What is a venous ulcer?

A venous ulcer is a slow-healing sore that usually forms on the lower leg or near the ankle. It develops when blood has trouble flowing properly through the veins, causing pressure to build and damage the skin.

Because circulation is affected, these wounds can take longer to heal and may come back if the underlying vein problem isn’t managed.

Symptoms and Causes

Venous ulcers often start with changes in how your legs feel and look before an open sore appears.

Common symptoms include:

• Aching or throbbing in the legs
• A feeling of heaviness, especially later in the day
• Swelling in the lower legs or ankles
• Skin that becomes discolored, dry, or thickened
• An open wound that may drain fluid

These ulcers are usually caused by problems with blood flow in the veins. When the valves in your veins don’t work properly, blood can pool in the lower legs and increase pressure on the skin.

Factors that can increase your risk include:

• Varicose veins or chronic venous disease
• Prior blood clots in the legs
• Being overweight
• Smoking
• Diabetes
• Long periods of standing or limited movement

How is it diagnosed?

Your provider will begin with a physical exam and a review of your symptoms and health history. They’ll examine the wound and the surrounding skin.

In many cases, an ultrasound is used to check how well blood is flowing through your leg veins. This helps identify the underlying cause and guide treatment.

How is it treated?

Treatment focuses on improving circulation and helping the wound heal safely.

Conservative treatments are usually the first step:

• Elevating your legs to reduce swelling
• Wearing compression stockings or bandages
• Staying active with walking or simple leg exercises
• Regular wound cleaning and dressing changes

If needed, your care team may:

• Remove damaged tissue to support healing
• Prescribe medications to improve circulation
• Recommend advanced treatments for slow-healing wounds

For more severe cases:

• Procedures to treat vein problems may be considered
• Skin grafts can help close larger or persistent ulcers

Healing can take several weeks or longer. Ongoing care is important to prevent infection and reduce the chance of the ulcer returning.