Venous Leg Ulcers

Vein disease is often painful and unsightly. This is what the great majority of patients with varicose and spider veins experience. However, approximately 8% of patients with vein disease develop complications. Among the complications of venous disease are bleeding, phlebitis and venous leg ulcer.

Venous leg ulcers result from the very slow venous outflow from failed veins so impeding arterial inflow that circulation is markedly impaired in the skin. Increased pressure inside the vein causes white blood cells to migrate through the vein wall into the skin inflaming the skin. The skin at first gradually darkens and thins. Ultimately, an ulcer develops. This usually occurs on the inside of the ankle. This is considered end stage vein disease i.e. the worst case scenario of untreated severe venous insufficiency. Venous leg ulcers can take many months to heal and frequently tend to recur if the underlying venous insufficiency is not addressed.

Bleeding can occasionally be severe as large amounts of blood stored in varicose veins can drain quickly through small cuts in small spider veins about the ankles. Bleeding can usually be stopped with elevating the limb and applying direct pressure. Any episode of heavy bleeding should be evaluated by a physician.

Phlebitis is clot forming in the slow moving blood of varicose veins which may be precipitated by minor trauma but often occurs spontaneously. These clots are painful and cause tender swollen cords which should be evaluated by a physician. Thankfully, in most instances, the clots are confined to the superficial veins of the skin and are not dangerous but this must be determined by a physician. Clots extending to the deep venous system are potentially threatening to both life and limb.

“The patient pictured to the right suffered with an open venous leg ulcer for over a year.  The ulcer measured over 3 ½ x 2 ½ inches.  The “after” picture was taken 8 weeks after a single treatment-endovenous laser ablation.  The ulcer is closed after being an open wound for over 12 months.  The skin is irreversibly scarred and darkened but the disease will not continue to progress and the ulcers should not recur.”