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Hemosiderin is a protein compound that helps the body store iron. Too much built up beneath the skin can lead to staining or skin discoloration, known as hemosiderin staining or deposition, or hemosiderin hyperpigmentation.

This article discusses the symptoms, causes, and treatment options for hemosiderin staining.

Doctor talking to patient in doctor's office

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What are the Symptoms of Hemosiderin?

Hemosiderin helps the body retain iron so that there is enough of the nutrient to help red blood cells transfer oxygen to tissues. A specific type of protein molecule, known as hemoglobin, contains iron. When red cells break down in the blood, they release hemoglobin and iron within it.

When there's too much hemosiderin in the body iron gets trapped within the tissues, changing the skin's pigment. The spots are most likely to be a golden-yellow-brown color. The area most likely to develop the staining is the lower legs between the ankles and the knees. However, it can develop anywhere, including the face.

Does Hemosiderin Staining Hurt?

The staining itself often comes without pain. However, the causes of hemosiderin discoloration are often severe health disorders that can present with their own symptoms, complications, and issues.

What Causes Hemosiderin?

Hemosiderin is often associated with blood vessel conditions that lead to an excessive breakdown of iron-containing cells. The most notable condition that causes hemosiderin staining is chronic venous insufficiency (CVI). CVI develops when blood flow is compromised due to ineffective blood valves in the legs.

The blood that is supposed to go up towards the heart flows backward into the veins in the legs, causing blood to pool. This leads to the overabundance of blood cell breakdown and iron accumulation.

Treatments that Cause Hemosiderin Deposits

Hemosiderin staining can occur due to treatments for other conditions. One such treatment that can lead to hemosiderin discoloration is sclerotherapy. The treatment is designed to reduce the appearance of spider and varicose veins. In some, it can cause hemosiderin to build up beneath the skin.

What Medications Can Cause Hemosiderin?

Research has found that people undergoing iron infusion therapy to address deficiencies may also develop hemosiderin staining. The side-effect is rare and most notably affects people with severe iron deficiency anemia. Staining because of iron infusions typically occurs where the iron is injected into the bloodstream instead of on the bottom of the legs.

Can Iron Supplements Cause Hemosiderin?

There is no evidence to support hemosiderin discoloration caused by iron supplements, such as powder or capsules. However, if a person takes too much iron and has a condition that can cause blood pooling, they may be at risk of hemosiderin staining.

How is Hemosiderin Treated?

Treatments for hemosiderin discoloration may first focus on the condition causing it. Since CVI can be severe, medical providers will likely address it before the stained patches. That said, there is treatment available for hemosiderin staining.

Research has shown that Q-Switched 755-mm laser therapy is the best option for people with hemosiderin staining. It works by directing light energy straight into the skin. The light energy breaks down the pigmentation so the lymphatic system can filter it out of the body.

Are There Tests to Diagnose the Cause of Hemosiderin?

Medical providers will examine the area and take a medical history to diagnose hemosiderin straining. Symptom collection is also vital to determine a possible cause of the staining.

Since CVI is often associated with hyperpigmentation, tests to diagnose that condition will likely be done. The way medical providers diagnose the cause of the stain will heavily rely on how you feel otherwise in accompaniment to the stain. The test most used for CVI is known as a Duplex ultrasound. It measures the blood flow in the legs and can aid in diagnosing a cause of hemosiderin staining.

A Sign of the Need for Better Disease Management

In some people with hemosiderin discoloration, the presence of the patches may indicate that they need further testing for an existing health condition. The hyperpigmentation could be a sign that you need to find better ways to manage the disease or indicate that it could be worsening. In that case, tests will be specific to the health condition instead of hemosiderin staining.

When to See a Healthcare Provider

If you notice any skin discoloration changes and do not know why they are there, it’s essential to see your healthcare provider. While not all skin discoloration is dangerous, it can be associated with severe health disorders that require prompt treatment.


Hemosiderin hyperpigmentation can develop in brown or golden-brown-yellow patches on the skin. It is typically caused by disorders that affect blood flow, such as CVI. In some cases, it may develop in other areas of the body, such as the inside of the elbow, after intravenous iron injections.

Treatment for varicose or spider veins, known as sclerotherapy, can also induce pigment changes caused by a buildup of iron beneath the skin. If you notice hemosiderin staining, you should contact your medical provider. They will help investigate the cause and enact a proper treatment.

A Word From Verywell

Seeing your skin change tones can be alarming. While not all hyperpigmentation is serious, if it occurs on the legs or is a golden-brown-yellow tone, it can indicate that you may have a condition compromising blood flow.

The best thing you can do for yourself if you notice your skin changing is to contact your healthcare provider. They can examine the patches, collect other symptoms, and order the right tests to get to the bottom of what's happening.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Hamilton HK, Dover JS, Arndt KA. Successful treatment of disfiguring hemosiderin-containing hyperpigmentation with the Q-switched 650-nm wavelength laser. JAMA Dermatol. 2014 Nov;150(11):1221-2. doi:10.1001/jamadermatol.2014.1838

  3. Johns Hopkins Medicine. Chronic venous insufficiency.

  4. Hauzer W, Gnus J, Rosińczuk J. Endovenous laser therapy with echosclerotherapy as a hybrid method for chronic venous insufficiency: experience in 200 patients and literature review. Eur Rev Med Pharmacol Sci. 2021 Dec;25(24):7777-7786. doi:10.26355/eurrev_202112_27624

  5. Crowley CM, McMahon G, Desmond J, Imcha M. Skin staining following intravenous iron infusion. BMJ Case Rep. 2019 Jun 6;12(6):e229113. doi:10.1136/bcr-2018-229113

  6. Gan SD, Orringer JS. Hemosiderin hyperpigmentation: Successful treatment with Q-switched 755-nm laser therapy. Dermatol Surg. 2015 Dec;41(12):1443-4. doi:10.1097/DSS.0000000000000513

By Angelica Bottaro
Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space.