What is Hemosiderin Staining and How Long Does It Last?

I had a mommy makeover March 1st, 2010. This included tummy tuck, breast lift, breast augmentation, hernia repair, and liposuction of the hips. I recently noticed that I have discoloration (bruising) in the area where I had liposuction. The bruising is almost symmetrical on both hips. Is there anything I can do to get rid of the bruising? My doctor has diagnosed me with hemosiderin staining. Will it be permanent? Can someone explain this condition to me?

Doctor Answers 37

Hemosiderin VS Hyperpigmentation

In conditions where there is constant bleeding into tissues (such as venous ulcers etc), the red cells in the blood break down and their contents are taken up "pac man" style by the macrophages, the cells responsible to eating up germs and debris in the body. Inside the macrophages the hemoglobin, the iron containing molecule which holds on to oxygen is broken up and its iron is combined into a storage form of iron and proteins with a dark yellow-brown pigment called hemosiderin. In effect, it is a natural form of auto-tattooing.

That being said, I do not think you demonstrate hemosiderin which is seen in chronic condition but just a case of inflammatory hyperpigmentation. You should be able to correct it with a course of bleaching cream (such as Hydroquinone). You may want to speak to a good dermatologist.

Memphis Plastic Surgeon
5.0 out of 5 stars 93 reviews

Hemosiderin staining of skin following surgery

Hemosiderin is a pigment that is a byproduct of hemoglobin that has spread into the tissues following injury with bleeding and bruising of the tissues. It contains iron pgiment and may take along time (years) for the body to metaoblize the iron and pigment that has spread into the tissues.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Hemosiderin Staining after Mommy Makeover

Hemosiderin staining is a discoloration of the skin that occurs in an area where significant bruising was seen.  It can happen after liposuction or any other surgery.  It typically resolves with time but can be a slow and frustrating process.  I would recommend patience, and you will likely see significant improvement.  Good luck.

Hemosiderin staining versus hyperpigmentation

 Hemosiderin staining refers to a process where iron from the blood can stain the skin.   In the process of some surgical procedures particularly light liposuction leading can happen.   If this blood sits around there is the potential for the breakdown products of this blood to cause a staining of the skin directly over it.   Although theoretically it can happen with any surgery that creates bleeding. In my own  practice I have only seen in associated with liposuction, particularly liposuction done in a very superficial layer.   Once the blood has oozed out into the tissues the body will go through a process of resorbing.  As the blood cells are broken down iron pigment may be spilled into the surrounding tissues, and if it is close enough to the skin could get into it causing hemosiderin staining.
 By contrast, hyper pigmentation refers to the process where the melanocytes and the skin proliferating creating dark patches. again in a general sense the most common type of hyper pigmentation one could argue is a suntan.  Here the UV energy from the sun causes the melanocytes in the skin to proliferate.  Melanocytes are protective cells that absorb UV energy to protect the underlying skin from injury caused by this form of radiating energy.  In the case of hyper pigmentation areas of inflammation which are results of trauma and/or surgery are more susceptible to the UV energy.  And as a result when one is exposed to sunlight these areas tend to get darker than other areas of the body, and we called these areas hyper pigmentation.
 For areas of hyper pigmentation treatment including the use of hydroquinone can very easily be done as a cream that is applied on a nightly basis.  Typically within 2-3 month he will see significant improvement.  The concentration of hydroquinone can vary depending on skin type, degree of hyper pigmentation, and amount of area treated.    Alternatively IPL and other  medical lasers can be very effective. Hemosiderin staining on the other hand is a lot more difficult to treat.    Although it may resolve some with time, most patients that end up with this are looking for a more expeditious way to improving. Typically there is no cream they can readily remove the iron out of the skin.  Treatment for this is better suited by laser therapy.  Specifically, the Q switch laser can be very effective.  But this may take multiple treatments to get complete clearance.

John Mancoll, MD
Virginia Beach Plastic Surgeon
5.0 out of 5 stars 26 reviews

What is Hemosiderin Staining and How Long Does It Last?

Hemosiderin staining happens when red blood cells become chronically congested in an area and die.  When they die, hemoglobin is released.  Hemoglobin contains iron, which is engulfed by local white blood cells.  Many people have hemosiderin staining around their ankles if they have jobs requiring them to stand for long periods of time.  It is an early warning sign that compression stockings need to be worn or ulcers can develop over several decades.

Hyperpigmentation can result from liposuction causing heat or brusing on the undersurface of the skin.  This is a relatively uncommon but known side effect of liposuction.  It will likely fade with time, but can be improved in the short term with bleaching creams containing Hydroquinone.  

Kind regards,

-- Dr. Mussman

Jason Mussman, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 3 reviews

Hemosiderin staining of tissues

Hemosiderin is just iron which has deposited after red blood cell break down (bruising). It should generally clear after 1-2 years. 

Susan Kaweski, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Hemosiderin is Iron staining from blood

Hemosiderin stains are difficult to remove and come from the iron in your blood. Iron can stain and pigment your skin. Post-inflammatory hyperpigmentation is also common and can be treated with creams and lasers.

Hemosiderin Staining

This is a byproduct of bruising.  It is a breakdown product of red blood cells.  It may last quite a while.   Two widely available products help bruising resolve faster. The first is Bromoline and the other is Arnica.  They can cut bruising time to less than half.

I hope this helps :)

John Paul Tutela, MD
Livingston Plastic Surgeon
5.0 out of 5 stars 10 reviews

Hemosiderin staining after liposuction and mommy makeover

Hemosiderin is an iron containing molecular complex found inside immune cells in areas of previous hemorrhage (like areas of liposuction).  It appears as a purplish staining of the skin.  It should not be confused with the tan to brown hyperpigmentation of the skin that can also occur following liposuction.  Each is treated differently.  In the case of hemosiderin/iron staining of the skin, lasers that target the iron in the tissues (IPL laser, YAG laser, Alexandrite laser, and Pulse dye laser) are effective.  In the case of hyper-pigmentation, treatment is with hydroquinone cream and lasers that target the melanin pigment in the skin.  Best of luck!

Paul Fortes, MD
Houston Plastic Surgeon
4.0 out of 5 stars 7 reviews

Staining can last up to 6 months.

Hemosiderin staining is a common problem to see after any surgical procedure where there is bruising or blood in the tissue. Liposuction naturally results in bruising because of the injury it causes to the fat cells, so finding some degree of it postoperatively is not a surprise. Depending on your skin color and the thickness of your dermis (the deeper layer of your skin) some people are more prone to this than others. Hemosiderin staining is the name that describes what happens when blood cells get outside of the veins and arteries, and settle under the skin. The red blood cells contain a red pigment that included iron and is called hemosiderin. When the red blood cells are outside of the blood vessels or damaged, your body just naturally starts breaking them down and digesting them. This releases the red pigment (hemosiderin) directly into the tissue. While it is there it give the skin a brownish discoloration that persist after the actual bruise goes away-this is the “staining” that you are experiencing. That pigment does slowly get processed by your system and washes away, but that can take as long as 6 months or more to happen. The good news is that eventually it does all resolve but there is not much you can do in the meantime to make it happen faster. It will not affect the final result you get from your liposuction.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.