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There are several conditions that may cause purple legs. The purple color can result from either a change in skin color or prominent visible vessels that make the legs look purple.

Although some skin conditions such as keratosis pilaris may cause the skin to appear purple in color the most common cause for purple legs is

Varicose veins

This condition causes the veins to become twisted, enlarged veins. Veins of legs and feet are most commonly affected. The reason for this is because standing upright increases the pressure on the leg and feet veins.
For most people varicose veins are only a cosmetic concern. However, for other people, varicose veins can result in pain and discomfort. Rarely varicose veins may lead to serious problems. Varicose veins may also be a symptom of other conditions.

Signs and symptoms of varicose veins include:

o Visible veins that are blue or purple in color.
o Veins that appear twisted and enlarged.
o Sometimes varicose veins cause heavy or achy feeling in legs and feet.
o Burning sensation, muscle cramping, throbbing and swelling in the legs and feet.
o The pain usually worse after sitting or standing for a long period of time
o Itching in your legs and feet
o Advanced form of varicose veins may cause skin ulcers next to your ankle, this form requires medical attention.
o Spider veins are milder form of varicose veins. Spider veins are more superficial than varicose veins and found closer to the skin's surface. They are red or blue in color and most commonly occur on the legs and the face.
Usually one patient doesn't have all the above symptoms only some of them.

Treatment choices

Lifestyle

Exercise and losing weight are very important to improve varicose veins. Elevating the legs, and avoiding standing or sitting for long periods of time, especially during long flights, it is highly recommended that you stand and walk back and forth periodically.
Compression stockings
This is usually the first treatment choice along with lifestyle modification. Compression stockings squeeze your legs to move blood more efficiently along the veins. For good results compression stockings should be worn all day. The amount of compression varies by type and brand.

Surgical treatments

Used for more advanced case and when conservative approach doesn't work.
o Sclerotherapy. This is done by injecting the varicose veins with a solution that scars and closes those veins. This procedure is done without anesthesia and can be done in your doctor's office.
o Laser surgeries. This is done by sending strong beams of light onto the vein, as a result the vein disappears.
o Vein stripping. This is done by removing a vein through tiny incisions. Removing the vein won't affect circulation because other veins in the leg kick in to take care of the larger amounts of blood.
o Endoscopic vein surgery. This is done only for advanced cases complicated with leg ulcers.

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