Leg ulcer treatment (Management of chronic leg ulceration)

An overview of how long-standing leg ulcers are treated — most commonly with compression and wound care — and why finding the cause first is essential.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Most leg ulcers are caused by poor vein circulation, and the main treatment is compression bandaging plus wound care.
Finding the cause first is essential — compression can be harmful if the arteries are too narrowed, so the leg's blood supply is checked first.
With proper compression, many venous ulcers heal within about 6 months, but healing is slow and needs regular dressing changes.
Ulcers often come back, so wearing compression stockings after healing and treating the underlying cause are key to preventing recurrence.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeNurse-led wound treatment, with tests to find the cause

AnaestheticNot usually needed; some causes need a separate procedure

How long it takesDressing and bandage changes are short; healing takes weeks to months

Hospital stayUsually none; treatment is mostly in the community or clinic

Time off workUsually none, though bandaging and appointments affect daily life

When you'll see resultsMany venous ulcers heal within about 6 months with proper compression

On the NHS?Routinely treated on the NHS, usually by community or practice nurses

A general guide. Your specialist will give you advice for your situation.

Best fit

Helps venous ulcers heal — many within about 6 months with proper compression

Pause if

Applying firm compression before the arterial blood supply has been checked, which can be harmful if arteries are narrowed.

Main recovery point

The cause is assessed, the arteries checked (ABPI), and the ulcer cleaned and dressed. If suitable, compression bandaging is started.

Good aftercare

A clear, regular schedule of dressing and bandage changes by trained staff.

First appointment

The cause is assessed, the arteries checked (ABPI), and the ulcer cleaned and dressed. If suitable, compression...

First weeks

You attend one to three times a week for dressing and bandage changes. The bandaging may feel firm at first; pain...

Weeks to months

The ulcer gradually shrinks and heals. Progress is monitored at each visit, and treatment of the underlying cause...

Around 6 months

Many venous ulcers have healed by now with proper compression. An ulcer not healing by this stage prompts...

Medical line illustration of lymphoedema compression therapy for Leg ulcer treatment. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

How are leg ulcers treated?

A leg ulcer is a wound, usually below the knee, that has not healed within a few weeks. Most are caused by poor vein circulation (a venous leg ulcer), where blood does not drain well from the leg. Some are caused by poor artery circulation (an arterial ulcer), and some by a mix of both, or by other conditions such as diabetes.

Finding the cause is the most important first step, because the right treatment depends on it. A key check is comparing the blood pressure at the ankle with the arm (the ankle-brachial pressure index, or ABPI) to make sure the arteries are healthy enough before any firm bandaging.

For a venous ulcer, the main treatment is compression — firm, multi-layer bandaging or stockings that squeeze the leg and help blood flow back up towards the heart — along with cleaning the wound and applying simple dressings. With proper compression, many venous ulcers heal within about 6 months.

Compression is not safe for everyone. If the arteries are too narrowed, firm bandaging can reduce blood flow and cause harm, which is why the assessment comes first. Treatment also looks at the underlying cause — for example, treating varicose veins — to help the ulcer heal and to stop it coming back.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Wound cleaning and dressings

The ulcer is cleaned, dead tissue removed, and a simple non-sticky dressing applied, usually changed one to three times a week. Dressings support healing but are not the main treatment for a venous ulcer.

Compression therapy

Firm, multi-layer bandages or stockings squeeze the leg to improve vein drainage. This is the main treatment for venous ulcers and should only be applied by trained staff after the arteries have been checked.

Treating the underlying cause

Where varicose veins or vein problems are driving the ulcer, treating the veins can help healing and reduce recurrence. Arterial ulcers may need treatment to improve the blood supply instead.

Managing infection and skin problems

Infected ulcers may need a course of antibiotics; antibiotics treat infection rather than speeding healing. Surrounding eczema or dry skin is treated with moisturisers and sometimes mild steroid creams.

Swelling and skin care

Leg elevation, skin care and, in some cases, addressing causes of swelling help the ulcer heal and protect the surrounding skin.

