Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Brown skin discoloration on lower legs aka hemosiderin deposition

by Dr. Zsolt Zatrok

A reddish-brown patch or even a large area of brown discoloration over the ankle on the shin is a common phenomenon. It is a symptom that may indicate venous insufficiency in the lower limb. In medical documents the patch is referred to as ‘hemosiderin deposition’. Let’s look at what causes it, how can you prevent it, and whether there is a way to get rid of it?

hemosiderin - Brown skin discoloration on lower legsThe “rusting” of the skin

The brown skin discoloration is actually caused by “rust”, or the deposition of oxidized iron.

It occurs when large numbers of red blood cells leak through the smallest blood vessels (capillaries) into the tissues. When these red blood cells die, the iron released from their haemoglobin is converted into hemosiderin. It is stored in the subcutaneous tissue and appears as a brown spot on the skin.

What causes brown skin discoloration?

Reddish-brown spotting of the lower leg is most often caused by problems with the veins. Especially if the veins in your leg have systematically increased pressure, venous hypertension or venous insufficiency may also be used to describe this condition. High pressure in the vein causes blood cells to “squeeze out” through the walls of the blood vessels into the skin tissue. When they die, a spot forms in the skin tissue.

If you stand or sit for long periods at work, you can expect to develop this lesion over time. You are also at higher risk if your parents or siblings have them, or if they are being treated for varicose veins or leg ulcers.

If at the end of a long day, your feet feel heavy (like they have lead shingles) or sore or swollen, that’s not a good sign. These symptoms are signs of hidden venous insufficiency. If you already have brownish-red patches and thinning, dry skin around them, you’re too late for prevention.

Vein hypertension/variceal insufficiency

Blood is pumped by your heart through arteries to the rest of your body. It then returns to your heart through your veins. Your blood is circulated by your heart, diaphragm and breathing muscles, and by the contraction of your muscles during movement.

Your veins contain “valves” (called venous valves) that allow blood to flow in only one direction (back towards your heart). As long as your veins and the valves in them close properly, they prevent your blood from flowing back towards your legs.

The problem arises when these valves weaken or the vein dilates. When this happens, the valve “lets go” and the upward flow of blood is impaired. More and more blood is left in the veins, they swell, dilate and become tortuous (colloquially called varicose veins)

If this condition persists, the walls of the increasingly swollen veins become overstretched and “leak”, meaning that blood bodies leak into the surrounding tissues. In this condition, your ankles may already be noticeably swollen. Brown spots may also appear. In more severe cases, blood circulation is so impaired that sores can form which may take months or even months to heal. These wounds are called ulcers.

What to do if you have reddish brown skin discoloration on your lower legs?

If the spots have appeared, you’re a little late. Nonetheless, visit a vascular surgery clinic and ask to be checked out.

You need to be sure of the severity of the problem. Once you know this, you can adjust your treatment to prevent it from worsening.

In addition to questioning you and giving you a physical examination, the clinic may also perform a Doppler ultrasound scan. This involves using ultrasound to determine the blood flow in the veins of your leg. This is a way of measuring how fast blood is flowing through the main (larger) blood vessels. They also compare the two sides.

Further tests may be needed for diabetes or heart involvement.

How to treat brown skin discoloration on the leg?

Hemosiderin deposited in the skin cannot be removed, which means the discolouration will haunt you for the rest of your life. What you can do is prevent the deterioration or at least slow it down.

Skin Hydration

The skin in the discolored area becomes thinner, drier and can crack. Avoid drying soaps. Use a moisturising cleanser or cosmetic. Bath water should not be too hot as this can also dry the skin. Avoid using towels or bath towels with coarse material, as they can damage thin skin.

Lymphatic Massage and Compression therapy

There are two types of compression therapy. Either stockings made of elastic material or mechanical pneumatic massage. You can do the latter with a device mostly referred to as a lymphatic massage machine in our country. Compression therapy improves blood flow in the veins. It is very effective in reducing and healing swelling and preventing sores or ulcers.

The lymphatic massage machine is the most effective tool for treating varicose veins and post-thrombotic conditions.

Power Q-1000 Plus lymphatic massage machinePower Q-1000 Plus compression therapy unit

  • simple lymphatic massage machine
  • for home use
  • 4 air chamber cuffs for legs, arms, hips
  • for mild lymphoedema
  • handling pressure identical in all air compartments
  • 1 treatment programme
  • available for purchase

Functional stimulation (FES)

A cheaper method than a compression machine is electrical stimulation of the lower limb muscles. The muscle contractions induced by the pulses help the circulation of the limb in a similar way to muscle movement. Positive results can be expected from 20-30 minutes of treatment a day.

Elite SII Multifunctional Electrotherapy Deviceblank

  • 2 channel electrotherapy device
  • multifunctional, versatile
  • sport applications
  • available for purchase

Test Exercise

Above I mentioned that the natural driver of venous circulation is the regular contraction of muscles, i.e. movement. The best way to stimulate varicose vein circulation is exercise, most commonly brisk walking, jogging or cycling. Try to move as often as possible. 1-2 times a day for 20-30 minutes or once for 40-50 minutes. More is better in this case!


Since Brown skin discoloration on the legs is a result of venous insufficiency, if you don’t want reddish brown spots on your legs, PREVENT it! The best way to do this is to exercise on a daily basis. Start when you are a child and never stop exercising. (I’ve written in detail what I recommend in the previous paragraph.)

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