For many people, the first signs of PVD begin slowly and irregularly. You may feel discomfort like fatigue and cramping in your legs and feet however there are several other symptoms associated with PVD including changes to the skin. The skin of the legs, ankles and feet may exhibit changes that can include any one or combination of the following: color changes, eczema, temperature changes, thickening of the skin, itching, open wounds and others.
Skin Changes
Symptom Details
Arterial conditions, such as peripheral artery disease (PAD) and critical limb ischemia (CLI), and venous conditions, such as deep venous disease (DVD) and superficial venous insufficiency (SVI) can produce notable changes in the skin, especially on the legs and feet.
Changes in the texture and color of the skin are a result of poor circulation in the arteries and veins.2,3,4
When the circulation is compromised blood flow is decreased resulting in increased pressure in the vessels, leading to inflammation of the skin on one or both legs. The resulting inflammation may cause the skin to become leathery, itchy or reddish.1 Without treatment, increased swelling and skin inflammation due to poor circulation of blood can lead to serious complications such as rash, sores that are open as well as other ulcerations.5 Venous insufficiencies (DVI) can lead to stasis dermatitis which causes itching, scaling, hyperpigmentation, and sometimes ulceration.7 These are serious conditions that require prompt diagnosis and treatment. It is important you take the step and seek help from your doctor if you notice changes in your skin.
Skin changes to your feet or legs can be a sign of several conditions such as PAD, DVD or SVI. The progressive conditions may start out with mild symptoms but with time, may lead to more moderate to severe symptoms.
Mild
- Arterial conditions may produce poor nail growth on the toes
- When blood pools around the extremities, it may lead to increased warmth around the affected leg
- The skin may become dry and itchy
- Skin feeling cool to the touch
Moderate
- There may be decreased hair growth on the legs as tissue begins to die
- The skin can become pigmented and thick (lipodermatosclerosis) and easily break down
- As venous disease progresses, there may be increased swelling, pressure and redness
Severe
- Ulcerations in the ankles or calves may occur, as the skin breaks down and are slow to heal
- Arterial conditions such as CLI may lead to ulcers on the feet and toes and eventually to black toes
- Gangrene may develop and is a sign that tissue has died because of lack of blood flow
Causes
When PVD causes skin changes it is a direct result of poor circulation. Trauma or surgery can also cause injury to an artery or vein resulting in skin changes.
There are a number of other diseases and conditions not related to PVD that can exhibit skin changes. Only your doctor can pinpoint the cause of your skin changes.
Risk Factors
There are many risk factors that may predispose a person to developing skin changes due to PVD.
In addition to vascular causes, other risk factors include:1
- Age can be a risk factor for developing skin changes as poor circulation commonly develops in adults over 60 years of age
- Previous trauma or injury can impair the body’s ability to move blood and can lead to skin changes
- Gender can play a role as women are twice as likely to develop the condition than men
- Multiple pregnancies can put pressure on a woman’s pelvic area and veins, resulting in skin changes in the lower extremities
- Lifestyle can play a role, as standing for long periods of time and lack of exercise can reduce the body’s ability to circulate blood
- Other medical conditions such as obesity and being overweight can increase the likelihood of developing skin changes due to increased pressure on the veins. High blood pressure and diabetes can also play a role in developing PVD and the resulting skin changes.
What to Look For
Skin Changes
- The skin can become dry, cracked and leathery
- The skin may feel itchy and irritated
- Hyperpigmentation may develop as the skin lacks proper blood flow and oxygen
- Redness may be present due to swelling
- Eczema or rash
- If the condition has progressed to severe stages, black toes or gangrene may be present
- Poor nail growth
- Reduced hair growth on the legs
- Lack of pulse or weak pulse
- Skin feels cool to the touch
- Sores on the legs or feet that may also bleed and are either slow to heal or non-healing.
- If the sores seep pus and have a bad odor, it may be an indication of an infection, which requires prompt medical attention
Associated Symptoms
Varicose Veins
Varicose veins can become inflamed when the pooling of blood results in pressure on the vein walls resulting in redness, swelling, and a diffuse pain.
Swelling
Blood pooling in the legs creates pressure on the valves of the veins and damages the capillaries (small blood vessels) and leads to swelling.
Non-Healing Wounds
Ulcers can develop on both the legs and the feet. Ulcers which are above the ankle are usually a result of severe venous disease; the skin breaks down over time and wounds develop. Wounds that won’t heal or are slow to heal on the lower ankle and foot and a result of CLI, where the arteries are unable to bring oxygen rich blood to the foot and the tissues begin to die.
When to See a Doctor
Skin changes and discoloration may be a sign of a condition, such as PAD and DVD, which progresses if not treated properly. Other conditions such as CLI may produce skin changes that require prompt medical attention right away.