Venous vs arterial leg ulcer

Point	Venous ulcer	Arterial ulcer
Main cause	Poor vein drainage	Poor artery blood supply
Typical site	Around the inner ankle	Foot, toes or pressure points
Compression	Mainstay of treatment	Can be harmful — needs caution
First step	Check arteries (ABPI), then compress	Assess and improve blood supply
Pain	Often aching, eased by elevation	Often worse on elevation, eased by hanging the leg down

Many ulcers are mixed, with both vein and artery problems. This is why assessment of the blood supply before compression is essential, and why specialist input is often needed.

Preparing for your treatment

Expect an assessment to find the cause, including checking the pulses and the ankle-brachial pressure index (ABPI) before any firm bandaging.
Tell the team about diabetes, previous ulcers, vein or artery problems, and any allergies to dressings or adhesives.
Mention how much pain you have and where, as this can help tell venous from arterial ulcers.
Be ready for regular appointments, as dressings and bandages are usually changed one to three times a week.
Ask whether your footwear and clothing will fit over bandaging, and arrange practical adjustments.
If you smoke, getting help to stop supports healing, especially if the arteries are involved.
Plan for the bandaging to feel firm or even uncomfortable at first; simple pain relief such as paracetamol may help.

What happens

Treatment usually starts with an assessment by a nurse or specialist, who examines the ulcer and the leg, checks the foot pulses, and measures the ankle-brachial pressure index (ABPI) to make sure the arteries are healthy enough for compression. Sometimes scans of the veins or arteries are arranged.

The ulcer is cleaned and any dead tissue removed, and a simple dressing is applied. If the arteries are healthy enough and the ulcer is venous, firm multi-layer compression bandaging is applied by trained staff to improve vein drainage. The first application can feel tight or uncomfortable.

You then attend regularly — usually one to three times a week — for the dressing and bandage to be changed and the ulcer monitored. The underlying cause, such as varicose veins, is assessed and treated where appropriate. Most of this care happens in the community or a clinic rather than as a hospital stay.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Applying firm compression before the arterial blood supply has been checked, which can be harmful if arteries are narrowed.
Treating an ulcer as simple when features suggest another cause, such as unusual edges that may need a biopsy.
Relying on dressings alone for a venous ulcer without compression, which rarely heals it.
Ignoring the underlying vein or artery problem, which makes recurrence more likely.

Delay or rearrange if…

There are signs of a spreading infection (cellulitis) that needs treating first.
The circulation has not yet been assessed, so it is not yet safe to compress.
Toes are painful, numb or discoloured, suggesting compression may be unsafe.
Sudden severe leg pain or signs of a blocked artery are present, which need urgent assessment.

Alternatives to discuss

Treating the underlying vein problem (for example, varicose vein treatment) to help healing and prevent recurrence.
Improving the artery blood supply (such as angioplasty or bypass) for an arterial or mixed ulcer.
Specialist wound clinic input for ulcers that are not healing.
Managing other causes, such as diabetes-related or inflammatory ulcers, with the relevant specialist.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Helps venous ulcers heal — many within about 6 months with proper compression
Reduces leg swelling and discomfort
Protects the surrounding skin and lowers the risk of infection
Finding and treating the cause can reduce the chance of the ulcer returning
Most care can be given close to home by community or practice nurses

Risks & complications

More common

The bandaging feeling tight or uncomfortable, especially at first
Slow healing, with many ulcers taking months and some longer
Skin irritation or eczema around the ulcer
Needing regular appointments that affect daily life

Less common

Wound infection, which may need a course of antibiotics
An allergic reaction to a dressing or bandage
The ulcer not healing despite treatment, needing specialist review
Pressure damage from bandaging if it is applied incorrectly

Rare but serious

Harm from compression where the arteries are too narrowed — numb, painful or discoloured toes are a warning sign
A serious spreading skin infection (cellulitis) needing urgent treatment
An ulcer that does not heal turning out to have another cause, such as skin cancer, needing a biopsy

The most important safety point is that compression can be harmful if the arteries in the leg are too narrowed, so the blood supply must be checked (ABPI) before firm bandaging. If toes become numb, painful, pale or discoloured under a bandage, the bandage should be removed and the team contacted. An ulcer that does not heal despite proper treatment should be reassessed, occasionally with a biopsy, to make sure nothing else is going on.

