Venous Ulcers

Venous ulcers are open sores or wounds that recur or will not heal, developing after veins in the legs have been damaged and penetrating deep into the skin. Venous ulcers are usually found on the inner part of your leg, just above your ankles. Typically forming on your skin near varicose veins, venous ulcers may affect one or both legs.

Overview and Symptoms

Overview and Symptoms

  • Darkening of skin at the ankles or legs
  • Leg pains
  • Itching
  • Skin appears thin and tissue-like
  • Skin irritation of the legs
  • Skin lesion or patch
  • Red spots on skin
  • Swelling of legs
  • Thickening of skin at ankles or legs

Venous ulcers tend to have these characteristics:

  • A base that is usually red
  • A covering of yellow fibrous tissue
  • Green or yellow discharge if the ulcer is infected
  • Significant fluid drainage
  • Irregularly shaped borders
  • Discoloration and/or swelling of the surrounding skin
  • Feeling hot to the touch
  • Shiny-looking skin in the area
  • Infections of the skin (cellulitis) often develop around a venous ulcer:
    • Typically, the infected skin is red, warm, swollen, and tender
    • Red streaks occasionally appear
    • A brown colored spot on the skin usually begins before an ulcer forms
Risk Factors
  • History of leg swelling
  • Varicose veins
  • History of blood clots in either the superficial or deep veins of the legs
  • Previous deep vein thrombosis or postphlebitic syndrome

Venous ulcers are primarily diagnosed by the appearance of your skin. Your doctor may also order a venous duplex ultrasound, which uses high frequency sound waves to check the blood flow in your legs and to help determine a treatment.


Venous ulcers can be difficult to treat, and often recur after healing.

Conservative treatment aims to reduce leg swelling and pressure in your veins, helping a venous ulcer to heal on its own:

  • Wearing compression stockings
  • Keeping your leg elevated as much as possible
  • Unna boot, a cast-like wrap to give the ulcer extra protection
  • Antibiotics can help fight infection, but will not heal the ulcer

Other treatment options include:

  • Apligraf, a living cell-based product, can be applied to help a venous ulcer heal.
  • Skin grafting, a surgical procedure, may be done for a very deep or non-healing venous ulcer.
  • Venefit Targeted Endovenous Therapy, a radiofrequency ablation treatment, can be used to seal the affected vein.
  • Debridement removes dead tissue on a venous ulcer. There are several types of surgical and non-surgical debridement procedures.