Hemosiderin Staining: Causes, Risks, and Treatment

Written By Dr. Brian Machida

• Hemosiderin staining happens in areas where a significant amount of bruising has occurred as a result of severe injuries, hemorrhages or, in certain cases, after a particularly invasive surgery.
• Generally, stains that last more than 12 months cause permanent marks as the skin has essentially been tattooed.
• The simplest, and most readily available treatments for hemosiderin staining, are topical creams that are applied to the stained area.

What is hemosiderin staining?

Hemosiderin staining is a permanent or semi-permanent, bruise-like mark that can vary dramatically in size, shape, and location on the body.

“It typically occurs around superficial veins, close to the surface of the skin,” says Dr. Aaron Shiloh of Shiloh Vein and Aesthetics, located just outside of Philadelphia. “Staining is represented by a brownish discoloration either in the vein or around it. ”

Hemosiderin

Hemosiderin is an iron-rich protein that occurs in the body naturally. It’s made up of approximately 35% iron and stored in a form that the body cannot easily consume.

Hemosiderin is created by a process that starts in our blood. Hemoglobin — a protein in red blood cells — carries oxygen throughout the body. When blood moves into tissue as a result of injury, hemoglobin decays and creates hematin.

This hematin needs to be removed, and our bodies have cells called phagocytes to manage this process. Phagocytes are a grouping of white blood cells that ingest harmful substances in the body. When phagocytes ingest hematin, they produce what is called “hemosiderin.”

Bruises are caused when an impact damages blood vessels and allows blood to seep into surrounding tissues. Hemosiderin is one of the various substances responsible for the coloring of most bruises, which is why hemosiderin staining so closely resembles bruising.

What causes hemosiderin staining?

Hemosiderin staining can essentially be regarded as a very severe form of bruising. Staining happens in areas where a significant amount of bruising has occurred as a result of severe injuries, hemorrhages or, in certain cases, after a particularly invasive surgery.

When damage occurs, the surrounding tissue is flooded with blood and a bruise then forms. The more severe the trauma is, the more blood leaks into surrounding tissues, indicating a greater presence of hemosiderin.

It is difficult for the body to access the iron in hemosiderin. This, combined with the fact that iron is responsible for the coloration of hemosiderin, results in prolonged staining that is visible on the surface of the skin.

Other than trauma, staining can also be a by-product of serious life-threatening conditions such as high blood pressure and heart disease.

“When vein valves fail, the regurgitated blood forces red blood cells out of capillaries,” explains Dr. Alex Roher of San Diego Botox. One of the more common reasons for valves leaking is Chronic Venous Insufficiency (CVI), a condition where malfunctioning leg valves, make blood-flow difficult in an area. This creates pools of blood that result in hemosiderin staining.Hemosiderin Staining

Can hemosiderin staining be dangerous?

Hemosiderin staining is not only a cosmetic issue. The underlying leaking valves, like those found in CVI, can result in more serious complications. “If left as is, people can develop skin ulcers that are hard to treat,” cautions Dr.Shiloh. This can also lead to chronic pain as well as stiffness in the leg joint.

Internally, hemosiderin staining of the liver can be a sign of hemochromatosis, or an iron surplus in the body.

hemochromatosis is caused by genetic factors or by receiving multiple blood transfusions. It can lead to a bronze discoloration of the skin as well as to cirrhosis of the liver, diabetes, and arthritis, among other issues.

This staining can also occur in the brain after a head trauma. A study published by the American Society for Experimental Neurotherapeutics suggests that patients with issues such as Alzheimer’s disease, Parkinson’s disease, and Multiple Sclerosis often have areas of the brain with increased iron deposits like hemosiderin stains.

That being said, research into the effects of iron-rich areas of the brain is relatively new, and conclusions are yet to be definitively drawn.

Can staining be treated?

The main issue with hemosiderin is that the iron present within it is difficult for the body to consume. Once the body is able to use this stored iron in the same way that the body uses iron derived from food, the stain will fade.

