What Does A Venous Ulcer Look Like?

When it comes to your vascular health, it is important to take care of any venous disease before it causes other problems. Without treatment, venous disease can start to damage your veins and tissues leading to complications like venous ulcers. Throughout this article, we’ll break down everything you need to know about venous ulcers from how they form to how long they take to heal.

A venous stasis ulcer is an open wound that occurs when blood pools in your legs and feet as the result of other health conditions. There are a number of reasons why blood can pool in your limbs, including:

• Chronic Venous Insufficiency
• Varicose Veins
• Deep Vein Thrombosis
• Obesity
• Inactivity
• Prolonged standing or sitting
• Pregnancy

Each of these conditions can cause you to have poor circulation. Since your blood struggles to travel back to your heart, it stagnates in your limbs and causes pressure to build up. As this pressure builds, your blood and other fluids will start to leak into your tissues and skin and prevent nutrients from reaching your skin. Over time, your tissues will break down and form an ulcer as a result.

Venous stasis ulcers commonly form on your lower legs, with the majority of cases appearing on the inside of your leg above the ankle. Although most ulcers appear in this area, it is possible for them to form anywhere across your lower leg from your mid-calf down. The skin around your ulcer may look discolored or swollen.

Venous stasis ulcers are distinct from other types of ulcers because of how they are formed, the location they develop, and the way they look. If you have a venous ulcer, you may notice:

• A shallow wound with irregular, uneven borders
• Swollen, hardened, or shiny skin around the wound
• Oozing fluid
• Brown, red, or yellow discolored skin

Along with the appearance of the ulcer, you may experience swelling, itching, or pain around your wound. If left untreated, the ulcer can become infected and begin to smell bad or leak pus.

Since venous ulcers gradually form, there are different stages that lead up to having an active and open venous ulcer. The initial noticeable stage is small, visible blood vessels appearing just below the surface of your skin, which eventually worsen into large, twisted varicose veins. The next stages include swelling in the ankles or legs, skin discoloration, and hardened skin. Finally, sores develop and persist without treatment.

If you believe that you may have a venous ulcer, make sure to visit your healthcare provider for an official diagnosis. Your doctor will perform a physical exam and look at your medical history to determine if you have a venous ulcer. During the physical exam, your doctor will look at the appearance of the wound and the skin around the wound. They will also look for other signs of venous disease such as varicose veins, venous dermatitis, edema, and more.

In addition to the physical exam, your doctor may run tests to evaluate your blood circulation. Some potential tests include:

• Ankle-Brachial Index (ABI): Your doctor will measure the blood pressure in your arm and in your ankle, then compare the numbers to see if there is a difference.
• Duplex Ultrasound: An ultrasound is used to see if there are any blockages or valve problems that could be reducing your blood flow.
• Intravascular Ultrasound (IVUS): This test is a minimally invasive procedure that uses an ultrasound wire to look for vein narrowing inside the veins.
• CT Venography: During a CTV, your doctor will inject contrast material into your veins prior to a CT scan to help visualize your veins on the image.

If your doctor notices signs of an infection during the diagnosis process, they may send a sample from your wound for a wound culture to determine if you have an infection and how to treat it.

In order for a venous ulcer to heal, you will need to talk to your doctor about different treatment options. Venous ulcers do not usually resolve on their own, since they result from an underlying condition. Based on your medical history and the condition of your ulcer, your doctor could recommend wound care methods, medications, advanced wound healing, lifestyle changes, and even surgery if necessary.

Properly cleaning and dressing your ulcer can help the healing process by removing dead tissue, debris, and bacteria to reduce your risk of infection. Using a saline solution or other wound cleaner recommended by your doctor, you can thoroughly rinse your wound to cleanse it. You should avoid any harsh soaps or antiseptic cleansers because it can damage healthy tissue and slow down your healing. If you have necrotic tissue, make sure to talk to your doctor about debriding your wound, as you should not attempt to remove any tissue yourself.

There are numerous types of wound dressings that can help with venous ulcers by retaining moisture while preventing infection, such as:

• Antimicrobial dressings
• Foam dressings
• Hydrocolloid dressings
• Alginate dressings

Based on the type of dressing used and how much your ulcer is draining, you will need to change your dressing every 1-3 days.

Compression therapy can also be a beneficial wound care method for venous ulcers because it helps improve blood flow and reduce swelling. For patients with arterial disease, compression therapy may not be an option as it can worsen circulation if your arteries are already blocked.

Following your initial exam and any diagnostic testing, your doctor may prescribe antibiotics to treat an infected venous ulcer. If your ulcer is infected, you might experience swelling, warm skin, redness, pus, foul-smelling drainage, or pain. Your doctor may recommend using topical treatments such as antibacterial ointments or medicated dressings to help treat and prevent infections.

For non-healing or chronic venous ulcers, your doctor will consider setting up advanced wound therapy to help. Advanced wound therapy utilizes the latest wound treatments to improve your wound’s healing environment. Treatments like negative pressure wound therapy, skin grafts, and more can help improve blood flow and nutrient to your wound site to close the wound.

Due to venous ulcers forming due to other health conditions, lifestyle changes can help improve your conditions and help your ulcer heal, such as:

• Elevating legs: Raising your legs can help blood naturally flow back up your legs to reduce swelling and improve your circulation.
• Regular exercise: Simple exercise can help get your blood flowing and prevent any vascular conditions from getting worse.
• Weight management: Excess weight can put strain on your veins, making it harder for your circulation to flow properly.
• Managing underlying conditions: For patients with CVI or diabetes, you’ll need to talk to your doctor about managing your condition to prevent ulcers from forming or getting worse.

If other treatment options do not improve your condition, surgery may be necessary to help move your recovery along. Surgical options for venous ulcers include:

• Microphlebectomy: A light is threaded through an incision into the vein, then a surgeon removes targeted problem veins through a suction device.
• Radiofrequency Ablation: After making a small incision on your leg, a surgeon will insert a narrow tube into your vein to use radiofrequency energy to eat the walls of the vein until they collapse and dissolve.
• Endovenous Laser Ablation: A laser is threaded through a catheter to heat and seal a vein off a vein.

With proper treatment, including wound care, medical treatment, and compression therapy, most venous ulcers heal within 3-6 months. If you experience complications, your ulcer could take 6 months or longer to heal. Additional factors that can affect your recovery time include:

• Size and depth of the ulcer
• Infection
• Underlying conditions
• Treatment consistency

Any ulcer that lasts longer than 3 months is considered to be chronic and may need additional healthcare interventions. Other signs your ulcer needs advanced intervention are:

• Recurrent ulcers despite treatment
• Signs of deeper infection like fever or swelling beyond the wound site
• Lack of noticeable improvement after 4 weeks of treatment
• Worsened pain or redness
• Increased wound drainage

For an expedited recovery, make sure to follow all of your doctor’s recommendations and treatment plans for both your wound and any underlying conditions.

If you are concerned about developing a venous stasis ulcer, contact us at Vein Solutions Flint. Our doctors are dedicated to helping you manage your vascular health and preventing new symptoms from developing.

For more information about venous ulcer treatment options at Vein Solutions, visit our website. While there, you can also learn more about our providers and read patient testimonies.

If you believe you are experiencing symptoms of a venous ulcer, schedule a vascular health screening with Vein Solutions Flint. Let our vascular experts help you get back to feeling healthy and confident with your veins!