In the development of varicose veins, skin changes like redness, itching, eczema, blackening, pigmentation, hardening of skin is noted followed by eventual breakdown of the skin forming an ulcer / open wound.

Varicose veins
skin pigmentation in CEAP C3 stage of varicose veins

Why and how does skin get affected in varicose veins?

The walls of the veins are thin and elastic like a balloon, sometimes they can get enlarged 3-5 times its original size. This causes the blood to move very slowly in the affected vein which is called pooling of blood. This causes increased blood pressure and other microscopic changes in the area. When the pooled (stagnant) blood degrades, it releases chemicals and some body cells which causes inflammation of the vein & surrounding tissues. This inflammation can be severe causing discomfort or can be totally imperceptible by the person.

Where do skin changes develop in venous disease?

The location of skin symptoms of varicose veins mostly start around the ankle and around the shin bone, especially in the lower half and inside of the legs. If you have such skin changes in this area, you may have underlying Vein disease like varicose veins / chronic venous insufficiency. You should visit a vein specialist doctor near you.

What skin changes are seen in varicose veins?

Along with swelling of the leg, there can be skin changes due to inflammation. The skin affected can become reddish, shiny, dry- peeling of skin, tight, black dot pigmentations or itchy. The combination of these symptoms is not seen in all patients. Sometimes eczema can also develop. Such a kind of eczema / dermatitis is called Venous eczema. The skin then becomes thick, hard, blackish which is a sign of lipodermatosclerosis. Such black pigmentations are deposits of haemosiderin which is a byproduct of blood breaking down. This blackish discolourations are irreversible.

Can varicose veins lead to open wounds or Ulcer?

Varicose veins
Venous ulcer, non-healing ulcer in C6 stage of varicose veins

Untreated, this will eventually lead to more skin and tissue destruction and lead to open wound or Ulcer formation. Venous ulcers are generally wet wounds. They tend to ooze lots of pus or fluid. Such ulcers are difficult to heal if the underlying cause is not treated. Simple and superficial treatment may not be enough to treat these kind of wounds. And most important high compression stockings (~46mm Hg) are required to help heal such wounds. Such stockings should be RAL (German institute) certified medical compression stockings from a reputed company.

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