Discolored Feet and Legs: What Does it Mean?

When a minor injury leaves you with a bruise on your lower leg, you know that any mild swelling, tenderness, and skin discoloration will gradually clear up as the injury heals.

But what does it mean when areas of skin on your lower extremities become discolored gradually — and stay that way perpetually? In many cases, such skin changes are a sign of underlying vascular disease.   

In this month’s blog, our expert team at Vascular Vein Centers discusses the links among vascular damage, poor circulation, and skin changes — and takes a closer look at chronic venous insufficiency (CVI), a leading cause of skin discoloration in the lower extremities. 

Vascular issues and skin discoloration 

Although skin conditions (e.g., eczema) and infections (e.g., cellulitis) can cause short-term discoloration on your legs and feet, persistent lower extremity skin discoloration often stems from vascular blockage, damage, or dysfunction. 

Peripheral artery disease (PAD)

Lower extremity PAD occurs when plaque buildup (atherosclerosis) narrows or blocks the arteries that supply your legs and feet with oxygen-rich blood. 

As the overlying skin tissues are starved of oxygen, your lower legs and feet may appear blue or pale, and reddish or purple when elevated. These discolored skin areas may also become thin, dry, itchy, tight, shiny, and cold to the touch.  

Diabetes damage

Diabetes causes leg and foot skin discoloration via two vascular pathways: It hastens the development of PAD, and it damages the small blood vessels that keep your skin healthy. You may notice blue or purple areas on the skin, brown scaly patches, or both.   

Chronic venous insufficiency (CVI)  

CVI develops when weakened vein valves allow blood to pool in your legs and feet, slowing circulation. As the overlying skin is robbed of oxygen and nutrients, it can develop reddish, brown, or rust-colored areas, as well as “bruise-like” patches of discoloration (hemosiderin staining) — especially around the ankles. 

Chronic venous disease is very common

Of these three exceptionally common conditions, CVI is perhaps the leading cause of poor lower-extremity circulation and related complications, including skin discoloration. 

CVD statistics and risk factors

Chronic venous disease (CVD) affects over 190 million people in the United States, making it 1.5 times more common than heart disease and five times more common than diabetes. 

CVD is common because its major risk factors — including older age, excess weight, lack of exercise, frequent sitting, female gender, pregnancy, smoking, and family history — affect so many people.  

CVD is a disease spectrum

CVD exists on a spectrum, with spider veins and varicose veins on the milder end, and CVI and its effects — including leg swelling, skin changes, and venous ulcers — on the severe end. CVI is vastly underdiagnosed, but experts estimate that more than 50 million Americans have it.

Skin changes are a sign of advanced CVI

As mentioned, impaired vein valves are the starting point for CVI. When these all-important valves can’t keep blood flowing efficiently from your lower extremities to your heart, it pools in your legs and feet. This creates areas of high-pressure buildup in the veins that can:

• Exert substantial pressure on the surrounding vessel walls
• Cause small and large vessels to swell, twist, and distort
• Damage nearby capillaries, prompting them to leak fluids 

Early CVD (stage zero) doesn’t cause symptoms beyond periodic mild leg achiness or fatigue. Stages one and two of venous disease progression are spider veins and varicose veins; CVI is diagnosed in the third stage, or persistent leg swelling (edema).  

Without intervention, edema leads to fourth-stage CVD: venous stasis dermatitis, or skin changes. Skin inflammation usually comes first, followed by irritation and itchiness. Next, you may develop:

• Red or purplish discoloration (on lighter skin)
• Brown or ashen discoloration (on darker skin)
• Red-brown “cayenne pepper” spots (capillaritis)
•  Itchy, dry, flaky, or scaly skin patches 
• Tight and shiny thickened skin areas 

CVI progression doesn’t end with skin discoloration and textural changes; without care, the skin may break down, leading to open wounds called venous ulcers. 

With a lack of oxygen and nutrients at the site, these wounds tend to heal very slowly (and in severe cases, not completely). For many people with advanced CVI, increased infection risk, mobility issues, and chronic pain are part of daily life. 

Our team can evaluate your skin changes

Luckily, advanced venous disease doesn’t have to be part of your future: Certain treatments and lifestyle changes can help slow CVI progression, improve lower extremity circulation, and protect your skin health. 

The first step? Schedule an evaluation at Vascular Vein Centers as soon as possible. As the only IAC-accredited vein and vascular testing facilities in Central Florida, we can assess your skin changes and the nature and severity of your underlying vascular condition — and get you started on a path to improved wellness. 

To learn more, contact our team at Vascular Vein Centers by calling 877-244-8558 today. We have six Central Florida offices in College Park of Orlando, Kissimmee, Lake Mary, Waterford Lakes of East Orlando, Davenport/Haines City, and The Villages, Florida.