A leg ulcer is an open wound on the lower leg or foot that takes more than six weeks to heal. These wounds can be painful, recurring, and difficult to manage without proper care. In Canada, leg ulcers affect people of all ages, though they become much more common after age 65. This article explains what causes leg ulcers, what symptoms to watch for, and when to reach out to your family doctor or walk-in clinic.
What Is a Leg Ulcer?
A leg ulcer is a break in the skin below the knee that exposes the tissue underneath. It may look like a shallow crater or an open sore. These wounds can vary widely in size, shape, and colour.
Leg ulcers are often a chronic condition — meaning they come back even after healing completely. They are not just a skin problem. In most cases, they point to an underlying issue with blood circulation in the legs.
Types of Leg Ulcers
There are several types of leg ulcers, and knowing the difference matters for treatment. The most common types include:
Venous leg ulcers: These make up 80–85% of all leg ulcers. They develop when blood does not flow properly through the veins.
Arterial ulcers: These form when the arteries cannot deliver enough blood to the legs.
Diabetic foot ulcers: These affect people with diabetes and often develop on the feet due to nerve damage and poor circulation.
For more background on wound types and vascular health, Mayo Clinic’s guide on varicose veins and venous disease is a helpful starting point.
How Common Are Leg Ulcers in Canada?
Leg ulcers are relatively rare in people under 45. However, they become much more common with age. Estimates suggest that 1 in every 50 people over the age of 80 lives with a leg ulcer at any given time.
In addition, certain groups face a higher risk. People who are obese, have limited mobility, or spend long periods in bed are more likely to develop a leg ulcer. As Canada’s population ages, leg ulcers are expected to become an increasingly common health concern across all provinces.
Symptoms of a Leg Ulcer
Recognizing the symptoms of a leg ulcer early can make a big difference in treatment outcomes. The wound itself is usually the most visible sign, but there are other symptoms to watch for as well.
What the Wound Looks Like
A venous leg ulcer typically appears as an open sore with a moist or weeping surface. The skin around the wound may look discoloured — often dark brown or reddish — a condition called hyperpigmentation.
The surrounding skin can also feel hard and tight, almost like leather. This is called lipodermatosclerosis. In some cases, small patches of pale, whitish skin with tiny red spots may appear nearby. Doctors call this atrophie blanche (white atrophy).
Other Symptoms to Watch For
Beyond the wound itself, a leg ulcer caused by venous insufficiency may come with the following symptoms:
Swelling in the lower leg or ankle, especially at the end of the day
A heavy or aching feeling in the affected leg
Itching or burning around the wound (venous eczema)
Pain that may be constant or come and go
Pitting oedema — swelling that keeps the indent of your finger after pressing
These symptoms are all signs that blood is not circulating properly through the veins of your lower legs. This underlying problem is known as chronic venous insufficiency.
What Causes a Leg Ulcer?
Most leg ulcers develop because of high blood pressure inside the veins of the lower leg. This happens when blood pools in the leg instead of flowing back up to the heart efficiently.
How Venous Pressure Damages the Skin
Normally, two systems work together to keep blood moving upward through your leg veins. First, the calf muscles act like a pump — they squeeze blood upward each time you take a step. Second, tiny valves inside the veins open and close to prevent blood from flowing backward (called venous reflux).
However, if either the muscle pump or the valves stop working properly, blood begins to pool. This raises the pressure inside the veins. As a result, fluid leaks into the surrounding tissue, causing swelling and skin damage. Over time, the skin becomes thin and fragile. Eventually, it breaks open and forms an ulcer.
Risk Factors for Developing a Leg Ulcer
Several factors can increase your chance of developing a leg ulcer. These include:
Obesity or being significantly overweight
Physical inactivity or prolonged periods of limited mobility
A history of deep vein thrombosis (DVT) — blood clots in the deep leg veins
Varicose veins (personal or family history)
Previous injury to the lower leg, such as a fracture
Older age, particularly over 65
Diabetes, which can contribute to both nerve damage and poor circulation
Healthline’s overview of chronic venous insufficiency explains how these risk factors contribute to long-term vein damage.
How Is a Leg Ulcer Diagnosed?
Your doctor or nurse will assess the wound carefully before deciding on treatment. Diagnosis is based on a physical examination and your medical history.
Physical Examination
During the exam, your healthcare provider will note the size, depth, and location of the ulcer. They will also ask whether the wound is painful, and whether there is any discharge or odour coming from it.
Your provider will examine your legs both lying down and standing up. They will look for signs of venous insufficiency, such as pitting oedema and venous eczema. They will also check for signs of infection, including redness, pus, or warmth around the wound — signs that may indicate cellulitis (a bacterial skin infection).
Doppler Ultrasound Test
To confirm the diagnosis and rule out arterial disease, your doctor will likely order a Doppler ultrasound. This is a painless test that uses sound waves to measure how well blood flows through your arteries and veins.