Talk to your doctor if you are concerned about skin changes. In the case of ulcerations, gangrene or black toes, see your doctor immediately.
Associated PVD Diseases
Helpful Resources
PVD Doctor
Discussion Guide
Get helpful tips and advice on how to talk to your doctor about a PVD screening.
Third-Party Resources
Apps
A mobile app built by cardiologists, to simplify understanding of most cardiac and peripheral vascular conditions and treatments.
Find a Doctor
If you think you are experiencing skin changes, it is important to get help. Take the step and talk to your doctor, or use our tool below to find a specialist near you.
Carl Fastabend
501 Dr. Michael DeBakey Drive (3rd Floor) | Lake Charles, LA, 70601
Thomas Lee
131 Madison Avenue 2nd Floor | Morristown, NJ, 7960
Peter Swischuk
3109 Stirling rd. Suite 100 | Fort Lauderdale, FL, 33312
David Draughn, FACS, RVT, RPVI
15825 John J Delaney Dr | Charlotte, NC, 28277
Joe Viramontes
960 N 16th Street Suite 108 | Springfield, OR, 97477
Michael Sergi
75 Kings highway Cutoff, Suite 4B | Fairfield, CT, 6824
Manish Chauhan
2200 Park bend | Austin, TX, 78757
James Cunningham
8767 Perimeter Park Blvd | Jacksonville, FL, 32216
Nouri Al-Khaled
4400 W 95th Street, Suite 306 | Oak Lawn, IL, 60453
Cindy Sturt
200 S. Orange Ave | Livingston, NJ, 7039
Jesus Jimenez
2800 S Seacrest Dr. Suite 200 | Boyton Beach, FL, 33435
Andrei Pop
800 Biesterfield Road | Elk Grove Village, IL, 60007
Ediberto Soto-Cora
1139 Caper Rd | El Paso, TX, 79925
Kaveh Shahmohammadi
1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488
Lori Pounds
7703 Floyd Curl Drive | SanAntonio, Texas, 78229
Alex Caballero
1879 Nightinglae Ln | Tavares , Florida, 32778
Thomas Levin
10837 South Cicero Avenue Suite 200 | Oak Lawn, IL, 60453
Leandro Perez
8188 Jog Rd. Suite 100 | Boyton Beach, FL, 33427
Jose Almeida
1501 S Miami Ave. | Miami Beach, FL, 33129
Saba Khan
800 Biesterfield Road | Elk Grove Village, IL, 60007
Jordan Knepper
5325 Elliot Drive, Suite 101 | Ypsilanti, MI, 48197
Jason Andre
12720 McManus Blvd, Suite 303 | Newport News, VA, 23602
Micheal Ayad
300A Faunce Corner Rd N | Darthmouth, MA, 02908
Yazan Khatib
Suite #160, FL, 32256
Santhosh Mathews
316 Manatee Ave W | Bradenton, FL, 34205
Patricio Rosa
601 N Flamingo Rd. Suite 408 | Pembroke Pines, FL, 33028
Akhilesh Sista
2315 Broadway 4th floor | New York, NY, 10024
Kathleen Gibson
1135 116th Avenue NE, Suite 305 | Bellevue, WA, 98004
James Sampson
101 Bodin Circle 60 SGCS/SGCH | Travis AFB, CA, 94535
Brian Heeringa
880 Munson Ave, Suite A | Traverse City, MI, 49686
Ravi Chandra
1920 SW 20th Place | Ocala, Florida, 34471
Vaqar Ali
7011 AC Skinner Parkway | Jacksonville, FL, 32256
David Burkart
4801 College Blvd | Leawood, KS, 66214
Asad Sawar
3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613
Andrew Barleben
9434 Medical Center Dr. | La Jolla, CA, 92037
Gennady Geskin
6637 State Route 30 | Jeannette, PA, 15644
William Grande
8200 east Belleview Ave Suite 600e | Greenwood Village, CO, 80111
Jeffrey Carr
1783 Troup Highway | Tyler, TX, 75701
Vincent Digiovanni
Riddle Health Center 3, 1098 W Baltimore Pike, Suite 3308 | Media, PA, 19063
Ido Weinberg
55 Fruit St | Boston, MA, 02114
Dale Buchbinder
1212 York Road | Lutherville, MD, 31093
Paul Gagne
85 Old Kings Highway North | Darien, CT, 6820
Vasco Marques
3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613
Scott Koss
725 American Ave | Waukesha, WI, 53188
Janardhan Srinivasan
