Skin changes associated with peripheral artery disease (PAD) include discoloration, dryness, and shiny or smooth texture. If you’re living with PAD, you may also be at a higher risk of developing foot sores and ulcers.

PAD is a circulatory condition that limits blood flow to the arteries in the limbs, often the legs.

It usually develops due to fatty deposits that harden inside the arteries, a condition known as atherosclerosis. Less common causes include inflammation and injuries.

Poor blood circulation from PAD sometimes triggers skin-related side effects. For example, if you have PAD, you might notice that the skin on your legs is unusually cool, shiny, or dry.

This article covers skin changes linked with PAD, how to treat them, and when to get medical help.

Skin changes are common in PAD. According to a 2019 study involving 541 participants, about 36% of people with PAD experienced skin-related symptoms.

Sometimes, skin changes are among the first signs of PAD. They tend to appear in parts of the body where circulation is the poorest, typically the legs, feet, and toes. But they can affect the arms as well.

Skin symptoms associated with PAD include:

  • Cool skin: Blood circulation warms the body. If you have PAD, your feet and toes might feel cold or numb to the touch.
  • Dependent rubor: This is when your foot turns bright red (erythematous) in a dependent position, such as when you sit with your feet dangling. This change in skin color occurs due to damage to the tiny blood vessels under the skin, known as capillaries. A doctor might look for dependent rubor if they suspect PAD.
  • Discoloration: People with PAD may notice that the skin on their legs or feet is blue or purple in color. This occurs when the skin doesn’t receive enough oxygen-rich blood.
  • Dry, itchy, or scaly skin: Without enough blood, skin cells can’t renew as quickly. This can lead to skin-related symptoms.
  • Foot sores, ulcers, and infection: Not enough blood supply can result in foot wounds that don’t heal, which increases the risk of infection.
  • Smooth or shiny skin: Skin that looks smooth or glossy may be a sign that skin cells aren’t getting enough nutrients.
  • Thinning body hair. Blood circulation supports hair growth. Without enough blood circulation, you might lose body hair, particularly on your legs.

It’s not clear why some people with PAD develop skin changes while others do not.

Skin changes may be a sign of PAD severity. Per the 2019 study, skin changes were more common in people with moderate to severe PAD.

You might be at a higher risk of skin symptoms if you:

PAD treatments aim to restore circulation to your limbs. With enough blood circulation, mild skin symptoms tend to clear up on their own.

Severe symptoms, such as wounds and infections, may require more treatments. Your doctor can help you decide on the best treatment based on your symptoms.

Lifestyle modifications

If you have PAD, a doctor might suggest lifestyle modifications to improve blood circulation and heart health. These include:

  • following a supervised exercise program (if you have access to one)
  • quitting smoking (if applicable)
  • adopting a heart-healthy diet
  • managing diabetes, high blood pressure, and high cholesterol


A doctor might prescribe medication to help prevent complications as a result of PAD and atherosclerosis, including:

If you have a foot ulcer, you might need oral or topical medication to help the wound heal and prevent infection.


In certain cases, lifestyle changes and medication may not be enough to help treat PAD. If this is the case, your doctor might recommend a surgical procedure to improve blood flow to the peripheral arteries, such as:

Around 1–2% of people with PAD develop a condition called acute limb ischemia, a medical emergency that occurs when limb tissues start to die due to lack of blood flow. This may require amputation.

It’s advisable to contact a healthcare professional if you notice worrisome skin symptoms or other signs of PAD, such as leg pain or numbness.

If you already have a PAD diagnosis, you might need to check the skin of your limbs for symptoms on a regular basis. Contact your doctor if you notice discoloration, coolness, changes in skin texture, or new wounds.

You might be at an increased risk of PAD if you smoke or have diabetes, high blood pressure, or high cholesterol. Speak with a medical professional about what you can do to lower your risk of skin-related symptoms.