In order to hasten the absorption of the iron present in hemosiderin, some sources suggest altering diets to reduce the total amount of iron in the body. Consuming less iron makes the body rely on its stored reserves. It is argued that forcing the body to more rapidly consume the iron in hemosiderin through this method will make the stains fade at a faster rate.

While there is no concrete evidence for the success of this method, the effects of iron deficiency are well-documented. A deficiency of iron can result in a lack of energy, focus, and the ability to fight off infections. Drastically altering a diet to reduce iron-intake is not recommended without the approval of a recognized dietician.

Over time, certain hemosiderin stains will fade naturally as the body slowly uses up the stored iron. This hands-off process can take several months -or even years -to completely remove all traces of the stain. Generally, stains that last more than 12 months cause permanent marks as the skin has essentially been tattooed.

RELATED: What Is Sclerotherapy? Is It Safe For Treating My Varicose and Spider Veins?

In cases where veins continuously leak, stains are unlikely to fade naturally over time, as hemosiderin is constantly present and replenished.

Several options exist to speed up the healing process. The simplest, and most readily available, are topical creams applied to the stained area. These creams generally help to make the iron in hemosiderin more accessible to the body, and expediting its consumption.

While creams specifically designed to deal with hemosiderin staining can potentially alleviate the issue, skin bleaches are not recommended for this purpose because the iron pigment is too deep in the skin to be accessed by the bleaching agents.

“At our clinic, we use a laser to treat hemosiderin staining,” says Dr.Roher. Laser treatment for hemosiderin staining is a relatively new technique. Following a process not entirely dissimilar to tattoo removal, professionals target the area with a laser capable of rendering the iron more consumable by the body. “Most patients find this treatment painless, and one to two visits are all that are normally required,” states Dr.Roher.

In cases where damage is more severe and veins continue to leak long after the initial injury occurs, treatment can be more difficult. Staining is unlikely to vanish naturally, and the typical treatments, which target the stain itself, will not be effective in the long-term.

“Treatments for the underlying leaking veins can help,” says Dr. Shiloh. “These range from simple injections in the veins, to ablation of the deeper veins.” Ablation is a technique whereby radiofrequencies or lasers are used to cauterize leaking veins, like those present in CVI.

“Cosmetic sclerotherapy is a treatment where the vein is directly injected with an agent like Asclera or Sotradecol. The vein then gets occluded and over time the body reabsorbs it,” explains Dr.Shiloh. “The results should be permanent as long as the deeper leaking veins are also addressed.”

Topical Creams for Hemosiderin Staining: Top Products

In cases where the damaged vein has ceased leaking, topical creams may help speed up the healing process. The following creams target bruising and staining to offer quick relief without using bleaches.

Heladerm Pro Bruise Cream

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Using arnica montana (wolf’s bane) flower extract, vitamin K, and African ginger, this cream accelerates the body’s natural healing process to improve the skin’s appearance. The makers of Heladerm recommend its application to the affected area two to three times per day for best results. In addition to bruising, the cream may also help erase dark under-eye circles, skin discoloration, and hyperpigmentation.

Miracle Plus Arnica Bruise Cream

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Arnica Bruise Cream by Miracle Plus is one of the most popular topical option for bruise fading at home. This cream uses L-arginine and horse chestnut to help improve circulation in the impacted area, and vitamin K to help heal and fade bruising. Miracle Plus’ Arnica Bruise Cream is non-greasy, and is quickly absorbed by the skin to minimize any staining to clothes.

Wild Thera Bruise Away Balm

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This bruise fading balm goes the natural route by incorporating organic herbs and essential oils into its non-GMO mix. Wild Thera recommends frequent application, as often as several times per hour, for optimal result. While a good option for light bruising and discoloration, a more robust treatment option may be required for severe hemosiderin staining.

Zax’s Original Bruise Cream

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Zax’s home remedy uses a trio of well-loved natural skincare ingredients to encourage bruise healing: arnica, witch hazel, and menthol. When applying the cream three times a day, most bruises will fade after a single week of use. Zax offers a refund if fading does not begin after one week of consistent application to assure satisfaction.

