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Thank you for your question. This is difficult to treat and may respond to IPL, 755, or a tattoo laser. See a Board Certified Plastic Surgeon or Board Certified Dermatologist to make a treatment plan. I hope this helps.
Brown pigmentation on the shins and and, in general, form the mid calf down is usually due to chronic venous insufficiency and resultant stasis of the veins leading to hyperpigmentation. The first step would be to have a full venous evaluation with a venous reflux ultrasound. If you have venous reflux (malfunctioning valves) then these should be closed first to arrest the progression of the problem. Following this, there are creams that can be tried but usually the discoloration will only slightly improve and not resolve. The other important thing to do is to make sure that there are no spider veins in this area contributing to the discoloration. If present, these can be treated with sclerotherapy to lighten the area.
Hyperpigmentation in the lower legs, areas which we call the 'gaiter areas' of the legs is the typical areas where there is staining of the skin with pigment and this is due to longstanding UNTREATED venous insufficiency. It is never too late to initiate treatment and such treatment includes wearing stockings, getting evaluated with Duplex vein scans and treating sources of venous insufficiency.Ancillary techniques to reduce hyperpigmentation includes the use of 2 topical products called Scleroquin plus and Sclerovase (see link below). These are cremes and will have to be applied topically for AT LEAST 1 year - the bronzing did not occur overnight and it will take more than a year for it to go away - at least 2 cycles of skin growth, each cycle being 180 days. We also recommend the use of the oral supplement Scler-x. Scler-X is an anti-inflammatory hyperpigmentation relief complex which should be taken for 3 months to six months after tretment.
Without treatment pigmentation from this type of vein doesn't occurr.with injection treatment pigmentation may occurr.varicose veins can cause discoloured shin areas.