Henry VIII, Venous Leg Ulcers, and You: A Royal Pain in the Leg

Henry VIII ruled England for 38 years, collected six wives, and helped reshape the Anglican Church. He also suffered from venous leg ulcers for the last two decades of his life.

It started in 1527, when a jousting accident left a wound on his leg that court physicians recorded as his "sorre legge." It never fully healed. Over the following two decades, the ulcers spread to both legs, turned purulent and foul-smelling, and required his physicians to lance them regularly with red-hot irons. By 1546, ambassadors reported that they could smell the infection from three rooms away before the King arrived. Henry VIII died on January 28, 1547, most likely from sepsis driven by his chronically infected venous leg ulcers.

His story is extreme. But venous leg ulcers are not a relic of Tudor medicine. According to PubMed, close to 500,000 Americans are living with venous ulcers right now, and an estimated 2 to 6 million have the advanced chronic venous insufficiency (CVI) that leads to them. Most start with symptoms they dismissed for years: aching legs after a long shift, swelling that showed up by evening, varicose veins they figured were just cosmetic—no jousting required.

This article explains how vein disease progresses to venous leg ulcers, what warning signs to watch for, and what modern treatment can do — things Henry VIII never had access to, but you do.

Center for Vein Restoration (CVR) is the nation's largest physician-led vein practice, with 130+ locations across 23 states. CVR's board-certified physicians specialize in diagnosing the underlying cause of leg symptoms and treating venous disease with minimally invasive, outpatient procedures. From varicose veins and chronic venous insufficiency to venous leg ulcers, CVR provides comprehensive care at every stage of vein disease.

If your legs are trying to tell you something, now is the time to listen. If you're experiencing leg pain or swelling, or suspect a venous ulcer, don't wait!

Call 240-249-8250, find a CVR location near you, or schedule a consultation today!

What Henry VIII Teaches Us About Vein Disease

Henry may not have been born with dysfunctional veins. Medical historians now believe his venous disease developed gradually, driven by a combination of injuries, immobility, and a lifestyle that would alarm any modern cardiologist.

The jousting accident of 1536 appears to have been the turning point. Henry was thrown from his horse at Greenwich, the fully-armored horse landing on top of him. He lost consciousness for two hours. His legs were crushed. According to research published in the Journal of the Royal Society of Medicine, the most likely result was deep vein thrombosis (DVT), a blood clot in the deep veins of the leg, caused by crush injury, probable fracture, and the immobility that followed. 

We know that DVT damages the valves in the veins. Damaged vein valves cause chronic venous hypertension. Chronic venous hypertension, left untreated, causes venous leg ulcers. And for Henry, the progression was relentless. 

As Henry's pain increased, his mobility decreased. As his mobility decreased, his weight climbed — from roughly 220 pounds in his twenties to an estimated 400 pounds by the time of his death, with his waist expanding from 32 inches to 52 inches. Obesity placed even more pressure on his already-failing venous system. His physicians, working with the medical knowledge of the 1540s, had nothing to offer but cautery with red-hot irons and open drainage of the infected wounds.

These words were treasonous enough to get a man beheaded. They were also medically accurate:

"He has a sorre legge that no poor man would be glad of, and he shall not live long." — Witnesses at the 1537 treason trial of the Marquis of Exeter, speaking of the King's condition

Today, Henry’s disease progression is entirely preventable. But only if vein disease is caught and treated before it reaches the ulcer stage.

What Is Chronic Venous Insufficiency, and How Does It Lead to Ulcers?

Chronic venous insufficiency is a condition in which the one-way valves inside your leg veins stop working correctly. Healthy valves push blood upward toward the heart and keep it from falling back down. When those valves weaken or fail, blood pools in the lower legs, raising pressure inside the veins.

According to the National Library of Medicine (StatPearls), CVI is a progressive disease. Left untreated, it typically progresses through stages: from mild swelling and varicose veins to skin changes and, finally, to open wounds. An estimated 25 million Americans have varicose veins, and according to PubMed, nearly 500,000 are living with painful venous ulcers — the most advanced and costly stage of the disease.

The lower leg, especially the area just above the ankle, is the most vulnerable spot. That area bears the greatest venous pressure when you are upright. Over time, the constant pressure weakens the skin from the inside. The skin thickens, darkens, and eventually tears. That tear is a venous leg ulcer.

The table below shows how CVI progresses from early disease to an open ulcer:

Don't let vein disease go from bad to worse. CVR vein experts use duplex ultrasound to find the root cause of your leg symptoms — before they have a chance to progress. Visit centerforvein.com for more information or call 240-249-8250. To schedule a consultation at one of CVR's 130+ locations across 23 states, click on the link below ⬇️

Warning Signs of Venous Ulcer You Should Not Ignore

Most people with CVI do not start with a wound. They start with symptoms that are easy to dismiss. Johns Hopkins Medicine notes that venous leg ulcers are caused by conditions such as varicose veins and CVI, in which blood pools in the lower legs and exerts extreme pressure on the skin.

