7. If it seems stable, how soon should she be seen?
If the discoloration has been gradual, both legs are affected, there is mild to moderate swelling, and she feels otherwise well, this is usually appropriate for a primary care visit within a few days to 2 weeks rather than an emergency room visit. Still, it should not be ignored for months. Early treatment helps prevent skin thickening, ulcers, and infection.
If itching is intense, sleep is being disturbed, or the skin is starting to crack, I would try to arrange an appointment sooner, ideally within a few days. A photo taken in good daylight can help track whether the area is spreading from, say, 3 inches wide to 5 inches wide over a week.
8. What you can do safely at home while waiting
The most helpful immediate step is leg elevation. Aim to raise the legs so the ankles are above heart level for 15 to 30 minutes, 3 or 4 times a day if possible. That means more than a footstool. Pillows on a couch often are not high enough; lying back with the legs propped on 2 firm pillows usually works better.
Use a bland, fragrance-free moisturizer at least twice daily, especially within 3 minutes after bathing. Thick creams or ointments tend to work better than thin lotions. Plain petroleum jelly or a ceramide cream can help reduce dryness and scaling. Keep baths and showers lukewarm, around 5 to 10 minutes, not long hot soaks, which can worsen itching.
If she scratches at night, cotton socks over moisturized lower legs can help protect the skin, provided they are not tight at the top. Encourage gentle walking if she is able, because calf-muscle movement helps push venous blood upward.
9. Compression stockings can help, but there is one big caution
Compression is a cornerstone treatment for venous stasis, but it is not something I recommend starting blindly in every older adult. Many people do benefit from knee-high compression stockings in the 15 to 20 mmHg or 20 to 30 mmHg range, especially if swelling is a regular issue. They are usually put on in the morning, before the legs swell, and removed at bedtime.
However, compression should be used carefully or delayed until a clinician weighs in if there is concern for poor arterial circulation. People with significant peripheral artery disease can be harmed by strong compression. Clues include foot pain while walking, a cold foot, weak pulses, or ulcers on the toes. In clinic, a clinician may check an ankle-brachial index before recommending tighter stockings. So if you are not sure, elevation and moisturizer are safer first steps than grabbing the strongest compression socks off a drugstore shelf.
