Leg ulcers are commonly found on the ankle and the lower legs. They appear as an asymmetrical wound with clear edges. Around the ulcer, the skin may be inflamed or hardened and pigmented. Leg ulcers may contain pus and are very painful, especially when standing or walking. There are many reasons why leg ulcers form but the most common causes are related to the health of the veins – deep vein thrombosis and ulceration of the veins.
Your veins are responsible for carrying deoxygenated blood back from the body to the heart. As the muscles around the veins contract, blood is pumped towards the heart and prevented from moving backwards with the help of one-way valves. The calves act as powerful muscular pumps to counteract the effects of gravity and push the blood upwards.
Problems with the veins such as blockages or venous insufficiency can hinder this pumping action and cause a pooling of blood in the lower extremities. As the blood collects, it causes inflammation of the surrounding tissues and leg ulcers.
While it is not known exactly how poor vein circulation can cause a leg ulcer, a popular theory states that as the blood pools in the legs, white blood cells collect and get trapped in the narrow capillaries and destroy the nearby skin cells and tissues. This may also account for the high levels of white blood cells found in the pus of leg ulcers. There are certain factors that increase a person’s chance of developing leg ulcers such as age, the presence of varicose veins or any form of arterial disease, and other medical conditions such as arthritis or diabetes. Smokers and those who take certain medications such as cardiovascular drugs are also prone to leg ulcers due to compromised circulation.
Treatment for a venous leg ulcer must begin with cleaning the wound well to remove any dead tissues. Since ulcers heal better when they are covered, you will need to dress the wound well and change the dressing on a weekly basis. There are a number of specialized products available that are customized for different stages of wound healing. Doctors also recommend the use of compression garments such as bandages or stockings that maintain a uniform level of internal pressure within the leg and encourage proper circulation.
Medications for leg ulcers usually include painkillers, topical leg ointments, and antibiotics (in case an infection has developed). Other ways to soothe a leg ulcer include:
In rare cases, surgery may be required to treat leg ulcers. Such surgery involves either an operation on the veins or a skin graft. In most cases however, leg ulcers do heal in three to four months with the proper treatment and care.