Leg ulcers are open sores that can occur when a wound breaks the skin and is then exposed to air or bacteria which prevent the wound from healing, or when such an infection arises in an unwounded leg. They can develop out of minor injuries or an ongoing disease which affects the veins in the legs. Where most wounds heal within a few days weeks at most, an ulcer instead grows larger and can take more than four to six weeks to heal.
Leg ulcers are often found on the inside of the leg above the ankle. Early and ongoing symptoms include pain, itching, and swelling of the affected area.You might also experience brown discoloration of the skin; hardened skin or scabbing; flaking, irritated skin; or worsening leg pain after long periods of standing. Pain can often be temporarily relieved by elevating the leg, exercising, or applying a compress.
Venous disease is the cause of around 80% of leg ulcers. Normally, veins are responsible for circulating blood out of your limbs and back up to your heart. However, veins weakened by disease can fail to pump all of the blood back up to the heart, which then increases the pressure in the veins. As a consequence, the skin in the area can become thin and inflamed, and venous ulcers can develop.
Similarly, a blockage in a leg artery can restrict blood flow into the leg, weakening the underlying tissue. Arterial disease is the cause of about 15% of leg ulcers.
Since leg ulcers are open, unhealing wound, they are at high risk of developing an infection and require careful care and cleaning. An infected ulcer can be identified by an increase in pain, by discharge from the ulcer (sometimes green, sometimes with an unpleasant smell), by red, swollen skin around the ulcer, or by a rise in temperature (either around the wound or a full-body fever).
If you notice any of the above symptoms, it is important to immediately report them to you doctor. Your doctor will conduct a physical examination and perform any other necessary tests to determine the cause and severity of the ulcer. For instance, a Doppler machine might be used to check the blood supply to your legs. If needed, your doctor may refer you to a vascular specialist for more specific care.