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Leg ulcers

Leg ulcers are breaks in the skin (generally below the knee) that can take a long time to heal due to underlying disease. You may hear them described as ‘chronic wounds’.

Elderly person exercising in group

The most common cause of chronic leg ulcers is poor blood circulation in the legs caused by a problem either in the veins, causing venous leg ulcers, or arteries causing arterial leg ulcers. Sometimes the cause is a combination of the two (mixed venous-arterial ulcers).

Approximately 70% of leg ulcers are venous. They are caused by increased blood pressure in the veins of the lower leg. As a result, fluid ‘oozes out’ of the veins beneath the skin making it swell and thicken. You are at risk of developing a venous ulcer if you have varicose veins, have had a deep vein thrombosis (DVT) in the past, or have a family history of venous disease.

Arterial ulcers tend to be found at the lower end of the leg, on the foot or toes. They generally cause pain at night, or if your legs are elevated. You are at risk of developing an arterial ulcer if you have heart disease, diabetes, peripheral vascular disease or if you smoke.

It is very important that your doctor examines your wound to determine the type as this will guide treatment. Diagnosis is usually made on the basis of the appearance and location of the ulcer (see table below).

Differences between venous leg ulcers and arterial leg ulcers

Venous leg ulcers
  • Swollen foot and leg
  • Ulcer is usually superficial/shallow with sloping edges
  • Dry, itchy, red or brown skin around the ulcer. Eczema may be present
  • Painful, especially if infected
Arterial leg ulcers
  • Cold feet and legs with a whitish or bluish, shiny appearance
  • Round, ‘punched out’ and painful ulcer
  • Increase in pain when your legs are elevated
  • Decrease in pain when sitting

Consulting a healthcare provider

If you think you have a known vascular disease and a wound on your lower leg, then you should consult a health care provider right away. If you are unsure about a wound that persists on your lower leg, then you should also consult a provider. While you are caring for your wound at home per your provider’s instructions and the wound gets worse or persists or if there are signs of infection such as redness, swelling, fever, pain or burning, increased drainage, becomes warm to the touch, then consult a health care provider.

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Other Wound Types

All Wound Types

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