Varicose Ulcers

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Varicose ulcers are open wounds, which are caused by varicose veins and take a long time to heal. They cause severe pain as well as itching and inflammation. Varicose leg ulcers are common types of leg ulcer and are caused by increased pressure in the veins, which damages the skin.

Symptoms and Diagnosis of Varicose Leg Ulcers

A varicose leg ulcer is an area of broken skin, which exposes the underlying tissue and is non- healing. Symptoms of this include:

  • Swollen ankles which can hold the print of an object when pressed
  • Discolouration of the skin around the ulcer
  • Hardened skin around the ulcer
  • Patches of smooth, white skin with red spots
  • Leg pain, which can be sporadic or continuous
  • Heaviness in the leg
  • Aching
  • Itching

Varicose leg ulcers can become infected which can lead to:

  • Increased pain
  • Increased temperature to at least 38 degrees centigrade
  • The development of a painful, tender and inflamed area around the ulcer

If you have any of the above symptoms, you should seek immediate medical advice so that your ulcer can be treated and the risk of infection can be minimised. The ulcer will be diagnosed through a physical examination and can be confirmed using a Doppler ultrasound test.

Causes of Varicose Leg Ulcers

Varicose leg ulcers are caused by increased pressure in varicose veins, which can cause fluid to build up under the skin. This becomes inflamed and hard and when it breaks it leads to an ulcer.

Treatment of Varicose Ulcers

Varicose ulcers must be treated to ensure that they do not become infected. The treatment will involve both the application of pressure through a bandage or stocking, and the treatment of the underlying varicose vein.

You will need to be examined to ensure that your arteries are functioning properly, as compression can cause gangrene if you have arterial problems. Compression bandages or stockings are effective in healing around 70 % of varicose ulcers within half a year.

Ulcer dressings are also applied to allow the ulcer to heal. The ulcer will first be cleaned with salt water, or warm water to remove the dead tissue and any dirt inside the ulcer. If there is too much dead tissue it may need to be pulled away, or dissolved using chemicals. This will be done under a local anaesthetic so that it does not cause you any discomfort. A basic dressing will then be applied to your ulcer to make it more comfortable and aid the healing process.

Infected Varicose Ulcers

If your varicose ulcer becomes infected it will become extremely painful, inflamed, and will produce huge amounts of pus. This will be cleaned and dressed in the same way that an uninfected venous ulcer would be. Compression may be applied but this may be made impossible if the ulcer causes too much pain. You will be prescribed antibiotics for the infection and will need to return to your doctor or nurse on a daily basis so that they can monitor your ulcer.

Treating the Associated Symptoms of Varicose Ulcers

Varicose ulcers can have symptoms, which are not treated through the treatment of the ulcer itself. Pain can be relieved using pain- killers and you may require prescription drugs to tackle severe pain. You may also suffer from itching around the venous ulcer caused by varicose eczema, which will require treatment with an emollient or corticosteroid medication.

After Your Varicose Ulcer Has Healed

After your varicose ulcer has healed, you will need treatment for your varicose veins to prevent further ulcers from developing. This may be achieved using compression socks but you may require more radical treatment such as surgery, sclerotherapy, radiofrequency ablation, or laser treatment. Without further treatment, there is a 25 % chance that you will develop another varicose leg ulcer within two years.

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