News & Articles

What Causes Brown Spots / Ankles

Leg with swollen ankles and protruding veinsPatients or their family members call to ask about the discoloration they have on one or both of their lower legs or  ankles.  Many patients with vein problems or varicose veins are told, “If your veins don’t bother you, no treatment is needed.”   Because of confusing information, these people do not seek the advice from a vein specialist and are shocked when they begin developing leg problems, such as:

  • Swelling in the feet, ankles, and legs
  • A brownish discoloration of the skin near the ankles
  • Thickening of the skin of the ankles
  • Open sores on the inner or outer ankles

Vein disorders develop because the one-way valves in the veins have stopped working.   In superficial veins, vein walls weaken and stretch, valves then malfunction and pressure in the lower leg increases due to the downward flow of the blood.  This high pressure, along with the weakness in the vein wall, causes fluid to seep out of the veins, resulting in swelling in the feet, ankles, and legs.

  • Small brown spots develop as red blood cells within the blood, release iron into the tissues.  This may present as a small brown spot but eventually the entire ankle or lower leg becomes brown.  This is known as hyperpigmentation.
  • If the area then turns red, the condition is called dermatitis.
  • As the entire lower leg becomes discolored, the skin may become thickened, hard or leathery.  This is known as lipodermatosclerosis.

How is this related to brown spots or skin discoloration?

These skin changes occur when the pressure in the veins has become dangerously high.  The pressure affects the health of the skin.  If the underlying vein is not corrected, the skin can break down and an open sore or ulceration can appear, even without trauma.  This is called a venous ulceration.

If you or someone you know has ankle swelling or skin changes, you should see a Vein Specialist.  The specialist will perform a quick and painless ultrasound exam.  This will clearly show whether you have veins that are allowing blood to move in the wrong direction, and just how severe your situation may be. Be certain to have these symptoms treated before they progress to ulcerations.





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