You should not ignore discoloration of ankles, swelling, or indents from socks that continue to worsen as it may be a sign of vein disease or some underlying medical condition. Schedule an appointment with your doctor without wasting time as dark ankles are not only unattractive to look at and affect your self-esteem but also turn serious if they are left untreated for a long time. Dr. Sobolevsky, vein specialist at the Downtown Vein & Vascular Center will determine the causes behind the bruising around your ankles, help to prevent resulting complications, and come up with the best vein treatment options to relieve your symptoms.

What Causes Discoloration on Ankles?

Ankle discoloration or darkening of the lower leg, ankle, or foot often results from hemosiderin deposits. Hemosiderin is a brownish pigment that results from the breakdown of blood hemoglobin, the iron content in the red blood cells. When hemosiderin causes foot and ankle discoloration, it is called stasis dermatitis. It is a sign of venous insufficiency or problems with blood flow.

What Is Stasis Dermatitis?

Also known as reflux disease and venous hypertension, stasis dermatitis is a common inflammatory skin disease that occurs in the lower part of the body. It is a sign of chronic venous insufficiency and may result in further complications such as vascular leg ulceration if left unattended.

It is identified by dark pigmentation around the ankles, but sometimes persistent redness in the lower legs and feet can also point to venous insufficiency. Stasis dermatitis usually affects people during their middle and later ages. It rarely occurs at a young age. People undergoing surgery, trauma, or thrombosis can suffer from venous insufficiency in exceptional cases. Accurate diagnosis is crucial for effective treatment, and you must consult a vein expert doctor to learn more about your condition and its causes.

Stasis dermatitis is different from other conditions such as cellulite when the redness or discoloration is evenly distributed between the two legs and seems unresponsive to common treatments. Sometimes, recurring cellulitis can be a result of venous insufficiency.

Read more: Bulging Veins In Arms And Hands

Symptoms of Stasis Dermatitis

Stasis dermatitis manifests itself by causing changes in the skin color at the inner or outer aspect of the ankle. You will find staining or development of brown color changes around the ankle that aggravate with time, accompanied by swelling. It will also result in poorly-healing wounds called venous stasis ulcers.

Other symptoms can include:

Brownish, reddish, or yellowish skin around or above the ankles
Varicose veins that look twisted, bulging, and dark purple or blue
Itching or irritation
Pain
Sores that secrete, crust, or look scaly
Thick skin around the ankles or shins
Loss of hair on ankles or shins
Inflammation in lower legs

These symptoms take some time, usually years to develop before you begin to notice them and seek medical attention.

Causes of stasis dermatitis

Stasis dermatitis occurs due to venous insufficiency when the leg veins do not support blood flow back up to the heart. It results from a disturbed one-way valvular system in the venous network of the legs that leads to the backflow of blood down the legs instead of its normal upward flow towards the heart.

Other causes include:

Deep venous thrombosis (DVT)
Surgery such as vein stripping, total knee arthroplasty, harvesting of saphenous veins for coronary bypass
Traumatic injury that severely damages the function of the lower-extremity venous system
Age-related decrease in the performance of valves that affects the valvular function of veins

The only way to manage stasis dermatitis is to treat the underlying vein condition.

Risk factors for stasis dermatitis
You might be at a higher risk of suffering from ankle discolor and consequent stasis dermatitis in certain situations. They include:

Advanced age – if you are older than 50
Overweight
Untreated varicose veins that lead to venous insufficiency in the long run
Blood clots in the legs that obstruct proper blood flow
High blood pressure
Prevailing heart disorder
Kidney disease
Multiple pregnancies
Injuries or surgeries in the lower extremities
Severe lack of movement or long hours of immobility

Seek medical help immediately if you are at a high risk of suffering from stasis dermatitis and notice ankle discoloration and other symptoms to prevent critical damage.

Ankle Discoloration Diagnosis

Evaluation of your condition is the first step towards accurate diagnosis and treatment. The experienced vein doctor will evaluate your symptoms to determine the causes and severity of venous insufficiency before recommending any solution. Diagnosis includes ultrasound to identify where the veins are damaged, how badly, and what symptoms you are suffering. The ultrasound examination assesses the flow of blood through the veins in the legs.

If the veins are not performing to their full capacity, the blood will not go back to the heart as it should. Valves located in the legs push the blood upwards to the heart, but due to certain health conditions, valves can have a problem in doing their job.

