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Venous ulcers
A venous ulcer is a wound on the lower leg, almost always near the ankle, that takes weeks or months to close because the veins do not return blood well and the pressure inside them stays high. It is the most common cause of leg ulcers. They heal better when both the wound and the venous cause are treated.
In summary
- They start from venous insufficiency that has not been treated or from the aftermath of a thrombosis.
- Before treating them, circulation in the veins and arteries is studied with Doppler ultrasound.
- Treatment combines wound care, compression and correction of the venous cause.
- A wound with fever, bad odor, pus or increasing pain needs prompt attention.
What is a venous ulcer?
It is a loss of skin that appears when the leg veins cannot return blood to the heart (chronic venous insufficiency). Blood pools, pressure rises and, over time, the skin is damaged until it breaks open. A knock or a small scrape can be the starting point, but the underlying cause is venous.
How to recognize it
- It is usually located on the lower leg, often on the inner side of the ankle.
- It is a shallow wound with irregular edges, a reddish or yellowish base and some discharge.
- The surrounding skin is often dark, hardened, eczema-like or swollen.
- It may hurt, but often less than other ulcers, and the pain usually eases when the leg is raised.
Not every leg ulcer is venous. Arterial ulcers usually hurt more (especially at night), with a cold or pale foot. That is why it is important to have them assessed by a specialist.
Causes and risk factors
- Chronic venous insufficiency or varicose veins that have not been treated.
- Aftermath of a deep vein thrombosis.
- Excess weight, limited mobility and long periods of standing or sitting.
- Age and a history of previous ulcers.
How it is diagnosed
The doctor examines the wound and the leg and studies circulation with a venous and arterial Doppler ultrasound. This study shows which veins are failing and also confirms that the arteries are healthy, which is key before recommending compression. If the ulcer does not improve or looks unusual, other tests such as a culture or a biopsy may be requested.
Treatment
Ulcers heal better when three aspects are addressed together:
1. Wound care
Cleaning, removal of tissue that cannot recover and dressings suited to each stage. Care should be prescribed and monitored by a health professional.
2. Compression
This is the foundation of treatment: bandages or stockings that help blood flow upward and reduce swelling. It is prescribed once a significant arterial problem has been ruled out and it must be well fitted.
3. Treating the venous cause
Closing the veins with reflux, using sclerotherapy or ultrasound-guided endovenous treatment, helps the ulcer close and come back less often.
If there is an infection, it is treated with the medications your doctor prescribes.
Care at home
- Raise your legs several times a day.
- Walk daily: calf movement helps circulation.
- Use the compression you were prescribed, every day.
- Moisturize the healthy skin around the wound.
- Do not self-medicate with creams or antibiotics and do not change treatment on your own.
- Keep a healthy weight and attend your check-ups.
What to expect
Healing time varies with the size of the ulcer and its cause: it can take weeks or months and requires consistency. Once closed, it can come back if the venous cause persists; that is why treating the veins, using compression and having regular check-ups are important.
When to seek urgent care
- Fever, bad odor, pus, spreading redness or increasing pain.
- A cold, pale or purple foot or leg.
- Bleeding that does not stop or an ulcer that grows quickly.
- Any wound on the leg or foot in people with diabetes.
Frequently asked questions
Does a venous ulcer heal on its own?
Rarely. If the venous cause is not treated, it usually takes a long time to close or comes back. An early assessment is advisable.
Is it contagious?
No. It comes from a circulation problem in the leg, not from a germ that can pass to other people.
Why does it come back?
Because the high pressure inside the veins is still there if it is not corrected. Treating the veins and keeping up compression reduces recurrence.
Can I walk if I have an ulcer?
In general yes, and it is usually recommended because movement improves circulation. Your doctor will tell you what is right for your case.
Do home remedies work?
They do not replace a medical assessment. Some products can irritate the wound or delay healing. Ask before using them.
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Book via WhatsAppThe information on this page is general and for guidance only. It does not replace a medical consultation. If you have a warning sign, go to the emergency department. The pages are written for patients in Colombia; consultations are in Spanish.
Last updated: October 15, 2026