Skin Changes Associated With Varicose Veins and Venous Insufficiency
What skin changes are associated with varicose veins and venous insufficiency
Varicose veins can lead to progressive skin changes, particularly in the lower legs, due to chronic venous insufficiency (CVI). As blood pools in the veins and pressure increases, the skin may undergo discoloration, thickening, and inflammation, often indicating worsening vein disease. Early symptoms include dryness, itching, and mild pigmentation (skin discolouration), but over time, more severe changes such as venous eczema, lipodermatosclerosis (skin hardening), and ulceration may develop. Recognising these skin alterations is crucial, as they not only affect appearance and comfort but may also signal a higher risk of complications, including venous ulcers. Proper treatment of varicose veins can help prevent or manage these skin changes, improving both vascular health and skin condition.
Visible Leg Varicose Veins
Varicose veins are enlarged blood vessels that bulge just beneath the skin's surface. They can vary in size and are typically blue or purple in colour. These veins become enlarged due to the weakening of vein walls and the poor functioning of the valves inside the veins (incompetent valves).
Varicose veins are often more noticeable when standing up and may disappear when lying down. This is because gravity causes the leg veins to fill with blood when standing, making them more visible.
Varicose veins commonly occur in the lower half of the body, particularly in the legs. Some patients may also develop them in the hip or pelvic region.
Spider Veins and Thread Veins
Spider veins and reticular veins are another type of venous disease. They are thinner and smaller than varicose veins. Spider veins may look like branches of a tree or spider webs. They can appear red or blue in colour and most often seen behind the knee, feet and on the face. Spider veins and reticular veins are usually associated with underlying vein problems.
Varicose Eczema
Also known as stasis dermatitis, is a skin condition that develops due to poor blood flow from underlying varicose veins. It causes the skin, especially around the lower legs and ankles, to become red, itchy, dry, and discolored. This happens when weakened veins allow fluid to leak into surrounding tissues, leading to inflammation. Treatment involves using moisturizers and anti-inflammatory creams to soothe the skin, along with compression stockings to improve circulation. To prevent recurrence and achieve lasting results, it’s important to address the root cause by treating the varicose veins with procedures such as endovenous laser therapy (EVLT), radiofrequency ablation (RFA), or sclerotherapy.
Hyperpigmentation (Skin Discolouration) in varicose veins
Hyperpigmentation refers to dark discolouration of the skin, usually a brownish or reddish-brown colour, caused by the leakage of red blood cells from damaged veins. As these cells break down, hemosiderin (an iron pigment) is deposited in the skin, leading to the visible color change. Hyperpigmentation is generally painless and is an early sign of venous insufficiency, but if left untreated, it can progress to more severe conditions like lipodermatosclerosis and skin ulcers.
Corona phlebectatica
Corona phlebectatica is a sign of advanced venous insufficiency, marked by a network of dilated, small bluish or reddish veins around the ankle and foot. These thread-like veins often indicate underlying venous disease and may be accompanied by symptoms like leg heaviness, discomfort, and swelling. If left untreated, it can progress to skin changes, or even skin ulcers. This condition requires early treatment of varicose veins.
Lipodermatosclerosis
​Lipodermatosclerosis is a condition marked by inflammation, hardening, and thickening of the skin and the tissues beneath it, usually affecting the lower legs and ankles. The skin in the affected area becomes tight, firm, and discoloured, often giving the leg a distinctive shape known as the “inverted champagne bottle” appearance, where the lower leg narrows around the ankle. This condition develops as a result of chronic venous pressure and poor circulation, leading to persistent inflammation and fibrosis (scarring of the tissue). It can cause significant discomfort or pain and, in advanced stages, may increase the risk of developing skin ulcers.
Venous Ulcer
A venous ulcer is an open, slow-healing wound that usually occurs on the lower leg or ankle due to chronic venous insufficiency. It develops when poor blood flow causes increased pressure in the veins, leading to skin breakdown. Venous ulcers often have irregular edges, are shallow, and may be surrounded by swollen, discoloured, or thickened skin. Treatment involves compression therapy, wound care, and addressing the underlying vein problem with procedures like sclerotherapy or endovenous laser therapy (EVLT), radiofrequency ablation, sclerotherapy to promote healing and prevent recurrence. ​
It is crucial for your doctor to rule out any arterial causes of the ulcer. At Dr. Soroush Sohrabi’s clinics in Dubai (Liv hospital City Walk Dubai), a comprehensive vascular assessment is performed to evaluate both arterial and venous conditions, ensuring that patients receive the most appropriate and effective treatment.
Diagnosis of skin changes associated with varicose veins and venous insufficiency
Diagnosing skin changes associated with varicose veins and venous insufficiency involves a thorough clinical examination and vascular assessment. A healthcare provider will evaluate visible skin discoloration, texture changes, and signs of inflammation, such as venous eczema, lipodermatosclerosis, or ulcer formation. In addition to physical examination, a Doppler ultrasound scan is often performed to assess blood flow, vein function, and the presence of reflux (backward blood flow) in the affected veins. This imaging test helps identify hidden varicose veins or deeper venous issues that may be contributing to skin deterioration. Early and accurate diagnosis is essential for preventing complications and determining the most effective treatment approach to restore both vascular health and skin integrity.
Treatment of skin changes associated with varicose veins and venous insufficiency in Dubai
Managing skin changes caused by varicose veins involves addressing both the underlying venous insufficiency and the associated skin symptoms. Treating the root cause with varicose vein procedures such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), Clarivein®, TRLOP, sclerotherapy, or venous surgery can improve circulation and help prevent further skin deterioration. To alleviate itching, inflammation, and discolouration, topical treatments such as moisturisers, corticosteroid creams (for venous eczema), and emollients can help restore the skin’s barrier function. Compression therapy is also essential, as it reduces swelling and enhances blood flow, slowing the progression of skin changes. In more advanced cases, where lipodermatosclerosis or venous ulcers are present, wound care, medicated dressings, and specialist intervention may be required. A comprehensive treatment plan, combining venous interventions, skincare, and lifestyle modifications, is crucial for improving both vascular and skin health while preventing long-term complications.
At Dr. Soroush Sohrabi’s Clinics in Dubai, advanced vascular assessments and customised treatments target skin changes secondary to varicose veins and venous insufficiency, addressing both the underlying cause and symptoms to prevent complications and restore skin health.