What is causing this ulcer on my leg?
- Posted on: May 31 2018
What is Causing This Ulcer on My Leg?
Leg ulcers are an unfortunate complication of several medical conditions and can be a source of concern and morbidity for many patients. Approximately 80% of leg ulcers are venous ulcers, and is the most common type of ulcers that affect individuals. Venous ulcers, also called venous stasis ulcers, affect upwards of 1% of the population. They typically occur over bony areas, often above the ankle. They can take months to heal, even with aggressive wound therapy. Recurrence of the ulcers are common. In fact, an ulcer that occurs again in the same spot is highly suggestive of a venous ulcer.
Venous ulcers are typically shallow and often have foul smelling drainage. They may or may not be painful, depending on the severity and location. As stated before they are very slow in healing, even despite aggressive wound therapy. Leg swelling, redness, and skin changes are commonly seen. Outlined below is a discussion of those who are at risk, what causes ulcers, and what you can do to help prevent them.
Who is at risk?
Leg ulcers may bring geriatric, bed-ridden patients to mind. Increasing age is certainly a risk factor to developing venous ulcers, as is immobility. But many people who are physically active can develop venous ulcers too. The contributing factor in the development of venous ulcers is underlying venous stasis. This is also known as varicose vein disease. Other risk factors include obesity, phlebitis (inflammation of the veins), blood clots in the deep veins, and leg injuries. The common theme with all of these risk factors though is that the veins do not work the way they were intended to.
What causes venous ulcers?
Venous stasis ulcers are so named because that is what causes them. Venous stasis. Stagnant or slow-moving blood. This causes venous hypertension, or high blood pressure in your veins. Your veins typically have a low pressure in them as blood makes its way back towards the heart. But when the veins do not work properly, or have become damaged due to a prior injury or blood clot, then blood backs up and pools at the lowest point due to gravity. While the exact reason people develop ulcer is still unclear we do know that this pooling of blood activates inflammatory molecules that contribute to inflammation and edema. Wound healing is impaired, the skin experiences changes due to the chronic swelling, and ulcers often develop. The aforementioned risk factors, acute trauma, and immobility all contribute to the development of a venous ulcer.
The best way to prevent venous ulcers is to treat varicose veins early before complications arise. If you know you have varicose veins seek treatment early! Skin changes, swelling, and leg pain should always be evaluated by a healthcare provider to determine the underlying cause. Maintaining a healthy weight, being physically active, and compression hose are all great ways to help prevent this unfortunate complication of varicose veins.
If you have an ulcer, or have had one in the past, seek medical help right away. Ask your healthcare provider about varicose vein treatments, and call our office for an appointment. Compression therapy and wound care is typical for venous ulcers, but this only treats the symptom. It does nothing to treat the cause. Treating the varicose veins, the cause of the ulcer, is crucial to achieve remission and to help prevent recurrence. Treatment of the ulcer itself without addressing the underlying cause will only result in short term improvement at best.
At Tennessee Vein Center we are experienced in the treatment of varicose vein disease and the related complications, including venous ulcers. If you or someone you know suffers from these conditions we can help! Call and schedule an evaluation today and let us help you love your legs again!
Written by: Chelsea Campbell, MSN, FNP-BC