A venous ulcer is a chronic wound, usually above the inner ankle, caused by high pressure in the leg veins from venous insufficiency or an old clot. Creams alone won't heal it; the core treatment is compression with bandages or stockings, plus treating the faulty vein with laser, radiofrequency or foam, which speeds healing and reduces recurrence.
A leg ulcer that lasts for months, heals and then comes back is one of the most draining problems for patients. In most cases the cause is in the veins, not the wound itself.
How does a venous ulcer form?
When vein valves fail, or after an old deep vein thrombosis, pressure in the lower-leg veins stays high. This pressure affects the skin and tissues around the ankle: they turn brown, harden, and an ulcer forms after any minor scratch.
Typical features
- Usually located above the ankle, especially on the inner side.
- A shallow wound with irregular edges.
- Leg swelling and skin discolouration around it.
- Pain that eases when the leg is raised.
- Often visible varicose veins or a history of a previous clot.
How it differs from an arterial ulcer
Arterial ulcers are usually on the toes, foot or pressure points, very painful especially at night, with a cold foot and weak pulses, and pain worsens when the leg is raised. Telling them apart matters, because compression that helps a venous ulcer can harm an arterial one, and both can occur in the same patient. Read about diabetic foot and peripheral artery disease.
Diagnosis
- Pulse check and ankle-brachial index to rule out arterial disease.
- Venous Doppler to locate reflux or old clot damage.
- A wound swab if there are signs of infection.
Treatment
- Compression: multilayer bandages or strong compression stockings, the cornerstone of healing.
- Wound care: regular cleaning and dressings suited to the wound.
- Treating the faulty vein: closing refluxing veins with laser, radiofrequency or foam speeds healing and clearly reduces recurrence.
- Leg elevation and walking to improve the calf pump.
- Treating infection when present.
Preventing recurrence
After healing, keep wearing compression stockings, attend Doppler follow-up and treat any remaining faulty veins. Stopping care after healing is the most common reason ulcers return.
Frequently asked questions
Why won't my leg ulcer heal?
Usually because the cause is high venous pressure, which creams alone don't fix; treatment needs compression and treating the faulty vein.
Does varicose vein treatment help ulcers heal?
Yes. Closing the faulty veins speeds healing and clearly lowers the chance of recurrence.
Is compression safe for all leg ulcers?
No. Arterial disease must be ruled out first, because compression can harm an arterial ulcer.
Content on this website is for awareness only and does not replace a specialist medical examination.