Leg Ulcers

Leg ulcers are open sores that develop when the veins in your leg fail to push the blood back up to your heart. When this happens, pressure builds inside the vein and creates an ulcer. If you experience a symptom that looks like a sore or wound that won’t heal on your leg, you should seek care from your healthcare provider.

This article will discuss the symptoms and causes of leg ulcers and appropriate treatments. It will also cover risk factors for developing leg ulcers and how to prevent them.

Symptoms of Leg Ulcers

A skin condition called stasis dermatitis is an early warning sign that a leg ulcer may develop. When the pressure starts to build inside the veins of your leg, skin changes begin to happen. Your skin will be dry, itchy, and inflamed.

Your healthcare provider will use a physical examination to diagnose a leg ulcer. Signs of a leg ulcer include:

• A shallow sore with a red base, covered with a yellow crust
• Uneven borders of the sore
• Surrounding skin that may be shiny and feel warm, hot, and tight
• Leg pain
• An infection with a foul odor and pus
  

Causes of Leg Ulcers

The most common causes of leg ulcers are:

• Varicose veins develop when the blood backs up inside twisted and swollen veins in your legs. Depending on the cause of varicose veins, they can turn into leg ulcers.
• Chronic venous insufficiency is when your legs can’t pump enough blood back into your heart. Blood pools inside your veins, putting pressure on your skin and causing the area to swell. If left untreated, it could cause leg ulcers.
• Diabetes increases your risk of developing ulcers on your legs and feet. High blood sugar damages the nerves and blood vessels, often causing numbness and an injury to go unnoticed. Wounds also take a long time to heal when you have diabetes, so by the time you get treatment, it may already be an ulcer.
  

How to Treat Leg Ulcers

Treatments for leg ulcers will include wound care, relieving the pressure in your legs, and (if you're diabetic) getting your blood sugar under control. Your healthcare provider will also consider the cause of your leg ulcer before deciding which treatment is best.

Treatments for leg ulcers include the following:

Pressure relief: Wearing compression stockings will help prevent blood from pooling in your legs, lower inflammation, and promote healing. Wear shoes that fit properly and are made of material that allows your feet to breathe (such as leather, canvas, or suede).

Wound care: Your healthcare provider will provide instructions for how to care for the ulcer. It should include keeping it clean, moisturized, bandaged, and dry. Your healthcare provider may also prescribe a treatment called debridement, which the removal of dead skin by a podiatrist (foot doctor).

Control blood sugar: High blood sugar causes blood vessel damage. Keeping your blood sugar within the healthy range your healthcare provider has established in your diabetes management plan is essential.

Surgery: If pressure and wound care don’t help, you may need surgery or a skin graft (replacing damaged skin with healthy skin from another area of the body) to close up the wound.

Surgical correction of venous insufficiency: If venous insufficiency is the cause of the ulceration, correction may accelerate healing.

Complications and Risk Factors Associated With Leg Ulcers

In addition to varicose veins, diabetes, and chronic venous insufficiency, other conditions and behaviors can increase your risk of developing leg ulcers. They include:

• A history of blood clots in the legs
• Lymphedema (swelling from lymph fluid buildup)
• Excess weight
• Older age
• Pregnancy
• Smoking
• Sitting or standing for long periods
• Serious injuries (burns, tissue damage)

As with any wound that does not heal, complications can become severe. This includes infection, amputation, or even death.

When to See a Healthcare Provider

Regardless of your treatment plan, your symptoms may change or worsen. Call your healthcare provider if you notice the following:

• Increased redness around the wound
• Foul odor, pus, or extra drainage
• Fever or chills
• Worsening pain
• A hardening of the area around the wound

Call 911 immediately if you notice:

• Black areas around the ulcer
• Fever of 100 degrees Fahrenheit for more than four hours
• Pain that does not go away with medicine
• Bleeding that does not stop after 10 minutes of pressure

Summary

Leg ulcers are open wounds that won't heal, caused by a buildup of pressure inside the veins of your leg. This results in bruising and eventually creates an ulcer. Symptoms include redness, pain, and discoloration of the area.

The cause of leg ulcers is usually due to an underlying condition, such as varicose veins or diabetes. Sometimes it results from a temporary condition, such as pregnancy or standing or sitting for too long. No matter the cause, getting treatment as soon as possible can help avoid serious complications.

See your healthcare provider immediately if you have symptoms that seem like an ulcer. They will diagnose you and get you started on a treatment plan. This will include wound care, pressure relief using compression stockings, and (if you're diabetic) getting your blood sugar under control. If left untreated, an infection can occur. In rare cases, your tissue may start to die, which puts you at risk of amputation.

A Word From Verywell

Staying abreast of skin changes can lead to an early diagnosis and increase your chances of a speedy recovery, prevent complications, and avoid more invasive treatments such as surgery. If you see any new skin changes that are concerning, contact your healthcare provider.