skin changes due to chronic venous insufficiency

Chronic venous insufficiency (CVI) is a condition in which the veins in the legs are unable to efficiently circulate blood back to the heart. This can lead to a variety of skin changes, such as discoloration, thickening, and ulcers. These skin changes are caused by a build-up of pressure in the veins, which can cause fluid to leak out into the surrounding tissue. This can lead to inflammation and damage to the skin, as well as a breakdown in the skin’s ability to heal itself. If left untreated, skin changes associated with CVI can progress and become more severe, leading to pain, discomfort, and a decreased quality of life. Treatment for skin changes associated with CVI typically involves addressing the underlying cause of the condition, as well as managing symptoms with lifestyle changes, compression therapy, and medical procedures such as sclerotherapy and laser treatment. If you are experiencing skin changes associated with CVI, it is important to seek medical attention promptly to prevent complications and promote healing.

What are the most common skin changes associated with varicose veins in the legs?

Skin changes of the legs are a common diagnosis and complication of venous incompetence, particularly in the lower legs and ankles. It is diagnosed clinically.

These changes are often the result of chronic venous insufficiency (CVI), which occurs when the veins in the legs are unable to effectively return the blood flow to the heart from the ankles.

When not treated, chronic venous insufficiency can lead to increased pressure in the veins, which can cause pain and fluid to leak into the blood clot surrounding tissues.

Over time, this venous insufficiency can lead to a range of circulation problems, including:

  1. Hyperpigmentation:

    Hyperpigmentation is a common increased pigmentation associated with CVI. It is characterised by darkening of the lower limb, often with a brown or reddish hue.

    Hyperpigmentation is caused by the buildup of hemosiderin, a pigment derived from red blood cells that leaks into the surrounding tissues when blood vessels are damaged.

  2. Venous eczema or stasis dermatitis:

    Venous eczema or stasis dermatitis is a form of dermatitis that is characterised by redness, scaling, itching, and sometimes weeping or crusting of the lower limbs.

    Stasis dermatitis is caused by the buildup of fluid and inflammatory cells in the legs. Stasis dermatitis is often confused in appearance with lipodermatosclerosis.

  3. Lipodermatosclerosis:

    Lipodermatosclerosis is a disease characterised by hardening and thickening of the subcutaneous fat in the lower legs due to raised pressure. The mechanism of this disease is ranked as a sclerosing panniculitis.

    Chronic Lipodermatosclerosis is caused by long-term inflammation associated with chronic venous disease. He can present as an acute phase called acute lipodermatosclerosis or a chronic phase called chronic lipodermatosclerosis.

    Lipodermatosclerosis can lead to pain, swelling, and ulceration of the legs. Lipodermatosclerosis is commonly looking as an inverted champagne bottle.

  4. Atrophie Blanche:

    Atrophie Blanche is a condition characterised by white, scar-like patches, often surrounded by a border of increased pigmentation.

    It is caused by chronic inflammation and scarring associated with CVI. Atrophie Blanche can be painful and may lead to ulceration of the affected area.

  5. Venous ulcers:

    Venous ulcers are open sores that occur in areas affected by skin changes venous disease such as stasis dermatitis.

    They are caused by the buildup of fluid and inflammatory cells in the affected area, which can lead to tissue damage and breakdown.

    They can be painful and difficult to heal, and may require specialised wound care.

These changes can be both unsightly and uncomfortable for the patients, and can significantly impact a person’s quality of life, as well as being worsened by obesity.

They can also be a sign of more serious underlying conditions, such as deep vein thrombosis (DVT) or acute chronic venous insufficiency, which requires medical attention by your doctor.

advance stage of varicose veins showing lipodermatosclerosis

What does skin discoloration look like?

Skin discoloration associated with varicose veins typically appears as a dark, reddish-brown patch of increased pigmentation around the affected veins, and is clinically diagnosed.

The discoloration may be localised or spread over a larger area, depending on the severity of the condition.

The skin may also appear thin and shiny, and may feel dry or itchy, like in stasis dermatitis. In some cases, the discoloration may be accompanied by other symptoms, such as swelling, pain, and a feeling of heaviness in the affected area.

If you are experiencing discoloration, it is important to see a doctor to determine the underlying cause and appropriate treatment.

What is the discoloration of skin called?

The discoloration of the skin is often called hyperpigmentation, which is the darkening of an area caused by increased production of melanin, a pigment that gives your skin colour, as well as raised pressure due to venous hypertension.

Various factors can cause hyperpigmentation such as sun exposure, hormonal changes, injury, inflammation, and certain medical conditions.

In the context of varicose veins, the discoloration is often referred to as venous stasis dermatitis or hemosiderin staining.

This is due to the accumulation of red blood cells and iron deposits in the tissues, caused by poor circulation and increased pressure in the affected veins.

How To Treat Skin Changes?

Treatment of skin changes associated with poor blood flow of the legs typically involves addressing the underlying venous insufficiency.

Treatment may include measures such as compression therapy.

This involves wearing specially designed stockings or bandages that apply firmness to the leg to improve blood flow and reduce swelling at the ankles.

In addition to medical treatment, medications such as topical corticosteroids or calcineurin inhibitors may be used to reduce inflammation.

It can improve skin symptoms, especially with lipodermatosclerosis.

For more severe cases or other conditions, treatments that don’t involve invasive surgery, such as:

  • Sclerotherapy

  • Endovenous Laser Treatment (EVLT) or Radio Frequency Ablation

Both procedures may be used to treat varicose veins or other underlying venous issues.

It is important to discuss all available treatment options with a doctor.

In addition to these medical treatments, other treatments are also several self-care measures that can help patients manage skin changes associated with venous disease and prevent further surgery.

These include:

  1. Maintaining good hygiene:

    Keeping the legs clean and dry can help prevent infection and promote healing.

  2. Skin care:

    Cream treatment on the legs is important in a context of lipodermatosclerosis and stasis dermatitis. It helps reduce the symptoms and prevent further surgery.

  3. Weight reduction:

    It helps reduce the raised pressure, which worsens the symptoms of lipodermatosclerosis and venous hypertension.

    Indeed, obesity is know to be an important risk factor for venous hypertension and stasis dermatitis due to the pressure applied in the leg veins for long periods.

  4. Elevating the affected leg:

    Elevating the affected leg above heart level several

  5. Compression stockings:

    compression stockings enhance blood flow and help reduce symptoms in the legs.

    This fact has been demonstrated in multiple cases evaluated in multiple studies.

  6. Ultrasound therapy:

    Ultrasound therapy has shown promising results for the softening of tissues in lipodermatosclerosis.


In summary, skin changes in venous incompetence typically include hyperpigmentation, eczema or stasis dermatitis, lipodermatosclerosis and ulceration.

Hyperpigmentation is caused by the deposition of hemosiderin, a byproduct of red blood cell breakdown.

Eczema or dermatitis is a common inflammatory response to venous insufficiency, while ulceration occurs when the skin breaks down due to chronic hypertension in the leg veins.


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