Treatment Options

Stasis dermatitis is treated by addressing the underlying vein disorder. The expert vein doctor will examine your ankles and perform a series of diagnostic tests to confirm venous insufficiency before proceeding with treatment. He will recommend the best solutions depending on your symptoms and the presence of leg wounds.

Treatments options for ankle discoloration and vein diseases are non-invasive medical therapies and minimally-invasive vein restoration procedures. They include:

Endovenous ablation – This procedure uses energy or heat to cauterize (burn) and close the damaged veins by performing minor surgery from within the vein. Normally, The procedure takes less than an hour, and you can resume routine activities after a couple of hours or as per the doctor’s advice.
Sclerotherapy – It is the most effective, non-invasive procedure in which a sclerosant solution is directly injected into the vein. This solution clots the blood in the vein and shrinks it, rerouting blood automatically through healthier veins as a result.
Ambulatory phlebectomy – Also known as micro-phlebectomy or stab phlebectomy, this procedure removes superficial veins through small, slit-like incisions in the skin.
Endovenous laser therapy – This procedure uses targeted laser energy to seal the damaged veins under the skin surface.

The goal of treatment is to alleviate any symptoms, reduce growing skin discoloration and prevent the development of venous ulcers that become serious in the long run. The doctor will discuss the risks and benefits to ensure you get permanent relief from discolored and swollen ankles and associated vein disease.

Managing and Reducing Ankle Discoloration

The doctor comes up with customized plans to manage your condition and reduce ankle discoloration.

Compression Therapy

It helps to manage conditions like venous insufficiency, deep vein thrombosis, superficial vein thrombosis, and venous obstruction. The most commonly recommended treatment is prescription strength graduated medical grade stockings. They ease swelling and improve blood flow in the legs by squeezing them to encourage the blood to flow past the faulty valves and back up to your heart, instead of pooling and causing damage. They come in knee-high and thigh-high varieties and deliver accurate pressure when fitted according to the patient’s individual needs. It is best to consult a doctor to get compression stockings that fit right and offer anticipated results.

Lifestyle Changes

Vein specialists also advise a change in lifestyle for treating stasis dermatitis and preventing further deterioration of the condition. They include:

Repetitive ankle exercises to keep the veins healthy
Keeping the legs elevated when sitting down
Avoiding sitting and standing for a prolonged time
Walking and running to ensure a healthy flow of blood
Avoiding wearing tight and constricting clothing
Massaging the skin to stimulate better blood flow

The expert vein doctor strives to improve blood circulation and comes up with customized treatment plans, specifically developed for your unique situation to restore the proper functioning of veins.

As you learn to manage your symptoms, Dr. Sergei Sobolevsky at the Downtown Vein & Vascular Center keeps an eye on your progress. He may also make some changes to the treatment plan if needed. The most effective treatment keeps ankle discoloration and vein diseases from disrupting your personal and work life and ensures overall health and wellbeing. Schedule an appointment with a vein specialist to know more about restorative options that provide lasting relief from darkened, swollen ankles and venous insufficiency with comprehensive vein care.

Sergei Sobolevsky, MD, is a leading specialist in endovascular medicine with experience in vascular and interventional radiology. Dr. Sobolevsky has decades of experience in the field, with over 25,000 procedures performed, accumulating extensive experience in image-guided minimally invasive medicine, diagnosing and treating a range of conditions.

Dr. Sobolevsky earned his Doctor of Medicine (MD) degree in 1997 from the University of Colorado School of Medicine. He received his specialty clinical training in vascular and interventional radiology at Harvard University. Later, he earned his MBA from the MIT Sloan School of Management. Recognized as a Castle Connolly Top Doctor and named to the Top Doctors New York Metro Area in 2020, 2021, and 2022, Dr. Sobolevsky is licensed in multiple states, has delivered presentations at numerous institutions in the US and abroad, and now acts as a clinical advisor for the biomedical industry. He also held multiple positions in the field during his career, including Chief of Vascular and Interventional Radiology at the Columbia University Medical Center in New York, NY, Senior Vice President in Clinical and Regulatory Affairs at Artann Laboratories in North Brunswick, NJ, and Medical Director at the American Endovascular and Amputation Prevention Center in Brooklyn.

More About Dr. Sobolevsky

Ankle Discoloration: A Sign of Vein Disease