I have friend aged 34, modestly built. He travels all day by 2 wheeler. He has dark pigmentation of both legs. It started around ankles and is now spreading up. No veins are visible. Feet are spared. Doctors suggested varicose vein surgery. Does it help?
Once the dark pigment is on legs it rarely goes away. Sometimes vein surgery will help with pain and might lighten the dark pigment.
Published on Jul 11, 2012
The first step for your friend would be to see a vein specialist for a full venous evaluation including a venous duplex ultrasound. This will determine if he has venous disease leading to venous insufficiency. There are many causes for browning discoloration of the lower legs besides venous insufficiency.
Published on Jul 11, 2012
Ankle brownish skin pigmentation is a classic sign of venous insufficiency and resulting tissue damage.
The fact that no veins are seen is irrelevant, as large varicosities frequently may be visually masked by the swelling that usually is present with this condition. Further, many varicose veins bulge "in" and can be palpable though not visual.
Finally determining whether vein treatment will help is dependent on the confirmation of the above issues by an expert.
Published on Jul 11, 2012
He should obtain an ultrasound by a vein physician (phlebologist). This will find out if he has venous insufficiency as his underlying problem which could be treated.
Published on Jul 11, 2012
This pigmentation can very well be due to venous insufficiency. An ultrasound would confirm this.
If so many cases can be improved with venous ablation therapy.
Published on Jul 11, 2012
Venous hypertension (high pressure in the leg veins) is one of the more common causes of brown skin near the ankles. Failure of valves in veins of the lower extremities and/or obstruction of veins in the legs or pelvis may cause lower extremity venous hypertension. Treatment of the venous reflux, if present, or treatment of venous obstruction will help considerably when done for the right indications.
In appropriate patients, periodic elevation of the legs above the level of the heart, use of elastic compression hose, exercise such as walking, calf muscle pump exercises, and weight loss (if over ideal body weight) may help considerably. A careful clinical evaluation and detailed venous color duplex ultrasound exam are necessary to answer the question for an individual patient since everyone is different.
Stephen F. Daugherty, MD, FACS, RVT, RPhS
Published on Jul 11, 2012
Difficult to give an easy answer based on your description, a suggestion is to see a general/ vascular surgeon to get a diagnosis
Published on Jul 11, 2012
It sounds like the dark pigmentation is related to venous insufficiency. I would suggest a consultation with a venous specialist.
Published on Jul 11, 2012