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Varicose Veins and Venous Ulcers: Here’s What You Need to Know

Treating varicose veins early can help prevent painful ulcers from forming.

Poor circulation in the legs can lead to varicose veins, but it can also cause venous ulcers. These painful sores usually develop just above the ankle and below the calf. While these injuries can be unsightly and uncomfortable, there are many ways to prevent them. Vein specialists can also recommend effective treatment options should ulcers appear.

What Are Venous Ulcers?

Varicose veins and venous ulcers stem from chronic venous insufficiency, a condition in which the valves of the veins cannot properly funnel blood from the extremities to the heart. The pooled blood then enlarges the veins and pushes them to the surface of the legs (or other affected body parts), where they show up as a rope-like, purple-tinted varicose veins. When pressure in the veins builds up even further, the skin swells to the point where a wound breaks through, causing a venous ulcer.

Before a venous ulcer forms, patients may notice some warning signs, such as heaviness in the legs, a tingling or itching sensation, or hardened skin with a dark red, purple, or brown hue. Later, an irregular-shaped, red-colored wound with a film of yellow tissue appears. The skin around the sore may feel tight and warm, and the leg becomes painful.

Risk Factors and Diagnosis

Individuals with varicose veins have a higher chance of developing venous ulcers. Being overweight, having a sedentary lifestyle, smoking, and having a family history of venous insufficiency also increase the risk.

If you think you may have a venous ulcer, the best course of action is to have it examined by a doctor as soon as possible. In addition to a physical exam, a specialist may use an ultrasound device to check the blood flow in the leg. An ankle brachial index test may also be performed. During this procedure, blood pressure cuffs are wrapped around the arm and the ankle. This is followed by an evaluation using an ultrasound or “Doppler” device to determine whether there is insufficient blood flow to the lower leg and feet.

Your vein specialist will also want to investigate if the wound is infected and requires treatment with antibiotics. Further, an X-ray or MRI can pick up if the sore is due to a bone infection that needs surgery.

Prevention of Venous Ulcers

As regular exercise promotes steady blood flow within the legs, patients should do their best to stay active. Losing weight and quitting smoking can help as well. Managing chronic conditions such as diabetes and hypertension may help prevent venous ulcers, too.

Ultimately, effective prevention hinges on treating underlying conditions like varicose veins. Current treatment methods for varicose veins are safe, effective, and minimally invasive. For example, endovenous ablation collapses the swollen vein with radiofrequency waves or a laser beam. The varicose vein disappears and blood shifts to healthier veins after a short procedure that requires only local anesthesia.

Treatment Options

If venous ulcers do appear, there are treatment options available to help promote healing and clear up the wound. After dead tissue is removed, the doctor will wrap the area in a bandage. Your vein specialist will advise how often to change the dressing and clean the sore over the following weeks. It’s also advisable to keep the wound and the skin around it as dry as possible to block the ulcer from spreading. Antibiotics may be prescribed if the wound shows signs of infection.

While the venous ulcer heals, patients may be asked to wear compression stockings to maintain a healthy blood flow. You can also reduce pressure on the veins by elevating your legs above your heart multiple times a day.

If you’d like to learn more about treatment options for varicose veins and venous ulcers, reach out to Dr. Tif Siragusa of Siragusa Vein and Laser Center in Nashville. His practice centers on venous disorders, and he is an expert in a variety of effective therapies. Contact the office today for a vein screening.


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