What Are Those Brown Spots on My Legs?

Medically reviewed by Vinay Satwah, DO, RPVI, on June 4, 2025

Have you noticed brown patches, purple stains, or darkening around your ankles and lower legs? Many people chalk these changes to sun damage, bruising, or “just getting older.” However, persistent discoloration below the knee is often your body’s early warning sign of a hidden circulation problem: chronic venous insufficiency (CVI), also called vein disease.

Left unaddressed, symptoms of vein disease can worsen from mild swelling to painful ulcers that may be hard to heal. However, modern vein treatments, such as thermal or non-thermal ablation and ambulatory phlebectomy, can address the root cause and help restore healthy color to your skin.

In this post, Dr. Vinay Satwah, lead vein physician at our Center for Vein Restoration (CVR) clinic in Greenbelt, MD, discusses how brown spots can form on your legs as a result of vein disease and what you can do today to protect your legs for life.

Just starting to embark on your voyage to better veins? Begin with our SELF-ASSESSMENT to clarify your current symptoms and how professional procedures can provide lasting relief, or schedule an appointment at a CVR vein clinic near you to explore your customized treatment options immediately.

Call 240-965-3915 or VISIT US ONLINE 🖥️ to book your consultation. You can also CLICK HERE to book an appointment at Dr. Satwah's clinic in Greenbelt.

Brown Spots: The Early Stages

The brown or reddish‑brown staining near your shins and ankles is an iron‑rich pigment left behind when red blood cells break down outside a blood vessel. Think of it as a permanent “rust mark” caused by old, leaked‑out blood. Early on, these spots may fade if you elevate your legs or wear medical-grade compression stockings; however, over time, they can merge into larger patches, cause the skin to become thin and shiny, or give it a bruised appearance that never quite disappears. No cream or lotion can erase it because the staining occurs from the inside out. This means these brown spots require professional treatment of the underlying problem causing the blood to leak.

Venous Stasis Dermatitis (Stasis Eczema)

The type of skin discoloration caused by this iron-rich pigment is medically referred to as hemosiderin staining, and it rarely travels alone. Ongoing vein pressure also triggers an inflammatory response, prompting symptoms that come in phases:

• Early signs include itching, mild redness, thin, shiny skin, and ankle swelling.
• Progressive changes include dark brown to gray hyperpigmentation, eczema‑like patches, and thickened (“woody” or “leathery”) skin.
• In its advanced stages, even a minor scratch can progress to a venous ulcer once the skin barrier is compromised. According to the Cleveland Clinic, venous ulcers are difficult to heal, can potentially become permanent, and may lead to limb loss.

Hemosiderin Staining and Venous Stasis Dermatitis: Similar Symptoms, Different Signals

Hemosiderin staining and venous stasis dermatitis are essentially two different messages your legs can send when the veins aren’t working well. Remember, the brown or “rusty” stains are leftover iron pigment (think of them as footprints showing that pressurized blood has been leaking out of tiny vessels over time), while venous stasis dermatitis is the active, itchy rash and thickened skin that occurs when that high pressure keeps irritating and inflaming the tissue.

So, the stains indicate a long‑term problem, while the dermatitis shows that the skin is currently fighting ongoing damage.

The takeaway? Both point to the same underlying cause: serious CVI that deserves medical attention.

More About the Root Cause: CVI

Leg veins work hardest when you stand or sit. Tiny one‑way valves inside each vein open to send blood upward toward your heart, then snap shut to keep it from sliding backward with gravity. CVI causes these valves to weaken or stretch. As a result, blood pools in the lower legs, pressure builds, and veins bulge outward in the form of varicose veins. The pooled blood has nowhere to go except through the vein wall and the surrounding tissue. Brown spots form as more red blood cells escape and break down.

Common CVI risk factors include:

• Family history: valve weakness may be hereditary and often runs in families
• Life stage or hormones: pregnancy, menopause, or birth‑control pills can over-relax the vein walls
• Jobs that keep you on your feet (or in a chair) all day: such as healthcare professionals, teachers, retail staff, truck drivers, and law enforcement
• Extra weight: adds extra pressure on leg veins
• Past leg injury or blood clot: scarred veins may struggle to move blood upward
• Age: valves and vein walls lose elasticity over the decades

While it may begin to form without showing physical symptoms, CVI isn’t just cosmetic. It can lead to aching, heaviness, nighttime cramps, restless legs, itching, and swelling. Skin that stays too full of fluid also starves oxygen and nutrients, setting the stage for slow‑healing wounds called venous ulcers.

Will Brown Spots Disappear on Their Own?

Once brown spots form from CVI, they are hard to reverse without professional vein treatment. While compression stockings, leg elevation, and exercise can slow new spots from developing, they won’t erase old ones. Additional risks of leaving CVI unaddressed include:

• Larger varicose veins that bulge and ache
• Persistent swelling (edema) that makes shoes feel tight by evening
• Itchy, scaly rashes
• Shallow sores that linger for weeks or months near the inside ankle, called venous leg ulcers

The most effective move is to treat faulty veins before discoloration becomes permanent and complications arise.

CVR’s board‑certified vein physicians perform these treatments, focusing solely on vein vascular disease and its symptoms. We also offer laser ablation, Varithena ™ chemical ablation, VenaSeal™ medical adhesive, and ambulatory phlebectomy, so your care plan is custom tailored, not a one‑size‑fits‑all.

Quick Tips to Protect Your Skin Color and Vein Health

✅Move often – Calf muscles act as a “second heart.” Flex your ankles, take brisk walks, or rock on your toes for a minute every hour.

✅ Elevate legs – Prop feet higher than your heart for 15 minutes after work. Gravity helps drain pooled blood.

✅Wear graduated compression stockings – Think of them as scaffolding that supports vein walls and valves. Your CVR physician can measure you to ensure the perfect strength and length.

✅Maintain a healthy weight – Every pound matters; even small losses relieve vein pressure.

✅Skin care – Keep lower legs moisturized to prevent cracking and treat minor cuts promptly to avoid infection.

While these tips should supplement professional medical treatment, they are not actual treatments for when valves are badly damaged. Consider them as an adjunctive way to protect the results of your procedure.

Your Next Step: Schedule a Leg Health Consultation

Brown ankle or calf spots aren’t simply cosmetic changes; they’re your skin asking for help. Addressing the underlying vein disease early can prevent ulcers, relieve discomfort, and may lighten existing discoloration over time.

Don’t wait for spots to spread or for swelling to become an everyday obstacle. Click the button below ⬇️ or call 240-965-3915 📱to book a vein screening with the board-certified physicians at a CVR near you. Our expert team will explain your ultrasound results, outline a step‑by‑step treatment plan, and answer any question, allowing you to walk, stand, and live each day with renewed comfort and confidence.