Why is the skin around my ankle brown?

Dark red, purple, brown, hardened skin is an early sign of venous insufficiency. It means blood is pooling, with fluid and blood cells leaking out into the skin, and it shows up before any ulcer forms.

The short explanation: dark red, purple, brown, hardened skin is a sign that blood is pooling.

It is one of the early signs of venous insufficiency. That’s what happens when the one-way valves in the leg veins become weak, or the veins become scarred and blocked, so blood flows backward and pools in the legs.

Here’s why the color changes. When blood pools in the veins of the lower leg, fluid and blood cells leak out into the skin and other tissues. Blood cells in the skin, rather than in the vessels, are what you are seeing.

The word early matters. This change comes before any wound exists. It is a sign that comes before a venous ulcer, not a feature of one. The other early signs are itchy, thin skin with faint, light red discoloration, called stasis dermatitis; leg swelling, heaviness and cramping; and itching and tingling.

Hardened is worth noticing alongside brown. The color comes with a change in the skin’s texture, so skin that has become firm or tight as well as discolored is the same thing.

That makes brown skin around an ankle an opportunity rather than only a worry. The measures for venous insufficiency — compression as instructed, feet above the heart as often as possible, daily walking or exercise, keeping the skin of the lower legs well moisturized, and the general measures of not smoking, controlling blood sugar if diabetic, managing blood pressure and cholesterol, and losing weight if overweight — are aimed at this stage.

Discoloration can have other causes, and this page cannot tell you what yours is. It is a reason to have the leg looked at, particularly if it is new or spreading.

What to watch for

This is one of the early signs, along with itchy thin skin and faint light red discoloration called stasis dermatitis, leg swelling, heaviness and cramping, and itching and tingling.

Prevention is aimed at this stage: wear compression as instructed, put your feet above your heart as often as possible, walk or exercise every day, and keep the skin of your lower legs well moisturized.

Skin that has become discolored and hardened is a reason to have the leg examined. This page cannot say what is causing yours.

If a sore has already formed, the signs of infection to contact a provider about are redness, increased warmth or swelling around the wound; more drainage than before or drainage that is yellowish or cloudy; bleeding; odor; fever or chills; increased pain.

Wound Wizard is general education and cannot assess your skin. Your own clinician is the right person to ask.

What we look at

  • Examining the skin of the lower legs
  • Checking the blood flow in the legs
  • Identifying what is causing the discolouration
  • Advising on compression, elevation and skin care

Sources

  1. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm