Venous ulcers usually occur on the legs due to blood circulation problems that damage your veins. Treatments are available to manage symptoms, help ulcers heal more quickly, or prevent them.
Venous ulcers are common sores on the lower legs, feet, or sometimes toes. They can take a long time to heal.
A problem with the blood pressure in your lower legs usually causes these shallow sores, which experts estimate affect 1% to 3% of the population. They’re the most common type of leg ulcer.
They can often accompany or follow heaviness in your lower leg and dull aches. The skin around the area can also turn tight, leathery, or hard and change color to darker or lighter.
Here’s what to know about venous ulcers: what they are, why they happen, and what you can do about them.
What are the symptoms of venous ulcers?
You may notice these sores around your ankle, below your knee, or sometimes on your feet. One of the most common places to find them is on the inside of the leg, just above the ankle. You may also have swelling, tingling, or numbness in that area.
Venous ulcers on light skin may look darker than the surrounding skin or like a sore that won’t go away. On dark skin, the ulcer may look darker than the skin around it or lighter with a pink or red tinge.
No matter your skin tone, the sore will likely heal slowly. Healing may take as long as 4 to 6 weeks .
Early symptoms of venous ulcers include:
- itchiness
- tingling
- cramping
- swelling
- tenderness
Later symptoms include:
- bad smell or discharge, if the wound is infected
- a shallow, red sore that is sometimes topped by yellow tissue
- surrounding skin that is hot, tight, shiny, or discolored
- a sore with uneven borders
Pictures of venous ulcers
Venous ulcers can look darker than the surrounding skin with a red or pink tinge. (Casa nayafana/Shutterstock)
Venous ulcers can develop around varicose veins and may have uneven borders. (Casa nayafana/Shutterstock)
Untreated venous ulcers are prone to infection, which may cause increased swelling, discoloration, bleeding, and pus. (JodiJacobson/Getty Images)
How do venous ulcers differ from arterial ulcers?
Venous and arterial ulcers can seem similar. Both can form on the lower legs and feet. Both types of ulcers are chronic (long-lasting) sores. Restricted blood flow is the culprit in both cases.
But venous and arterial ulcers have different causes and healing times. Damage to your veins causes venous ulcers. Damage or narrowing of your arteries causes arterial ulcers.
These ulcers can also appear in different places. While venous ulcers tend to occur on the inside of the leg above the ankle, arterial ulcers often appear over areas that receive external pressure, like the toes, heels, or ankles.
Healing times might also differ. Venous ulcers can heal within a few weeks, but arterial ulcers may take months or not heal without help.
Arterial ulcer symptoms include :
- pain that’s worse when you raise your leg
- border of dead skin in or around a dry sore
- surrounding skin that is shiny, cool, or hairless
- a sore that won’t heal despite care
What causes venous ulcers?
Chronic venous insufficiency (CVI) is the most common cause of venous ulcers.
Your veins have valves designed to keep blood flowing toward your heart. When these valves don’t work right, pressure from your blood can damage them and the veins. Because of the damage, blood pools in your lower body. When this happens over a long period, it’s called CVI.
The combination of extra fluid and pressure causes wounds because it prevents tissue from getting the nutrients it needs from the blood. That causes tissue cells to die.
Other conditions can cause venous ulcers, including diabetes and deep vein thrombosis (DVT) .
Venous ulcers happen more often in older adults and people assigned female at birth. Other risk factors for CVI include :
- smoking
- pregnancy
- previous leg clot
- joint or musculoskeletal disease
- having obesity
- sitting or standing for long periods
- family history of varicose veins
- using oral contraceptives
- taller height
When to contact a doctor
Contact a doctor if you notice signs of infection, such as:
- fever or chills
- warmth, discoloration, or swelling
- sore starts hurting more
- bleeding
- bad smell
- pus or more discharge
How do doctors diagnose venous ulcers?
Doctors usually diagnose venous leg ulcers during a physical exam. They may ask about your symptoms, past injuries, or conditions that may have caused or contributed to your ulcer.
Doctors may also look at your leg when you stand and lie down and check the blood pressure around your ankles and other areas of your body. They may refer you to a specialist if they determine you have a venous ulcer that needs further attention.
What is the treatment for venous ulcers?
Doctors often clean out the wound and prescribe compression therapy . It involves putting pressure on the area using a compression bandage or special stocking.
They may also prescribe medications, like pentoxifylline (Trental), that work by increasing blood flow to help heal the ulcer from the inside.
Home care tips for venous ulcers
Consider the following tips when caring for venous ulcers at home:
- Ensure it stays clean and bandaged.
- Keep the bandage and skin around it dry.
- Protect surrounding skin by keeping it clean and moisturized.
- Change the bandage as often as prescribed.
- Wear your compression garment over your bandage.
Can I prevent venous ulcers?
Some risk factors for venous ulcers are out of your control, like your genetics, sex, and age. Still, you can take several steps to help prevent venous ulcers.
Start by thoroughly checking every area of your feet and legs daily and looking for changes. Daily exercise can also help relieve high blood pressure in your legs and improve your overall health.
You can also:
Frequently asked questions
How long does a venous ulcer take to heal?
Venous ulcers can take 4 to 6 weeks or longer to heal. Some may not heal at all and may require medical care.
How do you heal a leg ulcer fast?
Walking regularly and keeping your leg elevated when you sit or lie down can help speed healing. Rotating your ankles and moving your feet when you sit down can help your circulation . Compression therapy to stimulate blood flow and dressings to cover the ulcer are also beneficial.
What is the best medication for a venous ulcer?
Doctors may prescribe medication such as pentoxifylline (Trental) to help your veins function better. They may also prescribe antibiotics if they believe there is a related infection.
Takeaway
Venous leg ulcers are the most common leg ulcers. Problems with your blood circulation cause venous ulcers. Inadequate blood flow causes blood to pool in your legs, causing extreme swelling that can damage your veins.
While several risk factors for venous ulcers are out of your control, you can still take steps to reduce your risk. Managing underlying conditions that may contribute, such as CVI, diabetes, and high blood pressure, may help prevent venous ulcers and help them heal faster if they do form.
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