When your veins do not function optimally, this can lead to problems that affect both your appearance and your health, one of which is called venous insufficiency. If you have been diagnosed with venous insufficiency near Houston, then you may end up needing treatment for venous ulcers. Venous ulcers can occur spontaneously or can be associated with scratching or trauma to the lower legs which results in a non-healing wound. When venous ulceration occurs, this can put you at risk for several health issues.
Quick Answer: The main health risks of venous ulceration are infection, which can spread to the skin, bone or bloodstream, along with chronic pain, bleeding, repeated recurrence, loss of ankle mobility and, very rarely, skin cancer forming in a wound that has been open for years. Many of these risks grow the longer an ulcer stays open. Treating the high vein pressure underneath with compression and a minimally invasive vein procedure shortens healing time and lowers the chance of the ulcer returning, which is the most reliable way to reduce every one of these complications.
Meet your vein specialist
Dr. Syed Raza, MD
Vascular & Interventional Radiology · Founder, Premier Vein & Vascular Center
Fellowship-trained interventional radiologist certified by the American Board of Radiology and the Royal College of Radiologists (UK). Former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with 15+ years treating varicose veins, venous reflux and peripheral arterial disease.
Wound Infection
A complication that can arise with a venous ulcer is an infection. After being diagnosed and treated for your venous ulceration, it is essential that you keep an eye on the wound and watch for any signs that could indicate an infection. Common symptoms of an infected venous ulcer include redness and swelling at the site, along with an increase in pain and the presence of pus. An infected wound can also cause you to feel sick and feverish. If you think that your venous ulcer may be infected, see your doctor immediately.
Bone Infection
If you have an infected venous ulcer that is left untreated, this can lead to additional health problems. When the bacteria in the wound are not addressed, they can spread from the site of the wound into nearby tissues. Osteomyelitis, for example, describes an infection of the bone and may cause the individual to experience nausea, fever, and pain in the affected bone. If diagnosed with a bone infection, you may need hospitalization to receive intravenous antibiotics.
Blood Poisoning
Another example of a health issue that can develop from infected venous ulceration is blood poisoning. If the infection is left untreated, the bacteria can make their way into the bloodstream. When this happens, the individual may experience diarrhea, rapid breathing, headaches, vomiting, and fever. As with a bone infection, blood poisoning will probably require hospital treatment. To help reduce your risk for these issues, seek treatment for your venous insufficiency and ulceration and see a doctor right away if you think that your wound may be infected.
Why Venous Ulceration Is More Than a Skin Wound
A venous ulcer looks like a skin problem, but it is really a circulation problem that has reached the surface. Valves in the leg veins have failed, blood falls back down the leg, and pressure at the ankle stays high every time you stand. That pressure starves the skin of healthy circulation and keeps it inflamed. The wound is simply the place where the tissue finally gave way.
This matters because the health risks of venous ulceration come from two directions at once. The open wound itself is a doorway for bacteria and a source of pain and drainage. The pressure underneath keeps the wound from closing and keeps damaging the surrounding skin. Infection, which is discussed above, is the most urgent risk. But in our practice we see several other complications that affect patients just as much over the long run.
Health Risks of Venous Ulceration Beyond Infection
Cellulitis of the surrounding leg
Even without a deep wound infection, bacteria can spread through the fragile, swollen skin around an ulcer and cause cellulitis: a warm, red, tender area that spreads up the leg. Swollen legs with chronic skin damage are especially prone to repeated episodes, and each episode can further damage the lymphatic vessels, making swelling worse.
Bleeding
The veins near an ulcer are under high pressure and the skin over them is thin. A varicose vein at the edge of an ulcer can bleed briskly after a minor knock or even in the shower. This bleeding looks alarming but usually stops with leg elevation and firm pressure. Repeated bleeding is a strong sign that the underlying vein needs treatment.
Chronic pain and poor sleep
Venous ulcers range from aching to genuinely painful. Pain often worsens at the end of the day and with dressing changes. Many patients sleep poorly, either from pain or from the need to keep the leg raised, and long-term poor sleep affects mood, energy and overall health.