Dermato Cosmetology Koxiderm OP Cream

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Dermato Cosmetology’s cream focuses on delivering vitamin K to the targeted area. This approach makes the cream a versatile option that may help to not only treat bruising, but also under-eye circles, varicose veins, and spider veins. Users have said that they notice results after as few as three applications. However, several applications may be necessary for severe bruising.

Causes, Concerns, Treatment & More

A bruise, or contusion, is an injury to skin or tissues just under your skin. Everyone bruises occasionally. There’s usually no reason for concern.

Keep reading to learn more about what causes bruising, the color-coded healing process, and warning signs that you need to see a doctor.

You get a bruise when a small blood vessel just under the skin’s surface breaks. The skin isn’t broken, so blood leaks into tissues. Blood platelets then form a clot to plug the leak.

Here are the different types of bruises:

• Ecchymosis is a flat bruise.
• Hematoma is a raised bruise with swelling.
• Petechiae are tiny purple or red spots that look like a bruise when clustered together.
• Purpura occur without injury, likely due to a blood-clotting disorder.

Everyday things that cause bruising include:

• falling
• bumping into something
• dropping something on your hand or foot
• muscle strain, sprain, or bone fracture

As you age, you tend to have thinner skin and less fat under the skin. This can make you bruise more easily.

Certain medications can make it easier to bruise, too, such as:

• antibiotics
• antiplatelet agents
• aspirin (Bayer, Bufferin)
• blood thinners (anticoagulants)
• certain dietary supplements, such as ginkgo
• topical and systemic corticosteroids

Some conditions that can lead to bruising are:

• deficiency of vitamins B-12, C, K, or folic acid
• hemophilia
• leukemia
• liver disease
• sepsis or other infections
• thrombocytopenia
• vasculitis
• von Willebrand disease

It takes a few weeks for a bruise to completely disappear. The color transition looks something like this:

• Red. Immediately following trauma, you’ll probably notice a red mark that becomes more apparent as blood begins to leak.
• Black, blue, or purple. Within 24 hours or so, the bruise turns black, blue, or dark purple as more blood pools in the area.
• Yellow or green. Within 2 to 3 days, your body starts reabsorbing the blood. There’s a greater concentration of yellow or green.
• Light brown. By day 10 to 14, the bruise fades to light brown before disappearing completely.

A bruise may clear in the center before the outer edges. The coloring and healing process vary from person to person. If you have darker skin, you may also have darker bruises.

If there’s no sign of improvement after 2 weeks, it could be a sign of an underlying health condition. The location of the bruising, plus other symptoms, can provide your doctor with diagnostic clues.

A bruise changes color and shrinks as it heals. If this doesn’t happen within 2 weeks, there may be something else going on.

Frequent bruising

Easy or frequent bruising could be the result of low or abnormal blood platelets or blood-clotting problems. This could be due to an underlying condition.

It could also be a side effect of medication. For example, anticoagulants, antiplatelets, and aspirin interfere with blood clotting. Corticosteroids can thin the skin. Even dietary supplements, such as gingko, can thin your blood.

If you suspect a prescribed medication is the cause, don’t stop taking it. Instead, ask your doctor if there’s an alternative medication.

Your doctor can also order blood tests to check platelet levels or measure your blood-clotting time.

Bruise that won’t go away on leg

If you have petechiae or bruising on the legs or calves that won’t heal, it could be due to a shortage of platelets. Some conditions that can cause this are:

• pregnancy
• certain types of anemia
• enlarged spleen
• heavy alcohol use
• bacteria in the blood
• hemolytic uremic syndrome
• hepatitis C, HIV, or other viruses
• leukemia
• lupus
• myelodysplastic syndromes

Certain medications can also affect platelet counts, such as:

• anticonvulsants
• chemotherapy drugs
• heparin
• quinine
• sulfa-containing antibiotics

Bruise that won’t go away on chest

A chest bruise that won’t go away could be due to:

• fractured or broken ribs
• fractured sternum
• injury to the chest wall

Chest bruising can take up to 6 weeks to heal. You may also have some pain and discomfort.