2232 Wilborn Avenue | South Boston, VA, 24592
Steve Lin
1401 Harrodsburg Rd Ste A300 | Lexington, KY, 40509
Kais Yehyawi
6375 W US 6 | Portage, IN, 46368
Diego Hernandez
43700 Woodward Avenue, Suite 207 | Bloomfield Hills, MI, 48302
Deepak Sudheendra
3400 Spruce Street | Philadelphia, PA, 19104
Fuad Rafidi
23101 Sherman Place | West Hills, CA, 91307
Thomas Kerr
19189 N Dale Mabry Hwy | Lutz, FL, 33548
Hesham Fakhri
3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613
Aaron Hurd
630 13th Street Suite 250 | Augusta, GA, 30901
Sunil Rayan
9850 Genesee Ave | La Jolla, CA, 92037
David Lipski
6420 Dutchmans Pkwy Suite 180 | Louisville, KY, 40205
Rias Ali
4740 Mile Stretch Drive | Holiday, FL, 34690
Jed Peterson
10123 SE Market Street | Portland, OR, 97216
Constantino Pena
8900 North Kendall Drive | Miami, FL, 33176
Zahi Nassoura
2710 Alameda Ave | Burbank, CA, 91505
Nader Chadda
6633 Forest Ave Ste 302 | New Port Richey, FL, 34653
Richard Ofstein
8075 N Shadeland Ave Ste 200 | Indianapolis, IN, 46037
Robert Davies
1301 Sigman Road, NE Suite 130 | Conyers, GA, 30012
Elizabeth Brooke Spencer, MD, FSIR
8200 east Belleview ave Suite 600 E | Greenwood Village, CO, 80111
Mazen Abu-Fadel
825 NE 10th St #2500 | Oklahoma City, OK, 73104
David Frankel
10666 N. Torrey Pines Rd. | La Jolla, CA, 92037
Patricia Thorpe
333 W Thomas Rd, Suite 207A | Phoenix, AZ, 85013
Peder Horner
1746 Cole Boulevard | Lakewood, CO, 80401
Fuad Rafidi
2710 | Burbank, CA, 91505
Gene Tanquilut
20060 Governors Drive Suite 102 | Olympia Fields, IL, 60461
Kannan Natarajan
8433 Harcourt Rd. Suite 100 | Indianapolis, IN, 46260
Charles Ross
95 Collier Road NW Suite 5015 | Atlanta, GA, 30309
Windsor Ting
1468 Madison Avenue or 1190 Fifth Avenue | New York, NY, 10029
Dev Mangalat
705 Jesse Jewell Parkway 125 | Gainseville, GA, 30501
Arun Jagannathan
23120 South LaGrange Road | Frankfort, IL, 60423
Michael Flisak
3231 South Euclid Avenue, Suite 207A | Berwyn, IL, 60402
Shahin Pourrabbani
3680 Imperial Highway | Lynwood, CA, 90262
Joe Viramontes, MD
960 N 16th Street | Springfield, OR, 97477
Blaine Borders
102 Thomas Rd. Suite 205 | West Monroe, LA, 71291
Pat Neville
4600 Memorial Dr. Suite 240 | Belleville, IL, 62226
Charles Wyble
61 Witcher Street, Suite 2100 | Marietta, GA, 30060
David Gillespie
363 Highland Ave | Fall River, MA, 2720
Polly Kokinos
2255 S. Bascom Avenue #200 | Campbell, CA, 95008
Howard Roth
23120 South LaGrange Road | Frankfort, IL, 60423
Anthony Avino, MD, FACS
4750 Water Avenue, Suite 500 | Savannah, GA, 31410
Murat Sor
3833 Fairfax Drive | Arlingston, VA, 22205
Mahesh Raju
3825 highland ave | downers Grove, IL, 60515
Kenneth Wright
19189 N Dale Mabry Hwy | Lutz, FL, 33548
Rick Coats
4600 Memorial Dr # 240 | Belleville, IL, 62260
Sendhil Subramanian
7130 Mt. Zion Blvd, Suite #10 | Jonesboro, GA, 30236
Richard Pin
363 Highland Ave | Fall River, MA, 2720
James McPherson
4644 Lincoln Blvd. Suite 500 | Marina del Rey, CA, 90292
Ben Marson
85 Old Kings Highway N, 1st Floor | Darien, CT, 6820
E. Jerry Cohn Jr., MD, FACS
4750 Water Avenue, Suite 500 | Savannah, GA, 31410
George Hemstreet
100 Rice Mine Road Loop | Tuscaloosa, AL, 35406
Harold Tabaie
18905 Sherman Way | Reseda, CA, 91335
Alberto Gonzalez
19189 N Dale Mabry Hwy | Lutz, FL, 33548
Ayaz Malik
1035 Bellevue Ave #500 | St. Louis, MO, 63117
Isabel Newton
200 W Arbor Dr. | San Diego, CA, 92103
Michael Ayad
363 Highland Avenue | Fall River, MA, 2720
Jozsef Lukacs
24800 S.E. Stark St. | Gresham, OR, 97030
