Why Do I Have Sores on My Legs?

If you've noticed a sore on your lower leg or ankle that doesn't seem to be healing, it's not just a skin problem. Slow-healing leg sores are often among the most visible signs of vein disease developing beneath the surface.

These sores are often venous ulcers, and they affect a significant number of Americans. According to research published in a 2023 NIH-indexed review, more than 25 million adults in the United States live with chronic venous insufficiency (CVI), and venous leg ulcers affect as much as two percent of the general population. The financial toll is equally striking: venous ulcer care costs the U.S. healthcare system an estimated $3 billion annually.

The encouraging news is that venous disease is treatable. When caught and addressed by a qualified vein expert, even stubborn leg sores can heal. 

That’s why we consulted Todd Jones, MD, a board-certified vein specialist leading Center for Vein Restoration (CVR) vein center in Happy Valley, Oregon, about what causes sores on legs, how to recognize the symptoms, and when to see a vein doctor.

Not sure if your leg pain is related to vein disease?Take CVR's Vein Quiz for a quick, personalized assessment.

What Are Venous Ulcers?

Venous ulcers are open wounds that typically develop on the lower leg, most often just above the ankle on the inner side. According to MedlinePlus, published by the U.S. National Library of Medicine, they are the most common type of chronic leg ulcer, particularly in older adults and people with venous insufficiency or varicose veins.

Unlike a cut or scrape that heals within days, a venous ulcer can persist for weeks, months, or even years without proper treatment. The same vein disease that causes the wound also blocks the nutrient-rich blood flow needed to heal it, creating a cycle that is very difficult to break without medical care.

Venous ulcers account for roughly 70 percent of all chronic lower-limb ulcers, according to NIH-published research, and they have a well-documented tendency to return, with recurrence rates ranging from 54 to 78 percent. That's why treating the underlying venous disease is just as important as treating the wound itself.

What Causes Sores on the Legs?

To understand the causes of sores on the legs, it helps to understand how healthy leg veins work. Your leg veins rely on tiny one-way valves to help keep blood flowing upward, against gravity, back toward the heart. When those valves weaken or become damaged, blood flows backward and pools inside the veins. This condition is called chronic venous insufficiency.

As blood pools, pressure builds inside the veins. That pressure, known as venous hypertension, causes fluid to leak out of the vein walls into the surrounding tissue. The result is swelling, skin changes, and eventually, breakdown of the skin itself.

Research published in the Journal of Clinical Medicine explains that leaking proteins trigger a local inflammatory response in the tissue, which further injures the skin and creates conditions in which an open sore can develop and struggle to close. Once an ulcer forms, poor circulation delays healing because oxygen and nutrients can't reach the damaged area efficiently.

Common risk factors for venous insufficiency and venous ulcers include advanced age, a personal or family history of varicose veins or deep vein thrombosis (DVT), prolonged sitting or standing at work, obesity, pregnancy, a sedentary lifestyle, and tobacco use. A 2025 case study in Cureus notes that venous hypertension caused by valve incompetence is the primary driver, with lifestyle and environmental factors accelerating the disease course.

Symptoms Checklist: Signs You May Have a Venous Ulcer 

Venous ulcers rarely appear without warning. Vein disease tends to progress in stages, and earlier signs typically appear before a wound opens. NIH StatPearls identifies the following as key warning signs:

Early warning signs of CVI:

• Aching, heaviness, or tiredness in the legs, especially after standing
• Swelling in the lower legs or ankles that worsens throughout the day
• Visible varicose veins
• Itching or irritation on the lower leg
• Skin that looks thin, shiny, or discolored (reddish-brown or tan)

Signs a venous ulcer may be forming or present:

• A shallow open wound on the inner ankle or lower leg
• A wound with a red or pink base, sometimes covered by yellow tissue
• Skin around the wound that feels tight, leathery, or hardened
• Wound drainage with or without an odor
• Leg pain that improves when you elevate your legs (a hallmark feature that distinguishes venous ulcers from arterial wounds)
• Swelling around the ulcer site

If any of these symptoms sound familiar, a board-certified CVR vein expert can evaluate what's happening beneath the skin and build a treatment plan.

Ready to take the next step? Schedule a Consultation with a CVR vein physician today ⬇️

Get Expert Vein Care at CVR

Venous ulcers are a serious complication of vein disease, but with the right diagnostics and a treatment plan that targets the root cause, wound healing is achievable, and recurrence is preventable.

Center for Vein Restoration is the nation's largest physician-led vein center, with locations across the country staffed by board-certified specialists. Whether you are managing an active leg sore, noticing early warning signs, or dealing with a recurring condition, CVR has the expertise to help.

📍Find a Center for Vein Restoration near you HERE

📞 Call Center for Vein Restoration at 240-249-8250

📅 Or, book an appointment at CVR online HERE

When to See a Vein Doctor

Many people wait far too long before seeking care for leg sores. If you have a wound on your lower leg or ankle that shows no signs of healing within two weeks, don't wait to seek evaluation.

