How We Treat Skin Pigmentation

Abnormal skin pigmentation can be due to many causes. 

One type is sun spots or age spots, where the skin produces extra melanin in response to the sun’s UV rays. These spots are completely harmless. 

Another comes from your circulatory system — specifically, the venous system that returns deoxygenated blood to your heart. If blood doesn’t flow properly, you can develop vein problems, including venous stasis dermatitis — discoloration around your lower legs and ankles. Left untreated, this can lead to skin ulcers, abscesses, and even bone infections.

At Dallas Vein Institute in Dallas, Texas, interventional radiologist and varicose vein specialist Dr. Dev Batra focuses on educating his patients about their circulatory system. He also offers comprehensive treatments, providing specific solutions that bring relief. 

Venous stasis dermatitis and its resulting skin pigmentation are a part of vein disease that’s not as well known as some other stages, so Dr. Batra and his team have put together this guide to help you understand what’s happening and what treatments can help.

The stages of vein disease

When blood returns to the heart from the body’s tissues, it has to fight the pull of gravity. To do that, the body uses two techniques. First, the muscles in your thighs and calves contract, forcing the blood upward. Second, the veins carrying the blood contain valves that snap shut once the blood has flowed past them, preventing backward movement.

However, if the vein walls weaken, it can damage the valves, which then can’t close completely. That allows the blood to move backward, pooling around the damaged valve. The result is what’s known as chronic venous insufficiency (CVI).

If the superficial veins around the valves engorge with blood, they form colored, ropy protrusions known as varicose veins. These may be purely a cosmetic concern, or they can cause swelling, itching, and burning. More importantly, they can lead to clots in the deep veins, a potentially life-threatening condition known as deep vein thrombosis (DVT).

If you don’t treat varicose veins, you can develop painful edema (leg swelling). Failure to address the edema can lead to venous stasis dermatitis, the second cause of skin pigmentation, changing both the color and the appearance of the skin on your legs.

The discoloration starts with orange-brown spots that arise when the pressure from the edema causes small capillaries to burst. The discoloration may progress to brown or red around your lower legs and ankles. You may also notice:

And if stasis dermatitis goes untreated, edema can lead to open sores called venous ulcers forming on the lower legs and the tops of the feet. These slow-healing ulcers may become infected and form scars once they’ve healed. For diabetics, venous ulcers are a leading cause of lower-limb amputation.

Venous stasis dermatitis treatments

At Dallas Vein Institute, we offer several minimally invasive treatments to eliminate your diseased veins, removing the problem at its source. These include:


ClosureFast is an endovenous radiofrequency (RF) ablation treatment. We send radiofrequency energy into the problematic vein, forcing its walls to collapse. Blood is rerouted to other healthy veins.


We use an injectable adhesive that seals the diseased veins shut. Once again, blood is then rerouted to healthy veins.

Ultrasound-guided foam sclerotherapy

In regular sclerotherapy, we inject a sclerosant (irritant) into the vein, which causes the vein to scar and collapse. Most sclerosing agents are liquids, making it difficult to achieve an even distribution within the veins. 

Instead, Dr. Batra uses ultrasound-guided sclerotherapy, which allows him to provide a more precise treatment. He first injects gas into the sclerosing agent, then injects the foam-sclerosant blend into the vein. 

The gas serves as a marker, viewable with ultrasound imaging. That allows him to target the treatment area more precisely.


When a varicose vein is close to the skin’s surface, microphlebectomy may be a good treatment option. Dr. Batra makes very small incisions (less than ¼-inch) and uses a hook to remove the veins in segments.

Are your legs and ankles painful and pigmented? You may have venous stasis dermatitis, requiring treatment from our team. Contact Dallas Vein Institute by calling 972-646-8346, or by scheduling your appointment online. We can help.

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