This test is important because treatment for venous leg ulcers (compression bandaging) can be harmful if arterial disease is also present. Therefore, ruling out arterial involvement is a key step before treatment begins. In most Canadian provinces, this test is covered under your provincial health plan.
Treatment Options for Leg Ulcers
Treating a leg ulcer takes time and consistency. Most venous leg ulcers respond well to compression therapy, but healing can take weeks or even months. Recurrence is also common, so ongoing management is important.
Compression Therapy
The most effective treatment for venous leg ulcers is compression bandaging. This involves wrapping the lower leg with multi-layer bandages to apply consistent pressure. This pressure helps push blood upward and reduces the pooling that causes ulcers.
Your wound care nurse or family doctor will typically apply the bandages and change the dressings at regular intervals. Compression stockings may be prescribed for long-term prevention once the wound has healed.
Wound Care and Dressings
Keeping the wound clean and moist promotes faster healing. Your healthcare provider will select an appropriate dressing based on the type and condition of the wound. Some dressings absorb excess fluid, while others help protect the wound from infection.
Furthermore, if the wound shows signs of infection, your doctor may prescribe a course of antibiotics. You should never attempt to treat a leg ulcer at home without professional guidance.
Lifestyle Changes That Help
In addition to medical treatment, certain lifestyle changes can speed healing and prevent recurrence:
Elevating your legs above heart level when resting
Staying as physically active as possible — walking regularly helps the calf muscle pump
Maintaining a healthy weight to reduce pressure on leg veins
Eating a balanced diet rich in fibre, vitamins, and minerals to support wound healing
Quitting smoking, as smoking impairs circulation and slows healing
Health Canada’s healthy living resources offer practical guidance on physical activity, nutrition, and weight management for all Canadians.
When to See a Doctor
You should see a healthcare provider as soon as you notice an open wound on your lower leg that is not healing after two weeks. Do not wait six weeks to seek help — early treatment leads to better outcomes.
If you have a family doctor, book an appointment right away. No family doctor? A walk-in clinic can assess the wound and refer you to a specialist if needed. In some provinces, wound care nurses are available through community health centres and can provide ongoing dressing changes and compression therapy at no cost under your provincial health plan.
Seek urgent care or go to an emergency department if your wound shows signs of serious infection, such as spreading redness, fever, red streaks moving up the leg, or significant swelling. These may be signs of cellulitis, which requires prompt antibiotic treatment.
Always speak with a qualified healthcare provider before starting any new treatment. The information in this article is for educational purposes only and does not replace professional medical advice.
Frequently Asked Questions About Leg Ulcers
What does a leg ulcer look like?
A leg ulcer usually appears as an open, shallow wound on the lower leg or ankle. The skin around the leg ulcer may look dark, discoloured, or feel hard and tight. The wound itself may weep fluid and can be painful or itchy.
Can a leg ulcer heal on its own?
A leg ulcer rarely heals on its own without treatment, especially if it is caused by poor circulation. Without compression therapy and proper wound care, the ulcer is likely to grow larger or become infected. It is important to see a doctor or wound care nurse as soon as possible.
How long does it take for a leg ulcer to heal?
Healing time varies depending on the size and cause of the leg ulcer. With proper compression therapy and wound care, many venous leg ulcers heal within three to four months. However, larger or more complex wounds can take a year or longer to close fully.
What is the main cause of leg ulcers?
The most common cause of a leg ulcer is chronic venous insufficiency — a condition where the veins in the legs cannot move blood back to the heart efficiently. This causes blood to pool and pressure to build up, which eventually damages the skin and leads to an open wound.
Are leg ulcers covered under provincial health plans in Canada?
In most Canadian provinces, diagnosis and treatment of leg ulcers — including Doppler ultrasound testing and wound care through community health centres — is covered under provincial health insurance plans. However, compression stockings and certain dressings may require additional coverage or out-of-pocket payment. Check with your provincial health authority for details.
Can diabetes cause a leg ulcer?
Yes. Diabetes can lead to a specific type of leg ulcer known as a diabetic foot ulcer. High blood sugar over time damages the nerves and blood vessels in the feet and lower legs, making the skin more vulnerable to injury and much slower to heal. People with diabetes should inspect their feet daily and report any wounds to their doctor immediately.
Key Takeaways
A leg ulcer is an open wound below the knee that takes more than six weeks to heal and often signals an underlying circulation problem.
Venous leg ulcers are the most common type, accounting for 80–85% of all cases, and are caused by poor blood flow through the leg veins.
Symptoms include an open sore, swelling, skin discolouration, itching, and a heavy feeling in the affected leg.
Risk factors include older age, obesity, inactivity, varicose veins, deep vein thrombosis, and diabetes.
Compression therapy is the most effective treatment for venous leg ulcers and is widely available through Canadian healthcare providers.
See your family doctor or a walk-in clinic early — do not wait for the wound to worsen before seeking care.
Lifestyle changes such as staying active, elevating your legs, and maintaining a healthy weight can prevent recurrence.
