What are leg ulcers?

Written by: Mr Ian Franklin
Published: | Updated: 08/10/2019
Edited by: Laura Burgess

Leg ulcers are wounds that form most commonly on the lower part of the leg around the ankle. They can be very painful, unpleasant and debilitating. There are many causes of a leg ulcer but by far the most common is faulty veins, either varicose veins or veins damaged by scarring from an old blood clot.


Are there any risk factors for leg ulcers?

Varicose veins are the main risk factor. Increasing age, obesity and poor mobility are also important. There are many other causes of leg ulcers including blocked arteries, blocked veins, faulty peripheral nerves, diabetes, infections, inflammation in skin/blood vessels and some skin cancers. It is very important as soon as an ulcer appears to determine what the underlying cause is. This invariably requires assessment by a vascular specialist to check the underlying circulation.

What is the treatment for leg ulcers?

Successful treatment of a leg ulcer requires an accurate diagnosis of the underlying cause with a specialist such as a vascular surgeon. Treatment by dressings and antibiotics alone is not enough. A Doppler ultrasound scan is vital to assess the underlying circulation and determine whether treatment is needed to correct faulty veins and sometimes arteries.

For many people, the ulcer is helped by applying compression bandaging. This can make the leg much more comfortable and promotes healing. Leg ulcers heal more quickly if, in addition to good compression bandaging, the underlying vein problem is treated. This can usually be done as an outpatient under local anaesthetic without admission to hospital.

Can the ulcer come back?

This depends on the cause of the ulcer. Venous leg ulcers (the commonest variety) are much less likely to come back if the veins which caused the problem are properly treated. Ulcers often come back if they are treated with dressings without identifying and treating the underlying cause.


If you think that you might have a leg ulcer, make an appointment with Mr Ian Franklin.

By Mr Ian Franklin
Vascular surgery

Mr Ian Franklin is a full-time private venous specialist, whose areas of expertise include varicose and thread veins, aesthetic phlebology, pelvic vein congestion, deep vein thrombosis, phlebitis, leg swelling and leg ulcers. He is also an expert in the management of COVID-related thrombosis.

Mr Franklin practised as an NHS doctor for 23 years, which included 12 years as consultant vascular surgeon at Imperial College NHS Trust where he performed a full range of arterial, venous and emergency vascular surgery. During this time, he also introduced many minimally invasive techniques and treatments to the NHS. For 10 years, Mr Franklin was also a programme director of the world-renowned, annual International Charing Cross Venous Course in which 5,000 surgeons attended every year.

As well as chairing the Circulation Foundation, a UK vascular disease charity, Mr Franklin was a former council member of the Vascular Society of Great Britain and Ireland for around 4 years. He is now the President of the Royal Society of Medicine Venous Forum and trains other specialists in modern vein techniques all over the world. Throughout his career, he has also written many scientific papers, book chapters and a surgical textbook.

Mr Franklin is one of a very small number of vascular surgeons in the UK with extensive acute COVID-19 experience. At the beginning of the coronavirus pandemic, Ian Franklin returned to the NHS Charing Cross Hospital after suspending his private practice and spent several weeks on the frontline attending COVID-19 patients. During which, it became clear that many of those with COVID-19 develop thrombotic (blood clot) problems that can lead to serious effects on blood circulation. Ian Franklin has now reopened his private practice.

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