Contact dermatitis and skin sensitivity
Skin around a chronic ulcer is easily irritated. Allergic or irritant reactions to adhesives, topical antibiotics, fragrances and some dressing materials are common and can look like a spreading infection. Using simple, bland products and reporting new itching or rash early helps prevent further skin damage.
Ankle stiffness and weaker calf pump
Patients with painful ulcers naturally move the ankle less and may walk with a flat-footed shuffle. Over months, the ankle stiffens, the calf muscle weakens, and the calf pump that pushes blood upward works even less. This creates a cycle in which reduced movement raises venous pressure, which slows healing further.
Lymphedema and hardened skin
Long-standing high vein pressure overloads the lymphatic system, which normally clears excess fluid. When it fails, swelling becomes firmer and harder to control, and the skin above the ankle can scar and tighten, a change called lipodermatosclerosis. These changes make future ulcers more likely.
Recurrence
Healing an ulcer does not repair the veins. If the reflux and pressure that caused it are left untreated, the healed skin remains fragile and ulcers often return in the same place. Preventing recurrence is a central part of good venous ulcer care.
Rare: skin cancer in a long-standing wound
Very rarely, a wound that has been open for many years can develop a skin cancer within it, sometimes called a Marjolin ulcer. Warning signs include raised, rolled or heaped-up edges, unusual tissue growth, easy bleeding, or a wound that changes character after a long period of stability. A biopsy is the way to check, and any wound that is not following the expected course deserves a closer look. We are always glad to review a wound that worries you, even if it turns out to be nothing serious.
Complications at a Glance: Warning Signs and What to Do
| Complication | Warning signs | What to do |
|---|---|---|
| Cellulitis | Spreading redness, warmth and tenderness up the leg, sometimes fever | See a doctor the same day; antibiotics are usually needed |
| Bleeding vein | Sudden bleeding from the ulcer edge or a nearby vein | Lie down, raise the leg, press firmly for 10 to 15 minutes; seek care if it continues |
| Contact dermatitis | Itchy, red, weeping rash under or around a dressing | Report it so the dressing or topical product can be changed |
| Ankle stiffness | Difficulty bending the ankle, shuffling walk | Ankle exercises and walking program, physical therapy if needed |
| Lymphedema | Firm swelling that no longer goes down overnight | Compression and specialist assessment |
| Recurrence | New itching, discoloration or a small break in healed skin | Early evaluation and treatment of the underlying veins |
| Possible malignancy | Raised or rolled edges, abnormal tissue, wound that changes or will not heal | Ask about a biopsy |
The Hidden Risk: Missed Arterial Disease
Some patients with leg ulcers have narrowed arteries as well as faulty veins. This mixed picture matters, because strong compression is a cornerstone of venous ulcer care but can reduce blood flow dangerously in a leg with poor arterial supply. A wound that becomes more painful under compression, a foot that feels cold or looks pale, or pain at night that eases when the leg hangs down can all point to arterial disease.
That is why we check the arteries with an ankle-brachial index before compression is started or increased. If peripheral arterial disease is found, improving arterial flow may need to come first.
How Venous Ulcers Affect Daily Life
The health risks of venous ulceration are not only physical. Patients often tell us about the practical burden: frequent dressing changes, drainage that soaks through clothing, odor, difficulty finding shoes that fit over bandages, and time away from work. Some stop going out, avoid exercise or give up activities they enjoy. Over months and years, this isolation and reduced activity affect mood and general health and can lead to weight gain that raises vein pressure further.
Recognizing this burden is part of good care. A treatment plan that shortens healing time helps the whole person, not just the wound.
How We Evaluate a Venous Ulcer and Its Risks
At Premier Vein & Vascular Center, our first visit focuses on why the ulcer formed and what is keeping it open.
- Focused history. We ask how long the wound has been present, what treatments you have tried, past clots, diabetes, smoking, medications and any episodes of infection or bleeding.
- Wound and leg examination. We assess the ulcer’s size, edges and drainage, signs of infection, skin changes, swelling, ankle movement and foot pulses.
- Arterial check. An ankle-brachial index confirms whether compression is safe and whether arterial disease is contributing.
- Venous duplex ultrasound. In our IAC-accredited vascular lab, this painless scan identifies which superficial and deep veins are refluxing or blocked.
