A varicose ulcer usually develops when there has been chronic or regular damage to the skin from varicose eczema/infection. 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.
The diagnosis is typically made based on the description of how the ulcer began and physical exam findings. If a varicose vein is suspected, it is important to check your suitability for compression stockings using s test called ABPI. This involves a check of your blood pressure in your arm and your ankle.
A vascular surgeon may also request additional tests, which will include the following:
Ankle brachial pressure index (ABPI): 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 flow at various points of your leg, which will help the physician determine if you have any blockages and how quickly blood flows through your arteries in the lower leg.
Imaging tests: X-rays, magnetic resonance imaging (MRI) or bone scans may also be required.
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 varies depending on the severity of the condition. 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.
Patients with varicose veins can be assessed by the vascular team at the Skin Clinic regarding their suitability for vein ablation, which may assist with ulcer healing.