Varicose Veins and Leg Ulcers: How They Develop and How to Prevent Them

Many patients think of varicose veins as only a cosmetic issue, but untreated vein disease can eventually lead to serious complications—including leg ulcers. Venous ulcers are open wounds that most commonly develop around the ankles and lower legs, and they can become painful, slow to heal, and prone to infection if not properly treated.

At the Vascular Center and Vein Clinic of Southern Indiana, board-certified vascular surgeon Dr. Ricardo Vasquez has over 20 years of experience treating varicose veins, venous insufficiency, and chronic leg ulcers. His office includes a fully accredited vascular ultrasound lab, allowing patients to receive immediate, in-office evaluation without hospital delays. Dr. Vasquez and Monroe Hospital were recognized as a Top 50 Vascular Surgery Hospital in the Nation by Healthgrades in 2024—the only hospital in Indiana with this distinction.

How Varicose Veins Lead to Leg Ulcers

Varicose veins develop when the valves inside the leg veins stop functioning properly. Instead of moving blood upward toward the heart, blood begins to pool in the lower legs. This creates increased pressure inside the veins, a condition known as venous hypertension.

Over time, this pressure damages the surrounding skin and tissue. Fluid leaks into the skin, causing swelling, inflammation, and discoloration. The skin may become itchy, hardened, or fragile. Eventually, even a small scrape, insect bite, or minor injury can lead to skin breakdown and the formation of a venous ulcer.

Most venous ulcers develop near the inner ankle, where venous pressure tends to be highest.

Early Warning Signs Before an Ulcer Forms

Leg ulcers rarely appear suddenly. Most patients develop warning signs beforehand, including:

• Persistent ankle swelling
• Brown or reddish skin discoloration
• Itching or irritated skin
• Thickening or hardening of the lower leg
• Aching, heaviness, or throbbing discomfort

These symptoms often indicate advanced venous insufficiency and should be evaluated before an open wound develops.

Why Venous Ulcers Are Difficult to Heal

Venous ulcers heal slowly because the underlying circulation problem remains present. Increased venous pressure limits oxygen delivery to the skin and prevents normal tissue repair. Swelling and chronic inflammation further impair healing.

Without treatment of the underlying vein disease, ulcers may repeatedly reopen even after appearing to heal temporarily.

Patients with venous ulcers are also at increased risk for infection, drainage, cellulitis, and chronic pain.

Preventing Leg Ulcers

The best way to prevent venous ulcers is to identify and treat venous insufficiency early. Patients with varicose veins, swelling, or skin changes should not wait until a wound develops to seek evaluation.

At Dr. Vasquez’s office, patients receive same-day vascular ultrasound to evaluate vein function and circulation. Because testing is performed in-office, patients avoid hospital scheduling delays and unnecessary facility fees.

Treatment may include minimally invasive procedures such as Venefit™ radiofrequency ablation, Varithena®, or sclerotherapy, which improve blood flow by closing diseased veins. Compression therapy, walking, leg elevation, and reducing prolonged standing may also help reduce venous pressure and protect the skin.

When to Seek Evaluation

If you have varicose veins along with swelling, skin discoloration, itching, or slow-healing wounds, it is important to seek evaluation early. These symptoms are often signs of progressing venous disease and may lead to ulcer formation if left untreated.

Patients do not need a referral and can schedule directly.

Call 812-336-6008 to schedule an appointment with Dr. Ricardo Vasquez at the Vascular Center and Vein Clinic of Southern Indiana. Early treatment of varicose veins can help prevent ulcers, improve circulation, and protect long-term leg health.