Hemosiderin is a byproduct produced by the breakdown of hemoglobin. Hemoglobin is found in red blood cells and serves to transport oxygen from the lungs to the rest of the body. One of the components of hemoglobin is iron; as red blood cells die, the iron is released from hemoglobin and leaks out from the blood vessels. The released iron is then converted into hemosiderin and is stored in tissues under the skin. The stored hemosiderin can lead to brown, discoloration of the skin, a condition known as hemosiderin staining.
Causes of Hemosiderin Staining
Chronic venous insufficiency
Chronic venous insufficiency is a condition that develops when veins in the lower legs are not able to return blood to the heart. This insufficient return thereby leads to pooling of blood in the lower legs. Over time, the red blood cells break down, releasing hemoglobin which is then converted to hemosiderin and stored in lower leg tissues. Causes of venous insufficiency are:
- Varicose veins: These can develop as a result of weak or incompetent valves in veins in the lower legs. These veins thereby become dilated and enlarged. As such, they are unable to prevent the backflow of blood thus leading to blood pooling in the lower legs.
- Physical inactivity: Blood can pool in the lower legs as a result of sitting or standing for long periods of time without moving.
Sclerotherapy is one of the treatment modalities for varicose veins. It involves the injection of a substance known as a sclerosant into the varicose vein. This leads to the scarring and reduction of the varicose vein. In some people, this treatment may leave them with a brown skin discoloration as a result of hemosiderin deposits. This discoloration is usually transient and disappears in a couple of weeks; however, in some people, the stain ends up being permanent.
In addition to those discussed above, other uncommon causes of hemosiderin staining are trauma, surgery, diabetes, and lipodermatosclerosis which is a disease of the skin.
Treatment of Hemosiderin Staining
- Creams and gels: Creams and gels applied topically can help lighten hemosiderin stains and improve their cosmetic appearance. The stains may not disappear entirely using the creams but make them less visible.
- Laser treatment: Lasers can be used to remove hemosiderin stains. Similar to topical creams, they may not remove the stains completely but reduce their visibility.
Ultimately, the best way to manage hemosiderin staining is to address the underlying causes. Avoiding long periods of immobility is essential. Furthermore, a medical professional should be seen if there is a suspicion of varicose veins.
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