Venous Insufficiency. This is a condition where there are damaged veins from faulty valves in the veins.

These one way valves are supposed to prevent blood flow past them where it can pool by the ankles. But when they fail, this is a leading cause of venous insufficiency that can lead to skin changes and another common symptom like swelling.

Occasionally with long term blood leaking past these damaged valves, when ulcers open a patient may need wound care and ultimately vein disease treatment. Ultimately this is a sign that the body tissues are experiencing poor circulation. In the extreme, one can get blood clots with reduced blood flow back through the veins which also can cause pain and swelling. This is known as a DVT.

Schedule a Consult for Foot/Ankle Discoloration >>


Ankle Discoloration / Stasis Dermatitis

Ankle discoloration - brown freckle like spots on feet and ankles - brown spots on ankles

Stasis dermatitis is a common inflammatory skin disease that occurs on the lower extremities. It can be the earliest cutaneous outcome of chronic venous insufficiency with venous hypertension and may be a precursor to more problematic conditions, such as venous leg ulceration and lipodermatosclerosis.

Accurate diagnosis is critical, as many patients admitted for the treatment of cellulitis actually have stasis dermatitis and lipodermatosclerosis. An early diagnosis can result from getting an evaluation by a vein doctor. At times this can be a suggestion of an issue with your immune system like an autoimmune disorder or other dermatological disorders, especially in patients who have healthier veins. Sometimes people with chronic venous insufficiency just have darker feet from pooling deoxygenated blood in their feet.

Stasis dermatitis typically affects middle-aged and elderly patients, but it can develop before the fifth decade of life. An exception would be patients with acquired venous insufficiency due to surgery, trauma, or a history of deep venous thrombosis.

A common manifestation of stasis dermatitis is the development of ankle discoloration / brown skin discoloration at the inner aspect of the ankle and lower legs. These changes can worsen over time and may eventually result in the development of open poorly-healing wounds called venous stasis ulcers. These changes usually take many years to develop and patients may be treated for years with creams and salves which do not solve the problem.


Causes of Ankle Discoloration

Stasis dermatitis occurs as a direct consequence of venous insufficiency. Disturbed function of the 1-way valvular system in the deep venous plexus of the legs results in a back flow of blood from the deep venous system to the superficial venous system, with accompanying venous hypertension. Venous hypertension is another way of saying high blood pressure in the veins.

This loss of valvular function can result from an age-related decrease in valve competency and can result in discolored ankles from chronic venous insufficiency.

Alternatively, specific events, such as deep venous thrombosis, surgery (eg, vein stripping, total knee arthroplasty, harvesting of saphenous veins for coronary bypass), or traumatic injury, can severely damage the function of the lower-extremity venous system valves and then one sees varicose veins and ankle discoloration after a few years.

Stasis Dermatitis Occurrence in the US

While not everyone with venous insufficiency develops brown discolored ankles, it’s a known complication in a significant portion of cases. It is estimated an approximately 6-7% prevalence of the condition in patients older than 50 years. This would translate into approximately 15-20 million patients older than 50 years with stasis dermatitis in the United States.

Treating Ankle & Lower Leg Discoloration

The key to treatment of stasis dermatitis is to treat the swelling with compression stockings or compression therapy, treat the skin with moisturizers and finally treating the underlying vein disease. 

Modern minimally invasive treatments of the veins are a great option. This can go a long way to reducing swelling and relieving pain in patients with chronic venous insufficiency.

Evaluation is important to determine the cause and severity of Venous Insufficiency and to check for other causes of poor circulation.

Diagnostic Ultrasound is used to identify where and how badly your veins are damaged. Ultrasound can can examine blood flow through your veins in your legs, localizing the problem areas.

Endovenous Ablation

This is a technique of harnessing technological advancements to get rid of damaged veins by performing minor surgery from within inside the vein. The results are cosmetically much better than vein stripping (surgically cutting the vein out leaving scars from stitches).

These minor surgeries allow people to carry on with normal daily activities sparing just a couple of hours for the procedure.

Branch Tributary Vein Treatments

This is done with ultrasound guided foam sclerotherapy or ambulatory phlebectomy for the bulging varicose veins seen on the surface of the skin changes.

Compression Therapy

This is an integral part of managing venous insufficiency, deep vein thrombosis, superficial vein thrombosis, and venous obstruction. The most commonly used form of compression treatment is prescription strength graduated medical grade stockings. These come in knee high and thigh high denominations.

Lifestyle Changes

Exercise and elevating the legs when at rest, avoidance of prolonged sitting and standing are all helpful measures. When one must sit or stand, repetitive ankle exercises are beneficial. For the same reason, exercise such as walking and maintaining a healthy weight is helpful.

Stasis dermatitis is a common problem for people that generally respond well to treatment.

Make An Appointment To See Us

Simply fill out our Online Vein Screening Form or call any of our clinics in Northwest Portland, Tigard, Happy Valley, Tanasbourne or Bend, Oregon or Vancouver, Washington.


Ready to Start your Vein Treatment Journey?

Request an appointment today to meet with leading vein experts at any of our clinics in:
NW Portland, Tigard, Happy Valley, Tanasbourne, Vancouver or Bend.


Newsletter Sign-Up