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Venous Ulcers

Venous ulcers, also known as vascular or stasis ulcers, develop when the leg veins do not return blood back toward the heart as they normally would (venous insufficiency). In venous insufficiency, the one-way valves in the veins of the leg that keep blood flowing toward the heart are damaged.  The damaged valves, allow blood to pool in the vein.  As the vein overfills, blood may leak out of the vein and into the surrounding tissue. This can lead to a breakdown of the tissue and development of a skin ulcer.

Venous insufficiency results in tissue damage that leads to wound development.  Venous ulcers commonly occur on the sides of the leg, above the ankle and below the knee.  Venous ulcers are commonly slow to heal and often require lifetime modifications to prevent re-development.


  • Deep vein thrombosis, a blood clot (thrombus) forms in the deep veins of the legs.

  • Obesity

  • Pregnancies (may make a vein problem) worse

  • A family history of varicose veins

  • Smoking

  • The lack of physical activity

  • Excessive alcohol use

  • Aging

  • Poor nutrition

  • Work that requires prolonged standing more


The first sign of a venous skin ulcer is skin that turns dark red or purple over the area where the blood is leaking out of the vein. The wound bed is often beefy red and may bleed easily.  The ulcer may be painful. You also may have swollen and achy legs.  Necrotic tissue, slough (yellow, tan, gray, green, or brown) and/or eschar (tan, brown, or black), may also be present. The skin also may become thick, dry, and itchy. Without treatment, an ulcer may form.

Care Basics

  • Adequate blood circulation helps prevent and treat venous ulcers. To improve your blood circulation, you can:

  • Lift your legs above the level of your heart as often as possible. This will help to  reduce swelling in your legs.

  • Walk daily. Walking helps improve your blood circulation.

  • Keep the skin clean and supple.  Apply an oil-based, fragrance-free moisturizer at least daily following your bath and as needed

  • Prevent injuries to the skin.


Call your doctor when you first notice the signs of a venous ulcer.  Newer and smaller venous ulcers tend to heal faster than larger ones.  Early treatment can prevent the progression of the ulcer to a non-healing state.

Treatment of venous ulcers is often achieved with the use of compression stockings or bandages. These help prevent blood from pooling in your legs. However, compression should not be applied without physician oversight.  Appropriate use must occur under direct supervision of a trained medical professional and use outside of these circumstances can have negative outcomes.

Generally, the use of compression is life-long.  After a venous ulcer has healed, compression stockings can help prevent other ulcers from forming.

Contact your physician immediately if there are any signs of an infection. An infection can spread to the rest of the body and cause serious problems. Signs of an infected ulcer include:

  • Redness, tenderness, warmth, or selling around the ulcer

  • A foul odor or pus from the ulcer

  • Fever, weakness, and confusion are signs that the infection may have spread to the blood or elsewhere in the body.

This information is for educational purposes, only.  It is not intended to replace the advice of a doctor. The iWOC Foundation disclaims any liability for any decisions made based on this information.