Venous Ulcers: What to Know

Picture of a venous ulcer on the leg

Venous, varicose or stasis ulcers often look terrible, but they can be treated.

The Breakdown:

Venous Ulcers are lesions that occur not in the stomach but on the skin. They’re a complication of what’s called venous insufficiency. The job of the vein s is to pump blood back to the heart. To makes sure that the blood doesn't flow back down, they have valves that shut. When the veins don’t shut, the blood flows back and pools. This causes the veins to dilate. These can be seen as ropey varicose veins usually on people’s legs and ankles. Capillaries that suffer from venous insufficiency are called spider veins and can also be seen on the legs as well as the face and the nose. Varicose veins can be treated by a vein specialist using either sclerotherapy or ablation.

Sometimes, an ulcer will form in the area of the varicose vein because blood has seeped from the injured vein and entered the tissues. This causes them to break down and form the lesion. People who have varicose veins are at greater risk for developing these skin lesions if they’re obese, if they smoke, if they're sedentary or if they have a job where they have to stand up all day. People are also at risk if they’re older, have phlebitis or a thrombosis in the deep veins of their leg or have hurt their leg before.

A patient or a vein specialist can tell if skin ulcers might be forming because the skin over the area starts to darken. The leg may also start to swell and ache. The skin also thickens, dries out and begins to itch much like it would during a bout of eczema. Though varicose vein s aren't generally painful, skin lesions can be. They’re usually shallow but also have a foul odor and are full of pus. They also cause the area around them to be inflamed and tender. The lesion may become larger over time and can last for weeks, months or years.

Untreated, the patient can progress to cellulitis, which is a condition where the skin is attacked by a spreading bacterial infection. The patient can also develop osteomyelitis, a condition where bacteria attacks the bone. The lesion can even become malignant.

Some Good News for Venous Ulcer Patients

The good news is that varicose lesions can be prevented if the patient goes to see his or her doctor right away. It’s important to see a doctor while the lesion is still small. Many vein specialists treat varicose lesions with compression bandages. They also have their patient elevate the leg and prescribe medications like pentoxifylline, which is used by itself or with compression bandages. They may also prescribe aspirin and oral antibiotics and may also recommend antiseptic ointments. For older and larger lesions, doctors have also been known to use debridement to treat the lesions. Skin grafts and artificial skin might also be used with compression bandages. Surgery may also be used as treatment of last resort.

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