Question: How do I rid my shins of the reddish-brown discoloration called "stasis dermatitis?"

Dr. Hibberd's Answer:

The reddish-brown pigmentation changes seen with stasis dermatitis are actually a late finding and reflect advanced disease of your venous system. Correction of this condition involves rectifying the venous disease.

There are a number of minimally invasive procedures that can be performed in the office or outpatient surgery center designed to help minimize stasis dermatitis progression as well as help heal any stasis ulcerations.

Most procedures available target relieving the excessive pressure in the superficial veins. Many newer techniques (using a vascular scope to either remove or destroy the incompetent perforator veins) are very successful and popular at present. These procedures combined with weight loss, smoking cessation, judicious exercise, and disease management (diabetes, infection, inflammation etc.) can delay skin changes and ulcerations if intervention is accomplished early enough.

These procedures will actually allow venous ulcerations to heal where they otherwise may never have totally healed. The previous days of wearing compression hose and medicated boots appear to be limited thanks to modern imaging and technology.

Once your circulatory condition is corrected, the pigment changes will gradually fade over time, but unfortunately will be unlikely to disappear. Blanching agents are available from your dermatologist, but these need to be used under close supervision, if at all. Laser treatment may actually cause further harm to these already fragile tissues and is not the optimal treatment.

No treatment available is a permanent cure. The lesson here is in prevention. Be proactive in modifying risk factors for this condition. Stop smoking, optimize exercise and nutrition, optimize lipids and circulation, and modify weight to reasonable goals.