Always see your doctor after a chest injury. Complications can include infection and difficulty breathing.

Is it cancer?

Frequent bruising or bruising that won’t heal can be a sign of leukemia. Other symptoms of leukemia include:

• fatigue
• pale skin
• frequent bleeding

Inflammatory breast cancer can look like bruising on the breast. Your breast may also feel tender and warm. Inflammatory breast cancer may not involve lumps like other types of breast cancer.

If you have signs and symptoms of leukemia or inflammatory breast cancer, see your doctor right away.

You can also develop bruising and bleeding problems during cancer treatment due to:

• antibiotics
• chemotherapy drugs
• poor nutrition
• radiation to blood-forming bones

You probably don’t need to see a doctor for an everyday bruise. Of course, seek immediate treatment if it’s possible that you’ve fractured a bone. An X-ray can confirm or rule this out.

Also see your doctor for these symptoms:

• painful swelling around the bruise
• continuing pain 3 days after a minor injury
• tendency to bruise for no apparent reason
• history of significant bleeding
• abnormal bleeding from the gums or nose
• fatigue, pale skin, loss of appetite, or unexplained weight loss

Be prepared to provide your personal and family health history as well as a list of medications and dietary supplements.

Blood tests can check platelet levels and measure blood-clotting time. Depending on your symptoms, you may also need an X-ray or other imaging tests to check for fractured bones. Initial tests plus a physical exam will inform the next steps.

If you have swelling or pain during the healing process, you can give the RICE method a try:

• Rest the bruised area.
• Ice the bruise for 10 to 20 minutes. Repeat a few times per day for up to 48 hours. Don’t place the ice directly on your skin. Wrap it in a towel first.
• Compress the area if there’s swelling, but take care not to cut off your circulation.
• Elevate the injury to ease pain and swelling.

Aspirin can cause more bleeding, so choose acetaminophen (Tylenol) for pain. You can also try a few home remedies:

• Aloe vera. Pure aloe vera applied directly to the skin has been shown to help with pain and inflammation.
• Arnica ointment or gel. A 2010 study found that this herb could reduce inflammation and swelling when applied a few times daily.
• Vitamin K cream. A small 2002 study found that this cream could reduce the severity of bruising when used at least twice per day.

If your injury isn’t serious, or there’s no underlying disease, no medical treatment is necessary.

Bruises aren’t usually serious, and they often clear up without treatment. If you have a bruise that doesn’t go away after 2 weeks, you bruise for no apparent reason, or you have additional symptoms, see your doctor for diagnosis. The sooner you get treatment, the sooner you’ll start feeling better.

What causes bruises under the eyes

The appearance of a bluish tint of the skin under the lower eyelid is an unsightly phenomenon from an aesthetic point of view, and alarming from the standpoint of clinical symptoms. Bruises do not occur on their own, and are usually the result of pathogenic changes in the body, lifestyle disorders, or the result of other etiological factors. And therefore, before trying to hide them under a layer of cosmetics or special ointments, you need to establish the nature of their appearance.

How to determine the cause of bruising under the eyes

Visually, even the initial stage of bruising is easy to establish in the morning, after sleep. The skin under the lower eyelid has a darker color. Finding the cause is more difficult. For this purpose, it is recommended to contact doctors who will prescribe complex diagnostic examinations:

• Ultrasound of the abdominal and thoracic organs;
• electrocardiogram;
• magnetic resonance imaging;
• blood and urine tests for biochemistry, sugar, general examinations;
• diagnosis of hormones secreted by the thyroid gland.

In this way, it will be possible to establish what causes bruises under the eyes, and take measures to get rid of them.

