Leg ulcers are defined as an open lesion on the lower leg (originating on or above the ankle and below the knee) that have not healed within two weeks.

It is estimated that over one million adults live with a leg ulcer in the UK, which equates to approx.two per cent of the adult population.

Types of leg ulcer

The most common type of leg ulcer is a venous leg ulcer (approx. 76% of all cases).

Other types of leg ulcer include:

• Arterial - caused by the arteries not working correctly
• Mixed- this has elements of both of the above
• Diabetic - caused by high blood sugar
• Other causes - such as those associated with chronic inflammatory disorders e.g. rheumatoid arthritis.

Causes of Venous Leg Ulcers

Venous ulcers occur when damaged veins cause blood to flow backward, increasing pressure and leaking fluid that harms the skin, leading to ulcers.

Risk Factors

Key risk factors include:

• obesity,
• immobility,
• deep vein thrombosis (DVT),
• varicose veins,
• previous leg injury
• age (reduced circulation as you get older).

Symptoms

Venous leg ulcers often cause swelling, darkened skin, and hardened or itchy skin around the ulcer.  You may also notice fluid leakage or discomfort.

Diagnosis

A Doppler study is used to assess blood flow and rule out other conditions like arterial disease. This helps determine the most appropriate treatment.

Treatment

The primary treatment for venous leg ulcers is compression therapy, which involves bandages or stockings that help restore proper blood flow.

The ulcer is regularly dressed and reassessed, with dressings changing depending on the healing process. Elevating the leg reduces pressure, and gentle exercise can help circulation.

In rare cases, surgery, such as skin grafts or vein operations, may be necessary.

Infection

Infected ulcers may become:

• more painful, swollen, or hot.
• you may also notice a bad smell
• you might experience increased fluid leakage.

If this occurs, contact your nurse or GP, as antibiotics may be needed.

Self-Care

Staying active, elevating your legs, and wearing comfortable shoes and compression garments as instructed will aid healing.

Eating a balanced diet rich in protein can speed recovery, while smoking cessation is crucial for better circulation.

Managing Pain and Other Symptoms

For pain, paracetamol can help with mild discomfort, but stronger pain relief may be needed for more severe pain.

Swelling is managed through compression therapy and elevating the leg, while itching can be alleviated with moisturisers and mild steroid creams.

Preventing Recurrence

After healing, continue to care for your legs by maintaining a healthy weight, staying active, and following proper skin care.

You can also:

• wash your legs daily
• moisturise
• wear compression garments as prescribed
• have regular check-ups and Doppler studies every six months.

Support

If you're struggling with emotional distress or isolation due to ulcers, speak to your GP.