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Leg Ulcers UK: Symptoms, Causes and How to Get the Right Treatment

Leg ulcers are painful and slow to heal. Learn the causes, symptoms and treatments available in the UK - and how to get faster specialist help.

Hebra Editorial Team

Hebra Journal

May 28, 20266 min read

If you have a wound on your lower leg that simply won't heal, you may be dealing with a leg ulcer. Leg ulcers are surprisingly common in the UK — there are estimated to be more than 100,000 active cases at any one time — yet many people are unsure what causes them, what the warning signs are, or how to access the right treatment quickly. In this guide, we explain everything you need to know about leg ulcers in the UK, from spotting the symptoms early to understanding your treatment options.

What Is a Leg Ulcer?

A leg ulcer is a chronic, open sore on the lower leg or foot that takes more than two weeks to heal. Unlike a regular cut or graze, a leg ulcer does not close up on its own, and without proper treatment it can persist for months — or even years.

There are several types of leg ulcer, but the most common by far is the venous leg ulcer, which accounts for around 70–80% of all cases. Venous ulcers are caused by problems with the veins in the leg, which leads to a build-up of pressure and eventually breaks down the skin.

Other types include:

Arterial leg ulcers — caused by poor blood flow to the legs, often linked to peripheral arterial disease
Mixed ulcers — a combination of venous and arterial causes
Diabetic foot ulcers — most common in people with poorly controlled diabetes

Leg Ulcer Symptoms: What to Look For

Recognising a leg ulcer early is important, because prompt treatment can significantly speed up healing. The most common signs of a venous leg ulcer include:

An open sore or wound on the lower leg, usually just above the ankle, that does not heal within two to three weeks
Pain, itching or heaviness in the affected leg, which may worsen when standing for long periods
Swelling of the lower leg and ankle
Discolouration or darkening of the skin around the wound (often brownish or reddish)
Hardened or tight skin around the ulcer — this is sometimes called lipodermatosclerosis
A discharge or crust forming over the wound

In some cases, the ulcer may become infected. Signs of infection include increased pain, warmth and redness around the wound, fever, and a foul-smelling discharge. If you notice any of these, it is important to seek medical attention promptly, as untreated infections can worsen significantly.

What Causes Leg Ulcers?

Venous Insufficiency

The most common cause of leg ulcers in the UK is venous insufficiency — a condition where the valves inside the leg veins stop working properly. Normally, these valves push blood upwards from the legs back to the heart. When they fail, blood pools in the lower leg, creating raised pressure in the veins. Over time, this pressure damages the small blood vessels near the surface of the skin, causing tissue to break down and ulcers to form.

Several factors increase the likelihood of developing venous insufficiency and venous leg ulcers:

Varicose veins — swollen, twisted veins near the surface of the skin that are a visible sign of venous valve failure
Previous deep vein thrombosis (DVT) — blood clots can permanently damage vein valves
Obesity — extra weight puts significant pressure on leg veins
Reduced mobility — being sedentary or having difficulty walking makes it harder for the calf muscles to help pump blood upwards
Age — vein valve damage tends to accumulate over time, so leg ulcers are more common in older adults
Previous leg injury or surgery

Arterial Disease

Arterial leg ulcers, while less common, occur when arteries supplying the legs become narrowed by fatty deposits — a condition known as peripheral arterial disease (PAD). This reduces blood flow and oxygen delivery to the skin, which can cause ulcers to develop on pressure points such as the heel, toes, and bony prominences.

How Are Leg Ulcers Treated in the UK?

Compression Therapy

For venous leg ulcers, compression bandaging is the cornerstone of NHS treatment. Compression bandages are designed to apply firm, graduated pressure to the lower leg — typically at least 40 mmHg at the ankle — which helps push blood upwards through the veins and reduces the build-up of pressure that causes tissue damage.

Compression can be delivered in several ways:

Multi-layer compression bandages — applied by a nurse in a community clinic and changed every one to two weeks
Compression stockings — used once the ulcer has healed to prevent recurrence
Compression hosiery kits — which some patients can apply themselves after training

Around 80% of venous leg ulcer care in the UK takes place in the community, managed by district nurses or specialist leg ulcer clinics. With appropriate compression, most venous leg ulcers heal within six months.

Wound Care

Alongside compression, wound care is essential. This typically involves:

Cleaning the ulcer and removing dead tissue (debridement)
Applying a suitable dressing to keep the wound moist and protected
Regular monitoring for signs of infection
Prescribing antibiotics if infection is confirmed

Treating the Underlying Veins

Evidence shows that treating the underlying venous disease — not just managing the wound — significantly speeds up healing and dramatically reduces the risk of recurrence. In the UK, this may involve:

Endovenous ablation — using heat (laser or radiofrequency energy) to seal damaged veins
Foam sclerotherapy — injecting a foam solution into the vein to collapse it
Surgical removal (less common today, but still used in some cases)

NICE guidelines recommend that patients with venous leg ulcers who have underlying venous reflux should be referred to a vascular service for assessment and intervention, ideally within two weeks of diagnosis.

Why Are Leg Ulcers So Difficult to Get Treated Quickly?

Despite being painful and debilitating, leg ulcers often fail to receive the urgent attention they deserve. Waits to see a vascular specialist via NHS referral can stretch from several weeks to many months, during which time the ulcer continues to deteriorate and the patient's quality of life suffers.

Even when community nursing care is available, the frequency of appointments may not always be sufficient for optimal wound management. Many patients describe a frustrating cycle of dressing changes without any clear treatment plan for the underlying cause.

This is where faster access to specialist advice can make a real difference.

When Should You See a Doctor?

You should contact your GP as soon as possible if:

You have a wound on your lower leg that has not healed within two to three weeks
The skin around the wound is discoloured, hardened or swollen
The wound is painful, particularly at night or when you lie down
You notice signs of infection (increased pain, redness, warmth, fever, or discharge)

Leg ulcers are unlikely to heal on their own. Early diagnosis and the right treatment plan are essential for faster recovery.

Get Faster Help with Hebra

Waiting months to see a specialist is not only frustrating — for leg ulcers, it can allow a treatable wound to worsen significantly. Hebra is a skin health triage app that allows you to share images and information about your skin condition and receive expert clinical triage within hours, not months.

Rather than waiting weeks for a GP appointment and then months for a specialist referral, Hebra connects you directly to dermatologists and clinical specialists who can assess your condition, advise on the right treatment, and help ensure you are on the fastest possible pathway to healing.

Try Hebra today at www.hebra.health and take control of your skin health without the wait.