Introduction
Red spots on the legs can be an indication of a variety of diseases, which can range from quite harmless in nature to dangerous clinical pictures. The most common causes of red spots on the legs include skin rashes of various kinds, venous insufficiency and inflammation of the blood vessels (vasculitis).
General information
To find out whether the red spots on the legs need treatment, a physical examination by a doctor is necessary. The exact collection of the medical history (anamnesis) is also important for the correct diagnosis. Factors such as the time of occurrence of the red spots, the exact localization and also possible accompanying symptoms such as severe itching, nausea, fever, breathing difficulties or pain play a major role.
A skin rash, which can lead to many different types and forms of red spots on the legs, is most often caused by an allergic reaction. For example, care or cosmetic products (e.g. sunscreen), wearing certain types of clothing or insect bites can cause an allergic rash on the legs, which is accompanied by red spots. If the trigger for the allergic skin rash is not known, a doctor should be consulted as the rash may also be an indication of an autoimmune disease, skin disease or vascular inflammation. If the spot on the leg has a typical circular ring shape that expands as the rash develops, a tick bite may be the trigger. In this case a doctor must also be consulted immediately, as the dangerous Lyme disease must be excluded or treated.
Causes
Red spots on the legs can have numerous causes. In the following we will discuss the most common and most dangerous of these. About three to ten percent of all adults in Germany suffer from the venous disease “Venous Insufficiency”.
It weakens the vascular system, especially in the legs, because so-called venous valves ensure that blood can flow to the heart and cannot flow back “down”. In venous insufficiency, these valves fail and the backflow of blood is not prevented. The disease manifests itself by water retention at the ankles and is accompanied by red spots on the lower legs, which are reactions of the veins and skin to the disease.
In order to support the veins, compression stockings are usually worn in the treatment of venous insufficiency. An inflammation of the blood vessels is medically called vasculitis. Vasculitis can occur anywhere on the body, regardless of where the veins are located or how large they are.
Depending on which blood vessels are affected by the inflammation, a variety of symptoms can occur. The symptoms of vasculitis result from the fact that the affected blood vessels can no longer supply certain organs with sufficient blood. In many cases, it is very difficult to diagnose vasculitis because the disease is very complex and multifaceted.
Red spots or spots on the legs can be a first and decisive indication of such an inflammation of the blood vessels. In addition, there are accompanying symptoms such as severe weight loss, general malaise, joint and muscle pain, deterioration of vision or numbness in the legs. If vasculitis is suspected, a doctor should be consulted immediately and appropriate therapy should be initiated, as the disease can lead to organ failure or even death, depending on the organs affected.
The most common venous diseases include spider veins and varicose veins. Spider veins are small blood vessels that run like a net under the skin and become visible as reddish-blue spots on the legs. Due to a disturbed blood flow and a weakening of the connective tissue, spider veins are usually harmless and painless.
About 50 percent of women and 25 percent of men in Germany suffer from the “crooked veins” (medically known as varicose veins). Varicose veins are a weakness of the veins that affect the superficial veins of the legs and increase the risk of blood clots (thromboses). Red spots on the legs can be the first signs of varicose veins, in addition to feelings of tension, night-time calf cramps or swollen lower legs and ankles.
The therapy consists of reducing body weight and physical exercise.or varicose veins. A thrombosis of the deep leg veins can begin without symptoms. In the course of the disease, pain similar to aching muscles develops, which disappears when the patient lies down.
The affected leg is often overheated and swollen, the skin may be tense and reddish in color. Particularly in a more advanced stage, red dot-like spots appear on the legs, caused by spontaneous bleeding and later turn yellow and greenish like bruises (haematomas). A venous thrombosis causes a serious circulatory disorder, which is why rapid treatment is necessary.
Mostly the therapy is carried out with the help of compression stockings, medication and exercise therapy. The greatest danger in venous thrombosis is pulmonary embolism, as the blood clot can be carried from the leg into a pulmonary blood vessel, where it can lead to severe and dangerous breathing difficulties and in some cases to death. You will find detailed information about thrombosis below.
Red spots on the legs can also indicate a circulatory disorder. This typically causes severe pain in the legs during exertion, which forces the person affected to stop and rest after a certain distance (so-called “window dressing”). The circulatory disorder leads to cramp-like pain because muscles, skin and tendons are no longer supplied with sufficient blood, oxygen and nutrients.
Such circulatory disorders occur in cases of lack of exercise, obesity and especially in smokers. The therapy of circulatory disorders in the legs is also derived from these causes: In the foreground are movement therapies (regular walking, cycling, jogging and swimming), weight loss and nicotine abstinence. If the disease is already more advanced, a surgical intervention is often necessary to restore the blood circulation in the legs.
The erythema nodusum is also known as nodular rose. This term reveals the appearance of the skin phenomenon: red nodules are formed. However, the color can also vary and change.
These skin areas are often pressure-sensitive and painful. Nodular erythema is an acute inflammation of the subcutaneous fatty tissue. It often occurs on the lower legs, knee and ankle joints.
More rarely, nodular erysipelas can be seen on the buttocks or arms. Often the nodular erysipelas appears in the context of other diseases. For example, it is found in 30% of patients with sarcoidosis.
In addition, nodular erysipelas can develop with various infections or inflammatory bowel diseases. After shaving the legs, red spots may appear on the skin. These are initially harmless.
However, they can become inflamed and cause unsightly shaving spots. In order to differentiate whether the red spots on the skin of the legs were caused by shaving or are due to other reasons, the legs should not be shaved for a few days to weeks. To exclude this, other causes should also be considered, such as an intolerance of nylon tights.
To prevent red spots on the legs after shaving, compatible shaving foam and good razor blades should be used. If red spots appear on the skin of the legs after standing for a long time, these can indicate a coagulation disorder. The red spots are caused by bleeding from the blood capillaries in the skin the size of a pinhead.
They are also known as petechiae in technical jargon. A medical examination is recommended. During pregnancy, red spots on the legs can indicate a certain skin rash, which usually occurs in the second half of pregnancy.
This is known by the abbreviation PUPP, which stands for pruritic urticarial papules and plaques pregnancy and for pruriginous and urticarial papules and plaques. This means that there are often itchy, red, raised spots and blotchy areas of the skin. The causes are not yet known.
The pregnancy and the unborn child are not endangered by this. Nevertheless, a doctor should be consulted to rule out other causes. For the treatment of PUPP, shaking mixtures and weak cream-based steroids are usually recommended.
