What are leg ulcers?

Leg ulcers are areas of the lower leg, ankle or foot where the skin has broken down and the underlying tissue is exposed. Some people refer to these as “open sores”.

In normal healthy people, the skin covers the whole of the surface of the body protecting the insides away from the outside environment. When the skin is ever broken, such as in a graze or cut, in normal healthy people a scab is formed and new skin grows underneath the scab healing the wound.

In patients with leg ulcers, something has gone wrong with this natural process and the wound does not heal. As such, it remains open. This open ulcer, which can be regarded as a chronic open wound or open sore, can get infected and can ooze a lot of fluid.

Ulcers can be big or small, painful or not painful, smelly or not smelly, wet or dry. There are a great many different appearances of ulcers when looked at on the surface and this has resulted in a lot of confusion particularly in nurses and dermatologists who only look at the surface.

Apart from checking that there is nothing a very abnormal with the leg ulcer, such as a rare skin cancer growing in it, there is very little of use that can be found just from looking at the surface of the leg ulcer. Certainly, it is impossible to tell which are curable or incurable from looking at the surface alone.

To understand leg ulcers, and to cure them, what they look like on the surface is virtually irrelevant. What is needed is to understand the underlying cause and then use specialist ultrasound investigations to identify the underlying cause and to direct treatment are to cure the ulcer.