Leg ulcers are stubborn wounds that usually appear on the lower legs, most often due to poor circulation. They can be painful and slow to heal, and they need medical attention. With early diagnosis, treatment of the underlying cause and some lifestyle changes, most people can heal and lower the risk of recurrence.
Risk Factors
Circulatory issues
Varicose veins, chronic venous insufficiency and blood clots (such as deep vein thrombosis) all hinder blood flow and raise the risk of ulcers.
Health conditions
Diabetes, uncontrolled high blood pressure and rheumatoid arthritis can affect circulation and wound healing, making ulcers more likely.
Lifestyle and other factors
Obesity, inactivity and smoking all impair circulation. A family history of vein problems, previous leg injuries and older age also increase risk. This list isn't exhaustive — some people develop ulcers without any obvious risk factor.
Types of Leg Ulcers
- Venous ulcers: the most common (over 70% of cases), caused by poor vein circulation. Signs include swelling, pain, discoloured skin and heavy legs.
- Arterial ulcers: caused by restricted flow from hardened arteries; often painful or cold, with a pale, shiny appearance.
- Diabetic ulcers: linked to nerve damage and poor flow; often on the sole of the foot and not always painful at first.
- Pressure ulcers: from prolonged pressure over bony areas like the ankle or heel, common with limited mobility.
Symptoms
Leg ulcers are open wounds that take more than two weeks to heal, usually between the ankle and knee. Watch for an open sore that won't heal; redness, swelling and warmth around it; oozing of fluid or pus; pain or tenderness; hardened skin around the wound; and, with infection, a foul odour.
Complications
Untreated, leg ulcers can lead to cellulitis (skin infection), deep vein thrombosis, chronic pain, bone infection and, in the most serious cases, tissue damage that may require amputation. Early treatment is key to avoiding these.
Diagnosis
A doctor will examine the ulcer and review your medical history for conditions like diabetes or circulatory problems. A painless Doppler ultrasound checks blood flow in the veins, and further tests can rule out infection or other causes.
Treatment
The goals are to heal the wound, reduce swelling and prevent recurrence. Common options include:
- Compression therapy — stockings or bandages to improve flow and reduce swelling; the mainstay for venous ulcers.
- Leg elevation above heart level, several times a day.
- Wound care — regular cleaning, debridement and suitable dressings.
- Antibiotics if the ulcer is infected.
- Medications such as vasodilators or topical creams for pain and inflammation.
- Hyperbaric oxygen therapy to boost healing in some cases.
- Sclerotherapy, endovascular ablation or surgery for varicose veins or large, severe ulcers.
Managing underlying conditions, keeping a healthy weight, staying active, stopping smoking and eating well all support healing and help prevent recurrence.
When to See a Doctor
Leg ulcers are serious and shouldn't be ignored. If you notice a non-healing sore or any of the symptoms above, see a doctor promptly. Early intervention gives the best chance of healing and avoids complications. This information is general and does not replace professional medical advice.
Derma & Dental Clinic, Lahore
For assessment and treatment, our experienced team offers in-person consultations in Bahria Town, Lahore. Book online at Derma.pk or by phone.