Seek prompt evaluation if you notice:

• A sore on your leg or ankle that is not healing
• Increasing pain, warmth, or redness around a wound
• Signs of infection such as fever, increased drainage, or a persistent odor
• Skin on your lower leg that has changed color, texture, or thickness
• Significant leg swelling that is new or getting worse

Who treats leg sores caused by vein disease? A vein doctor, also called a phlebologist or vascular specialist, is trained specifically to diagnose and treat conditions related to venous disease. At Center for Vein Restoration, our physicians are board-certified specialists who use advanced diagnostic tools, including duplex ultrasound, to map the venous system and pinpoint the exact source of the problem.

It’s important to understand that treating only the surface wound without addressing the underlying vein disease is one of the main reasons venous ulcers return. Getting an accurate diagnosis from a vein expert is the critical first step.

📍Find expert vein care close to home. Find a CVR Location Near You to connect with a CVR vein specialist.

How Venous Ulcers Are Treated

Treating a venous ulcer requires addressing both the wound and the vein problem underneath it.

Wound care. Active ulcer management typically includes regular wound cleaning and dressing to keep the wound moist and protected. In some cases, removing damaged tissue (called debridement) is necessary to promote healing. If infection is present, your physician may prescribe topical or oral antibiotics.

Compression therapy. Compression is considered the cornerstone of venous ulcer treatment. Compression stockings and bandages apply graduated pressure to the leg, which helps counteract the venous hypertension that contributes to the wound. A 2024 Cochrane systematic review confirmed that compression therapy significantly reduces venous ulcer recurrence, and most ulcers will heal with consistent, properly applied compression. Elevating the legs for periods throughout the day also supports healing by reducing swelling.

👉Visit the CVR Compression Stocking Store for medical-grade options recommended by vein specialists.

Treating the underlying vein disease. Once the wound is stable or healed, addressing the underlying vein disease is critical to prevent recurrence. Minimally invasive outpatient procedures can close the damaged veins responsible for venous hypertension. These include: 

• Radiofrequency ablation
• Endovenous laser ablation
• Endoadhesive ablation
• Ultrasound-guided foam sclerotherapy
• Ambulatory phlebectomy 

When the diseased veins are treated, circulation improves, and the risk of future ulceration drops significantly.

Preventing Leg Wound Recurrence

Because venous ulcer recurrence is so common, long-term prevention is an essential part of any treatment plan.

Wear compression stockings consistently. Continuing to wear compression stockings after an ulcer has healed is one of the most evidence-supported strategies for preventing a new wound. CVR's compression stocking store carries medical-grade options to support your ongoing vein health.

Exercise regularly. Walking for 30 minutes a day strengthens the calf muscles that help pump blood through the veins in the legs. Swimming and cycling are also excellent low-impact options for circulation.  Additionally, breaking up long periods of standing or sitting (greater than 90 minutes) with intermittent bouts of ambulation (5-15 minutes) can help reduce venous pooling and resting venous pressures.

Manage your weight. Excess body weight places additional pressure on the leg veins. Even modest weight loss can reduce that burden and improve venous blood flow.

Treat varicose veins early. Varicose veins are often an early sign of the same valve dysfunction that leads to ulcers. Treating them before complications develop is far simpler than managing an active wound.

Stay connected with your vein doctor. After a venous ulcer, ongoing follow-up with your CVR vein expert matters. Regular check-ins help your physician detect signs of recurrence early, when treatment is most straightforward.

Frequently Asked Questions

1. What does a venous ulcer look like? 
   Venous ulcers typically appear as shallow open sores on the inner ankle or lower leg. The wound base is often red or pink, sometimes covered by yellowish tissue. The surrounding skin may look discolored, feel hard or leathery, and appear shiny. The wound may produce drainage and, if infected, an odor.
2. Are leg sores always caused by vein disease?
   Venous disease is the most common cause, accounting for roughly 70% of chronic leg ulcers, but it is not the only one. Other causes include arterial disease, diabetes, and inflammatory conditions. A vein doctor can use diagnostic imaging to determine the cause and guide appropriate treatment.
3. How long does a venous ulcer take to heal?
   Healing time varies depending on wound size, severity of underlying venous disease, and how consistent treatment is followed. Some ulcers heal within weeks with proper care; others may take months. Addressing the underlying venous disease, not just the wound, is the key to lasting healing.
4. What kind of doctor treats leg sores from vein disease? 
   A phlebologist or vascular specialist is the most appropriate physician for venous ulcers. At Center for Vein Restoration, our board-certified physicians specialize in diagnosing and treating all stages of venous disease, from early varicose veins to active venous ulcers.
5. Can venous ulcers be prevented? 
   In many cases, yes. Treating underlying venous disease early, wearing compression stockings, exercising regularly, and maintaining a healthy weight all reduce the risk of developing venous ulcers.