Venous leg ulcer 

Introduction 

Venous leg ulcers most often develop on the inside of the leg, just above the ankle 

Other types of leg ulcer

Other common types of leg ulcer include:

  • arterial leg ulcers – caused by poor blood circulation in the arteries
  • diabetic leg ulcers – caused by the high blood sugar associated with diabetes
  • vasculitic leg ulcers – associated with chronic inflammatory disorders such as rheumatoid arthritis and lupus
  • traumatic leg ulcers – caused by injury to the leg
  • malignant leg ulcers – caused by a tumour of the skin of the leg

A leg ulcer is a long-lasting (chronic) sore on your leg or foot that takes more than four to six weeks to heal. They most often develop on the inside of the leg, just above the ankle.

The symptoms of a venous leg ulcer include pain, itching and swelling in the affected leg. There may also be discoloured or hardened skin around the ulcer, and the sore may produce a foul-smelling discharge.

See your GP if you think you have a leg ulcer, as it will not heal on its own. Your GP will examine your leg and may carry out additional tests to rule out other conditions.

Read more about how a venous leg ulcer is diagnosed.

What causes venous leg ulcers?

A venous leg ulcer is the most common type of leg ulcer, accounting for over 90% of all cases.

Venous leg ulcers can develop after a minor injury, where persistently high pressure in the veins of the legs has damaged the skin.

Read more about the causes of venous leg ulcers.

Who is affected

Venous leg ulcers are estimated to affect around 1 in 500 people in the UK, although they become much more common with age. It's estimated that around 1 in 50 people over the age of 80 has one.

You are more at risk of developing one if you find it difficult to move around because of a problem such as osteoarthritis, a leg fractureobesity or paralysis. You are also more at risk if you have recently had an operation on your leg, such as a hip replacement or knee replacement.

People with varicose veins (swollen and enlarged veins) also have a higher risk of developing venous leg ulcers.

How venous leg ulcers are treated

Most venous leg ulcers will heal within three to four months if they are treated by a healthcare professional trained in compression therapy for leg ulcers. However, some ulcers may take longer to heal, and a very small number never heal.

Treatment usually involves cleaning and dressing the wound and using compression bandages to improve the flow of blood in the legs. Antibiotics may also be used if the ulcer becomes infected, but they do not help uninfected ulcers heal.

However, unless the underlying cause of the ulcer is addressed, there is a high risk of a venous leg ulcer recurring after treatment. Underlying causes could include immobility, obesity or varicose veins.   

Read more about treating venous leg ulcers.

Can venous leg ulcers be prevented?

There are several ways to help prevent a venous leg ulcer, such as the long-term use of compression stockings, losing weight if you are obese, exercising regularly and elevating your leg when possible.

This is particularly important if you have previously had a leg ulcer – once a leg has suffered a venous ulcer, there is a significant chance of further ulcers developing within a few months or years.

Read more about preventing venous leg ulcers.

Page last reviewed: 26/03/2014

Next review due: 26/03/2016

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Lizabetcha said on 21 April 2014

My 82 year old mother has Type 2 diabetes and has developed severe leg ulcers. Her surgeon has told her that they need to clear up before he can proceed with operations to replace both her knees. In the meantime she is in a great deal of pain and is immobile. She has had a nurse coming to her house on a weekly basis to clean and dress them. Over the last week, one of the ulcers has caused her particular discomfort...soreness and excess discharge. When she tried to have a shower last night she could smell a very strong 'fishy smell', the ulcerous area was emitting a lot of discharge and had turned black. When the nurse came this morning to redress the wound, she told her to immediately go to the emergency Walk-In centre. My brother took her, and they had a 3 hour wait , only to be told there was nothing to worry about and they re-dressed the wound with antibacterial bandages. On bringing her home, when I spoke to her she could barely speak, couldn't hold the phone, and was shaking like a leaf as though she was reacting to the infection and has gone to bed. I am concerned that due to her diabetes there may be risk of gangrene. Surely if it smells very strongly of fish and has turned black..with heavy discharge...and clearly she is suffering from the infection....this doesn't sound right at all. Any advice would be very much appreciated. Lizabetcha

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janetirene said on 19 July 2012

This is most useful - thank you. I have recently developed leg ulcers and thought the fresh air treatment was the right thing to do. After nine weeks of antibiotics they seemed heal over, but a week later cracked and wept. A change in antibiotics revealed a resistance to them so was put back on Penicillin which I am not allergic to.
Am now using non adhesive pads and crepe bandages. Thank you for the garbage bag and saran wrap hint. I find not getting a shower, makes me feel uncomfortable. i will us that as I find showering takes away lots of aches and stiffness.
Although a UK citizen I am resident in Canada and find thier medical system not as responsive. so now taking steps to educate myself about these ulcers. This is my 13th week of antibiotics and one week of compression.
This article has been most informative. Thank you.

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Jms9002 said on 02 January 2012

I have a venous ankle ulcer and had to take care of it after learning how to do it from a Doctor. It took 9 weeks to heal each time.
What I do is order premier una boot dressing 3 inch wide by 10 yds, (has zinc oxide and calamine paste impregnated)
For each unna boot dressing I order 3m Coban wrap, 4 inch wide. I found the latex free does not work as well or wears out to quick.
There are web sites where this can be ordered for a reasonable price.
From there I wrap the foot and calf like instructions show, starting from behind the toes and going up to calf overlapping 1/2 inch, then back down. Keep it loose, don't wrap the zinc pasted gause tight. My ulcer was on the inner ankle, so I wrapped a few extra times there.
Then I wrap the elastic Coban the same way. This time apply a little pressure that is comfortable. The pressure from the Coban wrap helps the blood flow like it should and not pool.
Leave it on for one week at a time. I kept a nylon sock over it to help keep it clean. Place a plastic bag around it when taking a shower. I used a black plastic garbage bag the held it on top by going around with Saran wrap.
Use a scisors to cut it off and replace immediatly by the same method above.
I ussually cut it off, take a shower and replace.
It will heal in time. I have pictures if you need to see the before and after. Not all venous ulcers will heal the same, but if you catch it early enough it will heal sooner. I believe once you have one you will always have one that may come back. Lack of sleep is what caused mine to resurface in a spot just below the previous one.
I hope this helps - the cost is not that bad and it gets easier to do once you have done it a few times.

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