A health condition that causes open sores that often take a long time to heal is called leg ulcers. In general, it may happen due to multiple reasons, including poor circulation, diabetes, and others. If it is left untreated, the affected person may experience serious and even life-threatening complications. That’s why early detection and proper treatment help improve healing and reduce the risk of complications.
These ulcers often can ooze fluid or pus and may grow large if they are not managed. When a leg ulcer does not heal for more than 3 months, it is considered a chronic (long-term) disease. Approximately 1% of adults in the U.S. have leg ulcers. However, it occurs more commonly in older adults (over 65 years old), and it affects about 4% of them.
What Are The Symptoms of Leg Ulcers?
Commonly, the primary symptom of this condition is a sore on the leg that does not heal with treatment after 2 weeks. It may appear red, purple, brown, or yellow (sometimes, a mix of colors). Most of the time, leg ulcers have a liquid discharge, especially if the affected individual does not get treatment. Check for other symptoms of leg ulcers below:
- Dry, scaly, or itchy skin
- Red, blue, or purplish skin color (similar to a bruise)
- Swelling (edema) in the lower legs
- Leg pain
- Hard bumps on the skin
If any of the previous symptoms occur, immediately contact your healthcare professional. Otherwise, it may lead to unpleasant outcomes.
Causes
While leg ulcers may happen due to multiple causes, the most common of them are listed below. For example:
- Chronic venous insufficiency – It often happens when the faulty valves in the leg veins allow blood to flow back into the leg, where it starts to pool. Furthermore, people with hypertension may notice how their leg veins (capillaries) burst, which often causes inflammation.
- Diabetes – Increased levels of sugar in the blood may cause fat deposits to form in the blood vessels. As a result, the affected blood vessels become narrower, which reduces blood flow. Sometimes, it may also cause nerve damage or diabetic neuropathy. Typically, diabetes negatively affects the wound healing process.
- Peripheral artery disease (PAD) – In people with PAD, there are plaques inside their arteries (atherosclerosis). As a result, the affected blood vessels become narrower, causing poor blood circulation. Usually, people with diabetes are at increased risk for PAD.
- Hypertension (high blood pressure) – Long-term, unmanaged hypertension may cause an extremely painful ulcer on the leg (also known as Martorell ulcer). It happens because high blood pressure negatively affects the capillaries in the skin.
Risk Factors
Healthcare professionals have identified some factors that could elevate your risk of developing leg ulcers. Check some examples below:
- Obesity (excessive body weight)
- Pregnancy
- A family history of vein issues
- Certain diseases (including rheumatoid arthritis, high cholesterol, and others)
- Hip or knee replacement procedures
- Injuries and traumatic accidents (such as broken bones)
- Lack of physical activity
- Smoking
- Varicose veins, vasculitis (blood vessel inflammation), and venous blood clots (also called thromboembolism)
What Happens if Leg Ulcers Are Left Untreated?
People who leave leg ulcers untreated are at increased risk for the following complications. Examples include:
- Bone infections – One of them is osteomyelitis, which may also lead to limb loss (amputation).
- Cellulitis – This is a severe bacterial infection of the skin and certain layers under it.
- Sepsis (a life-threatening bacterial infection)
- Skin cancers (including squamous cell carcinoma)
- Reduced mobility or disability
- Recurrence – Sometimes, this condition may return, which makes management of the underlying conditions vital.
This document does not contain a full list of complications, but you can talk with your doctor about measures to reduce the risk.
Is There a Way to Prevent Leg Ulcers?
Doctors may recommend some tips to reduce the risk of recurrent leg ulcers. For example:
- Raise your legs above the heart when you are sleeping or sitting
- Manage chronic health conditions that negatively affect blood circulation (including hypertension, diabetes, hyperlipidemia, Raynaud’s syndrome, and others)
- Stop smoking – If you have problems with smoking cessation, discuss it with your doctor.
- Use gentle cleansers and moisturizing lotion to prevent dry skin
- Wear compression stockings or bandages – Usually, they help improve blood flow to the legs.
