Leg ulcers, also known as venous ulcers or stasis ulcers, are non-healing or slow-to-heal wounds on the skin that are most commonly caused by improper blood flow in your veins. Leg ulcers are a serious, and often long-term condition that is difficult to treat and may require multiple long-term therapies. Leg ulcer treatments can include compression, medication, or surgery.
Treating leg ulcers
Leg ulcers can have a significant impact on your quality of life, and treatment can be challenging. Your doctor can work with you to create a plan to heal your leg ulcer with a combination of conservative therapy, medication, and surgery.
- Compression in the form of bandages, gauze wrappings, and graduated compression stockings can improve your blood flow.
- Dressings over the ulcer can help keep it clean and prevent it from sticking to bandages or clothes.
- Lifestyle changes like regular exercise, elevating your legs, quitting smoking, eating a healthy diet and maintaining a healthy weight can improve your vein health.
- Vaccum assisted closure, also known as topical negative pressure, can shrink the size of the ulcer and help it heal by removing excess fluid and promoting blood flow.
- Hyperbaric oxygen therapy is a non-invasive procedure where your leg is placed in a chamber that feeds pure oxygen to the wound, helping with inflammation and infection.
- Antibiotics and antiseptics are used to treat infection in and around the ulcer.
- Anti-clotting or anti-platelet medications help prevent blood clots and improve your blood flow.
- Aspirin taken daily has been shown to speed up healing, especially in combination with compression therapy.
- Oral zinc can help with inflammation and speed up healing.
- Debridgement is the process of removing dead tissue and foreign material like dirt from your wound. It’s usually one on larger, deeper ulcers.
- Skin grafting applies healthy skin from your body to the ulcer to help it heal.
- Endovenous thermal ablation is a non-invasive procedure that uses a thin, wire-like catheter inserted into your varicose veins to heat them up from the inside. This shrinks and collapses the treated vein.
- Endoscopic vein surgery is a non-invasive procedure that uses a catheter inserted into your vein. The catheter has a camera and surgical tool. This can be used to close up your vein.
- Phlebectomy removes your unhealthy veins through tiny cuts or punctures in your skin.
- Sclerotherapy is a non-invasive chemical injection that shrinks and collapses your varicose veins to make them eventually dissolve.
Symptoms of leg ulcers
Venous ulcers appear as painful, shallow sores on the surface of your skin that look inflamed or red. They usually appear on top of bony areas around your ankles, but can develop in other areas as well. Venous ulcers are slow to heal, or may not heal at all without treatment. If the ulcer is infected it may have an odor or give off a yellow or green fluid. There can also be skin discoloration, thickening of the skin, and varicose veins in the area.
Leg ulcers can also have a psychological impact on you as well because they can affect your sleep, mobility, and even your social life. It’s important to discuss any anxiety, depression, or other mental effects with your doctor and address these symptoms as well.
Causes of leg ulcers
Venous ulcers are most commonly caused by improper, backwards blood flow in your veins that leads to pooling blood and increased pressure in your veins. Your veins have one-way valves inside of them that help your blood move back up to your heart, but these valves can be damaged by conditions like venous insufficiency and venous stasis. If these conditions are left untreated, it can damage your veins and lead to ulcers.
Venous ulcers are more common in women and older people, and risk factors include obesity, previous leg injuries, deep blood clots (called deep vein thrombosis, or DVT), and vein inflammation (phlebitis).
Diagnosing leg ulcers
Your doctor can diagnose leg ulcers by performing a physical exam, checking your blood pressure in your limbs, and performing imaging tests like duplex ultrasound, X-rays, or MRI. These imaging tests check how well blood flows through your veins. They can also detect blockages in your veins and see if there are specific vein segments that aren’t working properly.
There are many different treatments and therapies for leg ulcers, and the cost of treating venous leg ulcers varies depending on your area, physician and insurance coverage. You can speak with your doctor and health insurance provider for more exact cost information.