When we senior citizens exceed the age of 65, the veins in our legs have just about had it. They’ve been made to stand for long periods of time, walked on for miles and miles, and bumped and bruised many times. The ability to do their job becomes harder and harder because they have been stretched, and clotted, and alleviated of their elastic ability to expand and contract. Static, or non-functional veins, don’t move blood as actively as normal so the blood pools and either clots or stretches the veins.
Blood that has slowed or impaired movement causes the condition called Venous Stasis, or Venous Insufficiency. Static or slow moving blood causes pain and swelling in the legs. The pooled blood stretches the veins and two things can happen: 1. Iron pigment (hemosiderin) leaks out of the veins and causes a reddish-brown pigmentation of the skin. or 2. The vein wall thins, tears, and the skin overlying it ulcerates, breaks done forming an open sore (ulcer).
The term used for pigmentary changes of the legs is called Venous Stasis Dermatitis. It can be mild or extremely unsightly, a small area or involve the entire lower leg. Stasis dermatitis is a cosmetic concern for which nothing I know of will help and folks choose to cover up with long pants. The term used for open areas in the skin of the legs is Venous Stasis Ulcer(s).
Venous stasis ulcers was the subject of a Cochrane review found in the August 2025 issue of American Family Physician. The review studied various aspects of treating and preventing venous ulcers using compression stockings. The question asked was “do compression stockings prevent the recurrence of lower leg venous ulcers?”
The answer was “yes, they do,” with a high degree of clinical certainty. The higher the grade of compression, the more effective is the treatment. Three grades of compression exist:
Light compression—15-20 mmHg
Medium compression—20-30 mm Hg
Heavy compression—30-40 mmHg
Heavy compression stockings, if you can get them on, may reduce reulceration compared to no compression over a 6-month period. This led to the recommendation to wear stockings with the heaviest amount of compression that can be tolerated every day, all the time, for life. This will both prevent new venous stasis ulcers and heal old ulcers stubbornly remaining.
Dr. G’s Opinion: Stasis dermatitis is very unsightly, as are venous stasis ulcers. Because I have Stasis Dermatitis in both kegs, I never wear shorts. Ulcers take a long time to heal and require a lot of patience and perseverance because some days those tight compression stockings just won’t go on. Primary prevention is the best choice. Wearing compression stockings before these problems begin is your best bet. Persistence is important and finding a device that makes it easier to get stocking on your legs helps with treatment adherence.
Reference: Cochrane For Clinicians. Gregory D, Ellington JW. Compression Therapy for Preventing the Recurrence of Venous Leg Ulcers. Am Fam Phys 2025 August;112(2):128.