Symptoms to watch for include:

• Leg aching or heaviness that worsens after standing or sitting for long periods
• Swelling in the lower leg or ankle that gets better when you elevate your feet
• Skin that is darkening, thickening, or developing a brownish discoloration near the ankle
• Itching or a dry, flaky rash on the lower leg (called stasis dermatitis)
• A small wound near the ankle that is slow to heal

That last point matters. Venous leg ulcers do not always cause severe pain in the early stages, which is part of why they go untreated. A wound that seems minor but lingers for more than two weeks deserves a proper evaluation.

Who Is at Higher Risk for Vein Disease?

Anyone can develop CVI, but certain factors significantly increase the risk. Henry VIII checked several of them: immobility due to chronic pain, obesity, a history of lower leg injury, and likely deep vein thrombosis (DVT, a blood clot in a deep vein).

Other common risk factors include:

• A family history of varicose veins or vein disease
• Jobs that require prolonged standing or sitting
• Prior pregnancy
• Older age (risk increases significantly after 50)
• Obesity
• Prior DVT or blood clot

According to a PubMed study, varicose veins are more common in women, whereas venous ulcers are more common in men. Henry VIII's case fits that pattern precisely.

How Vein Disease and Venous Leg Ulcers Are Treated Today

The modern approach to vein treatment is nothing like Tudor medicine. 

CVR physicians begin with a duplex ultrasound, a non-invasive imaging test that maps blood flow in your veins and identifies where the valves have failed. This tells the vein expert exactly which veins are causing the problem.

Vein treatment focuses on the root cause. The Cleveland Clinic notes that venous ulcers can take several months to heal, and that managing the underlying vein condition is central to recovery. Treating only the surface wound without addressing the underlying venous insufficiency that drives it leads to recurrence.

CVR uses minimally invasive, outpatient procedures to close off or destroy faulty veins. Options include thermal ablation (using heat), chemical ablation (sclerotherapy, or targeted injections), and medical adhesive (a type of medical glue). Once the malfunctioning veins are treated, blood reroutes through healthier vessels and pressure in the lower leg drops.

For patients who already have an open ulcer, treatment runs on two tracks at once: wound care to clean and protect the wound, and compression therapy to reduce swelling and allow the skin edges to come back together. Treating venous insufficiency at the same time is what prevents the ulcer from coming back.

CVR diagnoses the underlying cause of leg symptoms and treats the venous component. When additional specialists are needed, CVR physicians refer patients to the appropriate care.

The Cost of Waiting

Henry VIII had no treatment options. You do. The gap between early CVI and a venous leg ulcer is not a matter of bad luck — it is a matter of time and intervention.

If you have visible varicose veins, leg swelling that gets worse through the day, skin changes near your ankles, or a wound that is not healing, those are not symptoms to watch and wait on. A vein specialist can determine whether venous insufficiency is driving them and whether treatment makes sense.

History's most famous venous ulcer patient did not have that option. You do.

Don't let vein disease become your own sorre legge. CVR's board-certified physicians offer minimally invasive, outpatient vein treatment at 130+ locations across 23 states. Visit centerforvein.com for more information, or schedule a consultation below.

Q: What does a venous leg ulcer look like?
A: A venous leg ulcer is an open wound, typically located on the lower leg just above the ankle. It often has irregular edges, may weep fluid, and is surrounded by skin that looks darkened, thickened, or discolored. These wounds are often large, wet, and surprisingly less painful than they appear.

Q: Can venous leg ulcers heal on their own?
A: They rarely do without medical treatment. Because the underlying cause is venous insufficiency (faulty vein valves creating pressure), the wound will not close permanently until that pressure is addressed. Compression alone can help, but treating the faulty veins is typically necessary to prevent recurrence.

Q: How is chronic venous insufficiency different from varicose veins?
A: Varicose veins are a visible symptom of vein valve problems. Chronic venous insufficiency is the broader condition those faulty valves cause. Not everyone with varicose veins will develop CVI, but varicose veins are a sign that the venous system is under stress. The National Library of Medicine describes CVI as a progressive disease that can advance from varicose veins to skin changes to ulcers if left untreated.

Q: Is venous disease hereditary?
A: There is a strong genetic component. Family history of varicose veins or venous insufficiency is one of the most consistent risk factors in the research literature. If a parent had significant vein disease or venous ulcers, your own risk is meaningfully higher.

Q: What kind of doctor treats venous leg ulcers?
A: A vein specialist, or phlebologist, is trained to diagnose and treat the venous insufficiency that causes leg ulcers. CVR physicians are board-certified in venous and lymphatic medicine and use duplex ultrasound to map the venous system before designing a treatment plan. Treatment for the ulcer itself often involves wound care in coordination with venous treatment.