- A clear plan. We explain the findings, coordinate with your wound care provider or primary care doctor, and outline how compression, wound care and vein treatment fit together.
Reducing the Risks: Treatment That Targets the Cause
The most effective way to lower every complication on this list is to shorten the time the ulcer is open and keep it from coming back. That means treating the pressure, not just the wound surface.
- Compression therapy, once arteries are confirmed to be adequate, reduces swelling and venous pressure and is the foundation of healing.
- Closing refluxing veins with radiofrequency ablation, non-thermal ablation or ultrasound-guided foam sclerotherapy lowers the pressure driving the wound. These are office procedures done under local anesthesia.
- Good wound care keeps the wound clean, manages drainage and protects the surrounding skin.
- Movement, including regular walking and ankle exercises, keeps the calf pump working.
Our venous ulcer treatment page explains these options in more detail, and our venous insufficiency page covers the underlying condition.
Call 911 or seek emergency care if…
- You have fever, chills, confusion, a racing heart or feel very unwell with a leg wound
- Redness and swelling spread quickly up the leg
- Bleeding from the leg does not stop after 15 minutes of firm pressure with the leg raised
- Your leg suddenly becomes swollen and painful, or you have chest pain or shortness of breath
- Your foot turns cold, pale, blue or numb
When to See a Vein Specialist in Houston About a Leg Ulcer
Any leg wound that has not healed within two to four weeks, or any ulcer that keeps returning in the same spot, deserves a vascular evaluation. The sooner the cause is found, the fewer complications there are to deal with.
Dr. Syed Raza is a fellowship-trained interventional radiologist with more than 15 years of experience treating venous reflux and leg ulcers, and a former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City. Patients across Houston, Katy and the surrounding communities come to our Houston vein specialist practice for same-week evaluation, and we accept most insurance plans, including Medicare.
Talk With a Specialist at Premier Vein
Have questions about your symptoms or treatment options? Dr. Syed Raza and the team at Premier Vein & Vascular Center can evaluate your concerns and explain your options clearly. Same-week appointments are usually available, and most insurance plans are accepted.
Frequently Asked Questions
Can a venous ulcer cause sepsis?
It can, although it is uncommon. If bacteria from an infected ulcer enter the bloodstream, they can cause a serious body-wide reaction. Fever, chills, confusion, rapid breathing or a racing heart with a leg wound need emergency care.
Why does my venous ulcer keep coming back in the same place?
Healing closes the skin but does not repair the faulty veins underneath. If the reflux that caused the ulcer is not treated, pressure stays high in the same area and the fragile healed skin breaks down again. Treating the refluxing veins and wearing compression lowers the chance of recurrence.
Is it normal for a venous ulcer to bleed?
Small amounts of bleeding during dressing changes are common. Brisk bleeding from a vein near the ulcer can happen because those veins are under high pressure. Lie down, raise the leg and press firmly, and seek care if it does not stop or keeps recurring.
Can a venous ulcer turn into cancer?
This is rare. Very long-standing wounds can occasionally develop a skin cancer, often called a Marjolin ulcer. A wound with raised or rolled edges, unusual growth or a sudden change in appearance should be checked, and a biopsy may be recommended.
How long does it take a venous ulcer to heal?
Healing time varies with the size of the wound, how long it has been open and whether the underlying vein problem is treated. Many ulcers heal within a few months with compression and proper care, while large or long-standing ones can take longer. Treating refluxing veins tends to speed healing and reduce recurrence.
Can I exercise with a venous ulcer?
Yes, gentle activity is usually encouraged. Walking and ankle exercises activate the calf muscle pump, which helps move blood out of the leg. Keep the wound covered, wear your compression and avoid activities that risk knocking the leg.
Should I stop wearing compression if my ulcer becomes more painful?
Do not simply stop, but do contact your doctor promptly. Increasing pain under compression can mean the bandage is too tight, the wound is infected, or arterial flow is reduced. Your provider may need to check the arteries with an ankle-brachial index and adjust the compression before you continue.
Trusted Health Resources
- Chronic Venous Insufficiency, Society for Vascular Surgery
- Venous Insufficiency, MedlinePlus Medical Encyclopedia (NIH)
- Varicose Veins and Spider Veins, MedlinePlus (NIH)