Timothy Manoni
85 Old Kings Highway N, 1st Floor | Darien, CT, 6820
Larry Horesh, MD
4750 Water Avenue, Suite 500 | Savannah, GA, 31410
Amiel Moshfegh
11411 Brookshire Ave | Downey, CA, 90241
Lev Pukin M.D
2560 Ocean Ave | Brooklyn, NY, 11229
Parag Patel
6633 Forest Ave #300 | New Port Richey, FL, 34653
Hoang Nguyen
2 Good Samaritan Way Suite 220 | Mt. Vernon, IL, 62864
(Charles) Daniel Procter
725 Jesse Jewell Parkway #125 | Gainesville, GA, 30501
Michael Naumann
7777 Alvarado Road, Suite 108 | La Mesa, CA, 91942
Stephen Lalka
1001 Blythe Blvd., Suite 300 | Charlotte, NC, 28203
Taras Kucher
495 Hawley Lane, Suite 2-A | Stratford, CT, 6614
Junyang Lou
520 Medical Center Drive | Medford, OR, 97504
Michael Lepore
600 North Cattlemen Rd | Sarasota, FL, 34232
Robert Freedman
3311 Prescott Road | Alexandria, LA, 71301
Daniel Simon
347 Mount Pleasant Ave Suite 100 | West Orange, NJ, 7052
Daniel McDevitt
1035 Southcrest Dr, Suite 250 | Stockbridge, GA, 30281
Marvin Padnick
350 South 40th Street | Muskogee, OK, 74401
Patrick Mahon
87 McGregor Street | Manchester, NH, 3102
Jamie Strachan
1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488
Aaron Aday
75 Francis St | Boston, MA, 02115
Russell Samson
600 North Cattlemen Rd | Sarasota, FL, 34232
Raghotham Patlola
5003 Hardy St, Ste 200 | Hattiesburg, MS, 39402
Bruce Brenner
200 S. Orange Ave | Livingston, NJ, 7052
Ernest Conti
3929 Mercy Drive | McHenry, IL, 60050
Sanjeev Trehan
6151 South Yale Ave Suite 1304 | Tulsa, OK, 74136
Tara Balint
2010 Health Campus Drive | Harrisonburg, VA, 22801
Stephen Bauer
1445 East Putman Ave, 1st Floor | Old Greenwich, CT, 6870
Deepak Nair
600 N Cattlemen Rd | Sarasota, FL, 34232
David Showalter
600 North Cattlemen Rd | Sarasota, Florida, 34232
Andrew Olinde
5131 O'Donovan Drive 301 | Baton Rouge, LA, 70808
Allison Barone
250 Engle Street | Englewood, NJ, 7631
Thomas Lutz
15 Tower Ct Suite 200 | Gurnee, IL, 60031
Mark Iafrati
800 Washington st | Boston, MA, 2111
Jerry Chen
2775 Laurel Street, Room 4203 | Vancouver, BC, V5Z1M9
Jonathan Bowman
495 Hawley Lane, Suite 2-A | Stratford, CT, 6614
Paul Vitulli
915 W Monroe St | Jacksonville, FL, 32004
Douglas Dorsay
600 North Cattlemen Rd | Sarasota, Florida, 34232
This tool is not inclusive of all specialists. Consult with your insurance provider to find specialists that are covered within your network.
1. “Statsis Dermatitis.” American Academy of Dermatology. 2017.
2. “Peripheral Vascular Disease.” John Hopkins Medicine. n.d.
3. “What are the signs and symptoms of Peripheral Artery Disease?” National Institutes of Health. U.S. Department of Health and Human Services. n.d.
4. Simon et al. “Peripheral artery disease and intermittent claudication.” University of Maryland Medical Center. May 24, 2012.
5. Eberhardt et al. “Chronic Venous Insufficiency.” Circulation. 2014;130:333-346. July 21, 2014.
7. “Venous ulcers,” Medline Plus. U.S. National Library of Medicine. May 24, 2016.
8. Stasis Dermatitis: merckmanuals.com/professional/dermatologic-disorders/dermatitis/stasis-dermatitis
Disclaimer
The opinions and clinical experiences presented herein are for informational purposes only. Individual results may vary depending on a variety of patient-specific attributes and related factors. Dr. Raghu Kolluri has been compensated by Philips for his services in preparing and providing this material for Philips further use and distribution.
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