What is Venous leg ulcer?

Venous leg ulcers (also known as venous stasis ulcers) are ulcers that develop in the leg veins, on the surface of the skin. They are usually caused by a combination of pressure and lack of oxygen in the blood. This usually occurs when the blood in the veins becomes too thick and hard, which causes the veins to bulge and collapse.

Venous leg ulcers are a common type of foot ulcer, but they are also much more common than you might think. They can occur in anyone, at any age, but they are most likely to affect older adults.

What causes Venous leg ulcers?

If you are having a leg ulcer, it is likely that you have venous leg ulcers. The main cause of venous leg ulcers is blood clots in the lower legs. Most commonly, this is caused by swollen veins. Other causes include:

  • Varicose veins
  • Blood clots
  • Pregnancy
  • Smoking
  • Obesity
  • Lack of exercise
  • Diabetes
  • Heart failure
  • Heart attack
  • Cancer
  • Immobility due to poor circulation
  • Infection
  • Inflammatory bowel disease (IBD)
  • Rheumatoid arthritis
  • Lupus
  • Lupus-like syndrome

Symptoms of venous leg ulcers

Venous leg ulcers often develop slowly, and can take many months to develop. They can develop on any part of your leg, including the top and bottom of your foot. They can also develop on your thigh, ankle and knee.

Signs of ulcers include:

  • Red and swollen skin (with or without a rash)
  • Tenderness
  • Pain that gets worse when you stand up or walk
  • Discolouration and blisters
  • A sensation of heaviness in your calf or foot

You may also have other symptoms, including:

  • Aching
  • Tiredness
  • Feeling of heaviness
  • Not being able to move your foot
  • Muscle aches

Diagnosing venous leg ulcers

If you have a red, swollen leg with a feeling of heaviness, you should see your GP. Your GP will examine your leg and ask you about your symptoms. They may ask you about your lifestyle and other health problems you have.

You may also have tests to check for blood clots, swelling and any infections.

You may have blood tests to check your blood for clotting. This can be done using a blood pressure monitor, or if your GP thinks you need more tests.

Your GP may also do a venous duplex scan. This is a scan which takes pictures of the inside of your leg. The pictures are used to look for blockages in the veins.

Treating venous leg ulcers

Treatment of your venous leg ulcers depends on how severe they are and how quickly they are getting worse. Treatments include:

  • Compression stockings
  • Aspirin
  • Aspirin and clopidogrel (Plavix)
  • Anticoagulant (blood thinning) medication

Compression stockings

Compression stockings are a good first step to take. They can help to control swelling and reduce the risk of blood clots. You can buy these from your local pharmacy or supermarket.

You should wear them every day. You should also keep your feet warm. This will help to prevent blood clots forming.

The best type of compression stockings for venous leg ulcers are different from the stockings you might wear to prevent varicose veins. Compression stockings are tighter on the calf, and are made of a cotton material. They should be worn at night, and you should change them every day.

Medicines for venous leg ulcers

You may also be given:

  • Anticoagulant medication
  • Medicines to reduce swelling and pain
  • Medicines to prevent blood clots

If you have a blood clot, your GP may inject an anticoagulant into your leg. This will stop your blood from clotting. If you have a blood clot, you will usually be given blood thinning medication, which you will take by mouth.

You may also need to change your lifestyle to reduce your risk of further blood clots. This includes not smoking, losing weight and being more active.

Other treatments

If you have an infection, your GP may prescribe antibiotics.

If your leg ulcer is caused by an infection, your GP may prescribe antibiotics, if you are not already on them.

If your leg ulcer is caused by an inflammatory bowel disease, your GP may prescribe medication to treat the condition.

If your ulcer is caused by cancer, your GP may prescribe chemotherapy.

How to stop leg ulcers getting worse?

You can help to prevent ulcers from getting worse by:

  • Wearing compression stockings
  • Eating a healthy diet
  • Losing weight
  • Exercising regularly
  • Not smoking

It is also important to keep your feet warm, and to keep your legs elevated.

You should also avoid activities that could cause blood clots, such as jogging and dancing.

If you are having a leg ulcer, or are concerned that one is developing, you should see your GP. This is especially important if you are over 60 years old, or if you are overweight.

Venous leg ulcher treatment

Treatment for venous ulcers may include:

  • Anticoagulation (blood thinning) treatment
  • Anti-inflammatory medication
  • Pain relief
  • Anti-blood-clotting medication
  • Surgery

You can also learn about treatment here.

Further information

If you would like to speak to a GP about your leg ulcer, you can contact NHS Direct on 0800 808 8080.

You can also book an appointment with a specialist nurse through the NHS Direct website.

You can also contact the NHS directly if you are concerned about your health.

Further reading

  • National Institute for Health and Care Excellence (NICE)
  • British Association for Paediatric and Adolescent Diabetes

You can find out about the National Institute for Health and Care Excellence (NICE) website here.

What is the takeaway?

Venous ulcers are sores that develop in your leg veins. They are usually due to pressure in the legs. They can also be caused by a lack of oxygen in your blood. They can occur in anyone, at any age. They are much more common than you might think.

However, they are not serious. Most can be treated quickly and easily, and most people can manage them at home. Most people will only need to be treated for a short time.

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