Causes of bruising under the eyes

In medical practice, there are several categories of causes that provoke bruising under the eyes. These are living conditions, lifestyle, progressive diseases or their complications. The most common non-health causes are:

• chronic sleep deprivation, as a result of which the structure of blood capillaries is destroyed and small local hematomas are formed;
• load on the pupils – usually felt when watching TV for a long time, working with a computer for a long time;
• poor lighting – a lack of light or, conversely, its excessive brightness, also has a destructive effect on the condition of the capillaries;
• low oxygen levels – caused by a lack of fresh air, prolonged exposure to an enclosed space;
• the action of the rays of the UV spectrum, which affects the retina, capillaries, subcutaneous fat is destroyed.

In the vast majority of cases, bruises under the eyes become a more serious problem, as they are a sign of health problems or a secondary pathology.

More often than other diseases, the formation of such consequences is provoked by diseases of the kidneys, pancreas or liver. This will be evidenced by additional signs – yellowness of the skin, frequent urination, swelling. The second most important are diseases of the cardiovascular system, especially the pathology of the myocardium and endocardium. Blood circulation becomes less intense, congestion forms.

If the bruises are not bluish, but purple, the cause is most likely a lack of oxygen or hemoglobin due to anemia of the blood.

Diseases of an infectious or invasive nature, caused by pathogenic microbes, helminths, fungi, have no less influence.

Also affects the age factor, accompanied by thinning of adipose tissue after 40 years.

Regardless of why bruises form under the eyes, to eliminate them, you need to get rid of the causes themselves, raise the body’s immune response, stabilize its resistance and create comfortable conditions for work and rest.

Why there are bruises on the legs

If bruises appear on the legs , then this not only leads to a cosmetic defect and psychological discomfort, but may also indicate the development of various pathological processes in the body of a man or woman. Finding out the cause of such formations is carried out by medical specialists of the first surgical department of the hospital for the subsequent choice of the most effective therapy, as well as the prevention of their reappearance in the future.

Why do bruises appear on the legs?

A blue-violet spot of the skin of the lower extremities is the result of hemorrhage in the tissue or pathological expansion of the lumen of the venous vessels with blood stasis. Hemorrhage usually develops after a bruise of the tissues of the lower extremities with a direct hit by an object or a fall of a person. Bruises on the legs without a cause appear due to the development of various pathological processes, which include:

• Varicose veins, which may be the result of a hereditary predisposition, stagnation of blood or a decrease in the strength of the walls of blood vessels due to a violation of their nutrition, an inflammatory reaction.
• A pronounced decrease in the strength of the walls of the structures of the microvasculature with insufficient intake of vitamin C, as well as some protein compounds with food.
• Violation of the functional activity of the coagulation system (hemostasis) of the blood, in which the course of the process of thrombus formation worsens to prevent the development of bleeding. This is possible with prolonged starvation of a person, liver failure (liver cells, hepatocytes synthesize factors that are directly involved in blood clotting, as well as the formation of a blood clot), pathology of the blood system, red bone marrow.
• Bruises on the legs in women are often the result of changes in the hormonal background of the body.

Normally, women may experience bruising on their legs after pregnancy and childbirth, which is provoked by a change in the level of various hormones, as well as congestion of the lower extremities associated with compression of the main vessels of the pelvic cavity by an enlarged uterus.

Diagnostics

Bruises on the legs, which are the result of the development of various pathological processes, require a thorough diagnosis of the causes of their occurrence. The first surgical department of the hospital conducts complex diagnostics using various modern methods of laboratory, instrumental and functional research. Based on the results of a comprehensive diagnostic study, medical specialists select an adequate and effective treatment.

Treatment

Modern treatment of the appearance of blue spots, formations of the lower extremities is complex. It implies the use of conservative therapy or surgical intervention, the choice of which is carried out after the diagnosed causes of the pathological process. Conservative therapy includes the use of various drugs that improve the functional state of hemostasis, as well as the strength of the walls of venous vessels and structures of the microvasculature. Surgical treatment is performed to remove vessels with irreversible changes in their walls.