My physician advised against injecting near the ankle because the lower part of the leg tends to turn brown permanently. Is this true?

Answers from doctors (15)


Artery and Vein Specialists of Idaho

Published on Apr 17, 2014

This can be true

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Answered by Artery and Vein Specialists of Idaho

This can be true

Published on Jul 11, 2012


Intermountain Vein Center

Published on Apr 16, 2014

Well, any part of your body that is injected with sclero, where you can see the vein has the potential for staining. The reason for not injecting around the ankles (which you still can depending on the circumstances) is that the closer you get toward the foot, the closer the superficial venous system meets with the deep venous system and the great the risk of developing a DVT.

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Answered by Intermountain Vein Center

Well, any part of your body that is injected with sclero, where you can see the vein has the potential for staining. The reason for not injecting around the ankles (which you still can depending on the circumstances) is that the closer you get toward the foot, the closer the superficial venous system meets with the deep venous system and the great the risk of developing a DVT.

Published on Jul 11, 2012


Finesse Surgical Solutions

Published on Apr 16, 2014

As long as appropriate technique is used, I have had no special problems with staining around the ankle.

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Answered by Finesse Surgical Solutions

As long as appropriate technique is used, I have had no special problems with staining around the ankle.

Published on Jul 11, 2012


Vein Clinic of North Carolina

Published on Apr 15, 2014

Each physician has their own way of treating veins. The brown area that he was referring to is called hyperpigmention and it does fade if it is a vein that is treated. It can happen to any vein that is injected. In our office we do carefully treat veins at the ankles. Find a skilled vein specialist who has has success treating ankle veins.

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Answered by Vein Clinic of North Carolina

Each physician has their own way of treating veins. The brown area that he was referring to is called hyperpigmention and it does fade if it is a vein that is treated. It can happen to any vein that is injected. In our office we do carefully treat veins at the ankles. Find a skilled vein specialist who has has success treating ankle veins.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Apr 11, 2014

It is only true when the injections are done incorrectly. As in anything, there is typically a correct way to inject veins and an incorrect way to inject them. I personally experience very few issues with permanent discoloration as a result of my treatments. The only permanent discoloration that I warn my patients about revolves around any discoloration that is already present on their legs prior to undergoing treatment. As for injecting at the ankle, I am more concerned about my patients' comfort since injections at or below the ankle are typically much more uncomfortable compared to those above the ankle. If you would like to learn more you should consult with a skilled/certified vein specialist.

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Answered by The Sheen Vein Institute

It is only true when the injections are done incorrectly. As in anything, there is typically a correct way to inject veins and an incorrect way to inject them. I personally experience very few issues with permanent discoloration as a result of my treatments. The only permanent discoloration that I warn my patients about revolves around any discoloration that is already present on their legs prior to undergoing treatment. As for injecting at the ankle, I am more concerned about my patients' comfort since injections at or below the ankle are typically much more uncomfortable compared to those above the ankle. If you would like to learn more you should consult with a skilled/certified vein specialist.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Apr 11, 2014

Actually, in our years of experience we do not find this. While anything performed in the ankle area takes longer to heal, I do not find any greater incidence of pigmentation. If the veins in the ankle are the larger blue spider veins, then there can be pigmentation just from the transfer of some iron (hemosiderin) from the blood through the thin vein wall into the thin overlying skin. While this can resolve over time, in some cases it can fade or leave a "shadow" where the veins were. This usually looks much better than the blue veins. Additionally, we use a low concentration of either Asclera or Sotradecol, which leaves little pigementation. "Saline" tends to stain more as it is super concentrated salt.

