An outcome of long-term, advanced chronic vein disease which many do not anticipate is change to skin pigmentation. Patients tend to expect the fatigue, discomfort, and the appearance of spider or varicose veins. In can be an unpleasant surprise that long-standing venous disorders may lead to a darkened appearance over the affected areas.
Typical changes in skin pigmentation present a reddish-brown stain that usually appears over the lower legs, starting at the ankle and moving up the leg. The pigmentation darkens over time—it may appear faint at first but will eventually become more pronounces as the condition worsens. With the veins malfunctioning beneath the skin, pressure within the veins builds, forcing red blood cells to seep out and into the surrounding soft tissues. The red cells then burst, releasing hemoglobin. The iron in the hemoglobin stains the skin. Not only is the pigmentation unsightly, it can cause extreme itching. Many patients find the itching to be more disturbing than the color change.
Successful treatment of the underlying vein disease should halt worsening of the pigment changes. Over time the pigment changes will fade, much like a tattoo.