1. What stasis dermatitis usually looks like
Stasis dermatitis most often shows up on the lower legs, especially around the ankles and shins, where gravity puts the most pressure on the veins. The skin may look rusty brown, reddish-brown, or tea-stained, and the color often wraps partly or fully around the lower leg rather than appearing as a neat round patch. The surface can be dry, flaky, itchy, or scaly, and over time the skin may become thicker, firmer, or shiny.
In many people, both legs are involved, though one side can be worse. The discoloration may cover an area as small as 2 to 3 inches across at first, then gradually spread over months. You may also notice mild swelling by evening, sock marks that stay for a while, or skin that feels tight after standing. Those details matter because stasis dermatitis is tied not just to the skin, but to circulation underneath it.
2. Why the skin turns brown and scaly
The root problem is usually chronic venous insufficiency. That means the veins in the legs are not pushing blood back toward the heart as efficiently as they should. Tiny one-way valves inside the veins can weaken over time, so blood pools in the lower legs. Pressure builds up in the small vessels, and fluid leaks into nearby tissue.
That leak sets off inflammation. Red blood cells can also escape into the skin, and when they break down, they leave behind iron pigment called hemosiderin. That is what often creates the rusty brown staining. The scaly, irritated surface happens because the skin is being chronically inflamed and stretched by swelling. It is a bit like what happens when wallpaper keeps getting damp: at first it just looks discolored, and later it starts to peel and break down.
3. Who gets it most often
Stasis dermatitis is most common in older adults, especially people over 60, and it is more likely in anyone with leg swelling, varicose veins, a history of blood clots, limited mobility, obesity, heart failure, or prior leg injury. Standing or sitting for long stretches can make it worse. I’ve seen this pattern in relatives who spent years on their feet at work and later developed “heavy legs” by the end of the day.