Diagnosis
Most of the time, the diagnosis starts with a physical examination and questions about your symptoms and medical history. However, doctors may perform some tests to rule out other conditions that cause similar symptoms and check for complications. These include:
- Ankle-brachial index test – This test uses ultrasound to measure blood pressure and flow in the legs.
- Biopsy – During this procedure, doctors will take a small sample of the wound for testing. It usually helps detect infections and skin diseases.
Treatment
In some cases, it is difficult to get rid of a leg ulcer because it can re-open even after treatment. However, treatments are often different among people because they depend on several factors. For example, the severity of the condition, underlying cause, age, sex, overall health, and preferences. Check some common options below:
- Compression therapy – It involves stockings or bandages that improve blood flow to the legs.
- Leg elevation
- Wound care – It includes debridement (removal of dead skin tissue), topical medicines, and regular bandage changes.
- Antibiotics – This group of medicines is used to prevent or treat bacterial infections.
- Vasodilators – They are used to widen blood vessels and improve blood flow.
- Hyperbaric oxygen therapy – Getting more oxygen during treatment may help improve healing speed.
- Sclerotherapy or endovascular ablation – Typically, doctors recommend these treatments for people with varicose veins.
- Surgery – It is used to remove, repair, or replace a damaged vein.
- Skin grafts – This treatment option is often recommended by doctors when a wound gets larger than 4 inches or does not heal with other treatment options.
Frequently Asked Questions
What is the outlook for someone with leg ulcers?
It is important to understand that leg ulcers may lead to disability, which negatively affects mobility, the ability to work, and the ability to enjoy life. That’s why leg ulcers should be treated as soon as possible. For more details, discuss it with your doctor.
When should I call my healthcare provider?
If any of the following symptoms occur, do not hesitate to see a doctor. For example, fever, chills, severe pain, or signs of wound infection (including swelling, foul-smelling discharge, or redness). It is also recommended to visit a doctor if the treatment you follow does not work.
How to avoid leg ulcers in old age?
To reduce the risk of developing leg ulcers, you should improve circulation, protect fragile skin, and manage underlying disorders. Doctors often recommend wearing prescribed compression stockings, staying active, elevating the legs, and stopping smoking.
Can leg ulcers heal on their own?
Most leg ulcers do not heal on their own, especially if they are caused by poor circulation, diabetes, or other underlying medical conditions. Without proper treatment, the wound may become larger, infected, or lead to serious complications. Medical evaluation and treatment are usually necessary.
Are leg ulcers contagious?
No, leg ulcers are not contagious and cannot spread from one person to another through physical contact. However, if the ulcer becomes infected, proper wound care and hygiene are important to prevent the spread of bacteria.
What foods can help support leg ulcer healing?
A balanced diet rich in protein, vitamins, and minerals may help support wound healing. Foods containing vitamin C, zinc, iron, and protein are especially important because they help repair damaged tissues and support the immune system.
Can walking help improve leg ulcers?
In many cases, regular walking and gentle exercise can improve blood circulation in the legs, which may support healing. However, the amount and type of physical activity should be discussed with a healthcare provider, especially if severe pain or peripheral artery disease is present.
How long does it take for a leg ulcer to heal?
Healing time varies depending on the size of the ulcer, its cause, overall health, and how well treatment is followed. Some ulcers heal within a few weeks, while chronic ulcers may take several months or longer to improve.
Can compression stockings prevent leg ulcers from coming back?
Yes, compression stockings are commonly recommended for people with venous leg ulcers. They help improve blood flow, reduce swelling, and lower the risk of ulcer recurrence when worn as directed by a healthcare professional.
Who is most likely to develop leg ulcers?
Leg ulcers are more common in older adults, people with chronic venous insufficiency, diabetes, peripheral artery disease, obesity, or a history of blood clots. Individuals who smoke or have limited mobility may also have a higher risk of developing this condition. If you have additional questions, ask your healthcare provider.