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Answered by Vein Specialties of St. Louis

Actually, in our years of experience we do not find this. While anything performed in the ankle area takes longer to heal, I do not find any greater incidence of pigmentation. If the veins in the ankle are the larger blue spider veins, then there can be pigmentation just from the transfer of some iron (hemosiderin) from the blood through the thin vein wall into the thin overlying skin. While this can resolve over time, in some cases it can fade or leave a "shadow" where the veins were. This usually looks much better than the blue veins. Additionally, we use a low concentration of either Asclera or Sotradecol, which leaves little pigementation. "Saline" tends to stain more as it is super concentrated salt.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Apr 10, 2014

That is not true! Many physicians who dabble in vein disorders avoid the ankle due to a fear of injecting an artery, which could cause catastrophic complications. However, after 25 years of specializing in venous disorders and routinely injecting ankle veins, this has never happened in my office. Light brown discoloration often occurs when thicker veins are successfully injected, but always fades in time and is never permanent. Bottom line: a vein specialist can safely inject

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Answered by Vein Center of Orange County

That is not true! Many physicians who dabble in vein disorders avoid the ankle due to a fear of injecting an artery, which could cause catastrophic complications. However, after 25 years of specializing in venous disorders and routinely injecting ankle veins, this has never happened in my office. Light brown discoloration often occurs when thicker veins are successfully injected, but always fades in time and is never permanent. Bottom line: a vein specialist can safely inject

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Apr 10, 2014

I usually do not inject below the ankle bone.



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Answered by Cosmetic Vein Centers of Texas

I usually do not inject below the ankle bone.



Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Apr 09, 2014

Brown pigmentation can occur anywhere on the leg after sclerotherapy. Brown stain is a bit more common around the ankle but that should not prevent treatment.

Answered by Laser Vein Center (View Profile)

Brown pigmentation can occur anywhere on the leg after sclerotherapy. Brown stain is a bit more common around the ankle but that should not prevent treatment.

Published on Jul 11, 2012


Vein Care of New Mexico

Published on Apr 09, 2014

Sclerotherapy near the ankle has particular risks related to the presence of small arterioles and risk for ulcerations. When done carefully with lower potency sclerosing agents such as glycerin, it can be done effectively and safely by an experienced phlebologist.

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Answered by Vein Care of New Mexico

Sclerotherapy near the ankle has particular risks related to the presence of small arterioles and risk for ulcerations. When done carefully with lower potency sclerosing agents such as glycerin, it can be done effectively and safely by an experienced phlebologist.

Published on Jul 11, 2012


I haven't heard of that. However, I am cautious about doing sclerotherapy in the lower ankle, and I don't inject in the foot because there is a higher risk of sclerosant getting into an artery which can cause a skin ulcer.

Answered by HeartCare Associates Vein Center (View Profile)

I haven't heard of that. However, I am cautious about doing sclerotherapy in the lower ankle, and I don't inject in the foot because there is a higher risk of sclerosant getting into an artery which can cause a skin ulcer.

Published on Jul 11, 2012


Bellagio Vein Clinic

Published on Apr 08, 2014

Sclerotherapy of veins in any area of the body has the potential to cause discoloration. They are not necessarily permanent. There
are some rare permanent discolorations, but most of them will resolve with time. Ankle veins are important veins to treat with sclerotherapy to prevent edema, pain, or other complications.

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Answered by Bellagio Vein Clinic

Sclerotherapy of veins in any area of the body has the potential to cause discoloration. They are not necessarily permanent. There
are some rare permanent discolorations, but most of them will resolve with time. Ankle veins are important veins to treat with sclerotherapy to prevent edema, pain, or other complications.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Apr 08, 2014

Any area can hyperpigment, although your physician is right that the ankle area is more prone.

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Answered by Bella MD Laser Vein and Aesthetic Center

Any area can hyperpigment, although your physician is right that the ankle area is more prone.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Apr 08, 2014

Yes, your physician is correct.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

Yes, your physician is correct.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Apr 08, 2014

This is not true. Veins around the ankle can be safely injected with excellent cosmetic results. Injecting around this area, however, is usually more sensitive. Using the right slcerosing solution and the right injector should solve your problem. Seek out a physician who is certified and skilled at performing this procedure.

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Answered by Vanish Vein and Laser Center

This is not true. Veins around the ankle can be safely injected with excellent cosmetic results. Injecting around this area, however, is usually more sensitive. Using the right slcerosing solution and the right injector should solve your problem. Seek out a physician who is certified and skilled at performing this procedure.

Published on Jul 11, 2012


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