A varicose ulcer can occur when the leg veins don’t circulate blood back toward the heart. Blood can back up in the veins, building up pressure on the skin, which can cause an open sore to form.
Varicose ulcers usually form on the sides of the lower leg, above the ankle and below the calf. They are slow to heal and often return. Without proper treatment, they can become larger and cause additional leg problems.
Signs and Symptoms
Varicose ulcer symptoms include:
- Dark red or purple skin patches that can be thick, dry and itchy
- Swollen and achy legs
- A shallow, red sore with irregular edges which may also have clear, yellow or bloody drainage
If a varicose ulcer is suspected, it is important to complete physical, including a check of your blood pressure in your arm and your ankle. The diagnosis is typically made based on the description of how the ulcer began and physical exam findings. Additional tests may include:
Ankle brachial index test: During this test, blood pressure cuffs are placed on the arms and ankles. A handheld ultrasound device or ‘Doppler’ is used to listen to the blood flow and measure the blood pressure. This helps doctors understand if there is a decreased blood flow to the lower legs and feet.
Ultrasound: An ultrasound device can measure blood pressure on various points of your arm or leg, which will help the physician determine if you have any blockages and how quickly blood flows through your arteries in the lower leg.
In addition, ulcers should be assessed for infection. A culture of the wound may be used to determine if antibiotics are needed. In addition, these tests may also be used:
Imaging tests: X-rays, magnetic resonance imaging (MRI), or bone scans can help identify bone infection and help determine whether surgery is needed to remove all of the infection.
The following can lead to varicose ulcers:
- Standing or sitting for long periods
Risk factors that can contribute to venous ulcers include:
- Age:As you get older, your veins lose elasticity and the valves in your veins become weak, leading to venous ulcers.
- Being female:Women develop venous ulcers more often than men.
- Deep vein thrombosis:Blood clots that form in the deep veins of the leg can cause venous ulcers.
- Family history:Venous ulcers may be hereditary.
- Pregnancy:Pregnancy can sometimes cause pressure in the lower legs, which can lead to venous ulcers.
- Varicose veins:Varicose veins can increase the risk of developing venous ulcers.
- Venous insufficiency:When leg veins can’t circulate blood properly, blood pools in the legs and can cause venous ulcers
Treatment of varicose ulcers may vary depending on the severity of the condition. These treatments will typically include cleaning of the affected area, application of dressings and the use of compression stockings which work to encourage blood flow back to the heart. Pain relief will be upon the advice of your Consultant.
Patients who have developed poorly healing sores in relation to their varicose veins, may require more advanced wound care and treatments including minimally invasive surgical intervention to address the varicose veins directly.