My wife has a problem with her leg called CRPS. It started after she had her leg veins stripped for varicose veins. She often complains of pain. I notice the skin seems very thin and shiny in her lower leg. She's lost all the hair on her leg except a hairy patch in one area. What causes these changes?

It's not entirely clear what causes this condition or its symptoms. Complex regional pain syndrome (CRPS) comes with a wide range of symptoms. Most people report a cutting, sharp, or stabbing pain. It's intense and it's constant. They may also notice increased or decreased sweating of the area. Hair patches or hair loss (or both) are common.

Some patients' have a change in temperature, too. The limb may become very hot and sweaty or cold and clammy. Some recent research has taken a look at the nerves, blood vessels, and hair follicles of patients with CRPS. They have reported a few interesting findings.

First, the fibers around the hair follicles are very thin and disorganized. The nerves and blood vessels to the upper layers of skin and hair follicles are changed, too. There are far less of them and they seem to be missing some of the chemicals that make them work.

Tiny nerves to the blood vessels are also missing. The walls of the arteries become hypertrophied (thicker) cutting down blood flow to the area. Even the layers of the blood vessels are disrupted.

All of these changes probably contribute to the symptoms described with CRPS.