Why leg ulcers happen – and how varicose veins may be to blame

A leg ulcer that doesn’t heal could be more than a skin issue, it’s often a sign of something deeper. In many cases, these wounds result from chronic venous insufficiency, commonly caused by untreated varicose veins. When blood flow in the legs is impaired, pressure builds up in the veins and damages surrounding tissue. Eventually, the skin can break down, leading to a venous leg ulcer.

At UK Vein Care, we specialise in treating the underlying vein conditions that cause venous leg ulcers. We don’t treat open wounds directly, but we help patients break the cycle by addressing what’s truly driving the problem: poor circulation due to damaged or failing veins.

What is a venous leg ulcer?

A venous leg ulcer is a chronic, slow-healing sore, most often found on the inside of the lower leg near the ankle. These ulcers occur when damaged veins allow blood to pool in the legs instead of flowing back to the heart. This increases pressure in the veins and surrounding tissues, eventually leading to skin breakdown.

This is one of the more serious long-term complications of untreated varicose veins or other forms of venous insufficiency. If left unmanaged, the wound can persist for weeks or months, returning again and again.

You can learn more about the underlying circulation problem in our article on venous insufficiency: symptoms, causes, and treatments.

Early signs and symptoms

A venous leg ulcer rarely starts as a dramatic wound. Most often, there are early warning signs—especially in people with varicose veins:

• Skin discolouration near the ankle (brown, red, or purplish patches)
  
• Dry, itchy, or flaky skin (venous eczema)
  
• Aching, heaviness, or pressure in the lower legs
  
• Swelling that worsens by evening
  
• A shallow open sore that weeps fluid and is slow to heal
  
• Hardened or thickened skin around the site
  

These signs are often dismissed until the wound becomes painful or infected. If you notice persistent swelling or skin changes, we recommend reading our article on swollen feet, ankles, and legs: causes, treatments, and tips.

How are varicose veins involved?

Varicose veins are a common and visible sign of venous insufficiency. When the valves inside the veins no longer function properly, blood flows backward and pools in the lower legs. This raises pressure in the venous system, damaging both deeper and superficial tissue over time.

The excess pressure doesn’t just cause bulging veins—it also affects nearby skin and fat layers, reducing oxygen supply and triggering inflammation. Eventually, the skin may break down, even after a minor injury, leading to a venous leg ulcer.

At UK Vein Care, we work with patients who’ve had ulcers—or are at risk—to treat the underlying vein disease and stop the damage before it worsens.

Who is most at risk?

You may be more likely to develop a venous leg ulcer if you have:

• Varicose veins (treated or untreated)
  
• A history of deep vein thrombosis (DVT)
  
• Swollen legs or ankles
  
• Limited mobility or long periods of sitting or standing
  
• Excess weight
  
• Older age
  
• Family history of vein disease
  
• Smoking or other factors affecting circulation
  

If you have discolouration or frequent unexplained marks on your legs, you may also find our article on unexplained bruising on legs useful for identifying other venous symptoms.

Treatment of venous leg ulcers

Treating a venous leg ulcer involves more than managing the wound itself. It’s essential to treat the underlying circulation issue. Otherwise, the ulcer is likely to return.

Compression therapy

Compression stockings or bandaging are key. They help reduce pressure in the veins and support blood return to the heart. Most patients with venous ulcers will need compression as part of their ongoing management.

Wound care

Ulcers should be cleaned, dressed, and monitored regularly. While UK Vein Care doesn’t provide direct wound care, we strongly recommend working with a wound specialist alongside your venous treatment.

Treatment for vein disease

Addressing the underlying cause—such as varicose veins—is often the missing piece. Minimally invasive procedures like endovenous ablation or foam sclerotherapy can restore healthy blood flow and prevent future ulcers.

We’ve written more about how to support healing naturally in our article on how to improve blood circulation in the legs.

What you can do at home

Even after medical treatment, you play an essential role in preventing recurrence. Everyday habits matter:

• Wear compression stockings daily as directed
  
• Stay active—gentle walking is ideal
  
• Elevate your legs when resting
  
• Avoid long periods of sitting or standing
  
• Moisturise dry or sensitive skin
  
• Check for early signs of discolouration or new wounds
  

Venous leg ulcers are often a long-term condition, but with the right approach, they don’t have to return.

When should you seek help?

You should speak to your GP or a vein specialist if:

• You have a sore on your leg that hasn’t healed in two weeks
  
• The wound is getting larger or showing signs of infection
  
• You have varicose veins or a history of venous issues
  
• You’ve had leg ulcers before
  
• You notice persistent leg swelling, skin changes, or heaviness
  

At UK Vein Care, we specialise in treating the underlying vein conditions that lead to venous leg ulcers, helping patients avoid future wounds and enjoy better circulation long-term.