Leg wounds that will not heal are more common than many people realize, and venous leg ulcers are the most frequent type. These open sores usually develop on the lower leg, often near the ankle, and they can linger for weeks or months when the cause underneath them goes unaddressed. The encouraging part is that most venous leg ulcers respond well to consistent, evidence based care. The sooner treatment begins, the better the outlook tends to be.
At Precision Wound Centers, our wound care specialists in Los Angeles help patients understand why these ulcers form and how to close them for good. This guide walks through the causes, the standard treatments, the more advanced options, the signs of infection to watch for, and the point at which it makes sense to bring in a specialist.
A venous leg ulcer is a shallow, open wound that forms when the veins in the leg cannot return blood to the heart efficiently. Instead of flowing upward, blood pools in the lower leg and raises the pressure inside the veins. Over time that pressure damages the skin and the tissue beneath it, and even a minor bump or scratch can turn into a sore that refuses to close.
These ulcers typically appear on the inner part of the lower leg, above the ankle. The skin around them often looks discolored, feels firm or leathery, and may itch or ache. Because a venous ulcer is a type of chronic wound, it usually needs more than a simple bandage. Understanding what chronic wound care involves can help explain why steady, structured treatment matters so much.
The root cause of most venous leg ulcers is a condition called venous insufficiency. Healthy leg veins contain one way valves that keep blood moving toward the heart. When those valves weaken or become damaged, blood leaks backward and collects in the lower leg. As the National Library of Medicine explains, this pooling raises pressure in the veins and is the leading reason venous ulcers develop.
As the pressure builds, fluid and blood cells push out into the surrounding tissue. The skin may darken, swell, and grow thin and fragile. This is why a wound that would heal quickly on a healthy leg can become a stubborn ulcer when circulation is compromised. Swelling also makes it harder for oxygen and nutrients to reach the skin, which slows the body’s natural repair process and leaves the area vulnerable to breakdown.
Venous leg ulcers can affect almost anyone, but certain factors raise the odds. You may be more likely to develop one if you:
Having one or more of these risk factors does not make an ulcer inevitable. It does mean that any slow healing sore on the lower leg deserves prompt attention rather than a wait and see approach.
Compression is the cornerstone of venous ulcer treatment. Specially designed bandages or stockings apply gentle, graduated pressure to the leg, which helps the veins move blood upward and reduces swelling. Guidance summarized by the National Library of Medicine notes that consistent compression is central to healing venous ulcers. Compression is not right for every patient, though, especially those with certain artery problems, so it should always be guided by a clinician who has checked your circulation first.
Keeping the wound clean and appropriately moist supports healing. In practice that means gentle cleansing, a dressing matched to how much the wound is draining, and regular changes to protect the skin around the ulcer. The right dressing manages moisture, guards against bacteria, and creates a stable environment where new tissue can grow.
Raising the legs above the level of the heart for short periods through the day helps drain excess fluid and lowers vein pressure. Gentle movement matters just as much. Walking and simple ankle exercises activate the calf muscles, which act like a pump that pushes blood back toward the heart. Small, repeatable daily habits like these add up over the course of treatment.
When an ulcer is large, deeply established, or slow to respond, our wound care specialists can layer more advanced therapies onto the plan. These options draw on the fuller toolkit of advanced wound care and are chosen to fit the specific wound in front of us.
Debridement is the careful removal of dead or unhealthy tissue from the wound bed. Clearing away that tissue lowers the risk of infection and lets healthy cells take over the repair. Removing the barrier of dead tissue often gives a stalled ulcer the reset it needs to start healing again.
Beyond standard dressings, options such as specialized moisture managing dressings and skin substitute products can help difficult wounds move forward. These are selected based on the ulcer’s size, depth, and behavior, and they are adjusted as the wound changes rather than left in place indefinitely.
Closing the ulcer is only half the job. If the vein problem that caused it remains, a new ulcer can form later. That is why addressing the underlying venous insufficiency, sometimes with procedures that treat the faulty veins, is an important part of long term success. Treating the cause is what turns a temporary fix into lasting healing.
Any open wound can become infected, and catching it early makes a real difference. Reach out to a clinician promptly if you notice:
An infected venous ulcer needs timely care to prevent complications. If you are unsure whether what you are seeing is normal healing or a warning sign, it is always safer to ask. A quick check can spare you a much larger problem down the road.
Many small leg wounds heal on their own within a couple of weeks. A venous leg ulcer is different. As a general rule, a sore on the lower leg that has not shown clear improvement after two weeks, or a wound that keeps coming back, should be evaluated by a professional. The Wound Healing Society emphasizes that chronic wounds do best with structured, specialized care rather than a wait and see approach.
Our wound care specialists focus specifically on wounds that will not heal, and we build a plan around your circulation, your skin, and the realities of your daily life. If you are living with a persistent leg ulcer, learning what a wound care specialist does can help you decide on your next step. Seeking help early does not mean something has gone wrong. It simply gives the wound the best possible chance to close and stay closed.
A venous leg ulcer is driven by poor blood flow in the leg veins rather than by a single injury. It tends to be shallow, sits on the lower leg above the ankle, and heals slowly because the underlying vein pressure keeps working against it. Ordinary cuts or scrapes on healthy skin usually close on their own within a few days.
They most often form on the inner part of the lower leg, just above the ankle. The skin nearby is frequently discolored, swollen, or hardened, which reflects the long standing pressure inside the veins.
Healing time depends on the size of the ulcer, your overall circulation, and how consistently the treatment plan is followed. With steady compression and proper wound care, many venous ulcers improve over several weeks to a few months. Wounds that stall despite good care should be reassessed by a specialist.
Compression helps most people with venous ulcers, but it is not appropriate for everyone, particularly those with significant artery disease. That is why a clinician should assess your circulation before compression begins and choose the level of pressure that is right for you.
Yes. If the underlying venous insufficiency is not managed, a new ulcer can form. Wearing prescribed compression stockings, staying active, elevating the legs, and following up on the vein condition all lower the chance of a recurrence.
Watch for growing pain, spreading redness or warmth, yellow or green drainage, a foul odor, worsening swelling, or fever. If any of these appear, contact a wound care provider promptly, because an infected ulcer needs timely treatment.
Any leg sore that has not clearly improved within two weeks, keeps returning, or shows signs of infection should be evaluated. Early specialist care often shortens healing time and reduces the risk of complications.
Precision Wound Centers provides specialized care for chronic and complex wounds across Los Angeles, including diabetic and vascular ulcers and hyperbaric oxygen therapy. Learn more at Precision Wound Centers.
* Illustrative images on this page are models, not actual patients. Real patient results are shown in our Before & After gallery.