Published figures to discuss

How quickly a leg ulcer heals depends on its cause, the circulation, infection and how consistently compression and dressings are used. Venous ulcers generally heal well with proper compression, but recurrence is common. Reliable single percentages for every situation are limited, so the figures here are broad and drawn from NHS and guideline sources.

Figure	Reported range	How to interpret it	Source / confidence
Venous ulcers healing with proper compression	Many heal within about 6 months	From NHS patient information; some ulcers take longer, especially if large or long-standing.	NHS — Venous leg ulcer: treatmentnhs.ukSource-linked context
Recurrence after healing	Common; reduced by wearing compression stockings	The underlying circulation problem usually remains, so ongoing compression and skin care matter.	Guide sourcesClinical context
Arterial disease making compression unsafe or needing modification	Common enough that ankle-brachial pressure assessment is standard	Pain at rest, cold foot, weak pulses or very low ABPI should prompt vascular assessment.	Guide sourcesClinical context
Cancer or inflammatory disease masquerading as a chronic ulcer	Rare but important	A non-healing, atypical, bleeding or rapidly changing ulcer may need biopsy.	NHS — Venous leg ulcer: treatmentnhs.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Leg ulcer treatment is an ongoing process rather than a one-off procedure: 'afterwards' means weeks to months of regular care while the ulcer heals, then steps to stop it coming back.

First appointment

The cause is assessed, the arteries checked (ABPI), and the ulcer cleaned and dressed. If suitable, compression bandaging is started.

First weeks

You attend one to three times a week for dressing and bandage changes. The bandaging may feel firm at first; pain often eases as swelling improves.

Weeks to months

The ulcer gradually shrinks and heals. Progress is monitored at each visit, and treatment of the underlying cause is arranged where appropriate.

Around 6 months

Many venous ulcers have healed by now with proper compression. An ulcer not healing by this stage prompts specialist review.

After healing

You move to compression stockings to keep the leg supported and reduce the chance of the ulcer returning.

What's normal — and not a worry

The bandaging feeling tight or uncomfortable for the first day or so after each change
Slow, gradual healing rather than a quick change
Some leakage from the ulcer onto the dressing between changes
Itchy or dry skin around the ulcer that needs moisturising

Aftercare

Keep your dressing and bandage appointments — regular changes are central to healing.
Wear compression exactly as advised, and after healing wear compression stockings when you are up and about.
Elevate your leg when resting, ideally with toes above hip level, to reduce swelling.
Moisturise the surrounding skin and avoid scratching, which can damage skin and cause new ulcers.
Stay active and walk when you can, as gentle movement helps the calf muscle pump blood back.
Watch for signs of infection or a problem under the bandage and report them promptly.
If you smoke, get help to stop, especially if the arteries are involved.

Before your treatment

Regular dressing and bandage appointments arranged
Footwear and clothing that fit over bandaging
Knowledge of warning signs (numb or discoloured toes, spreading redness)
Plan for leg elevation and skin care at home
Compression stockings discussed for after healing
Contact number for the nursing team saved
Smoking-cessation support arranged if you smoke

Scars and how they heal

Healed leg ulcers usually leave a flat scar and often some lasting skin colour change (brown or reddish staining) around the ankle, especially with venous disease. The skin there can stay fragile and prone to breaking down again, which is why ongoing skin care and compression stockings matter. New or non-healing areas should always be reviewed.

⚠ Get urgent help if…

Toes becoming numb, painful, pale, blue or cold under a bandage — remove the bandage, elevate the leg and contact your team
Spreading redness, warmth, swelling or increasing pain around the ulcer (possible cellulitis) — seek urgent help
Fever or feeling generally very unwell
A sudden increase in pain, bleeding or discharge from the ulcer
An ulcer that is getting larger or not healing despite treatment
New ulcers appearing, or changes in the ulcer's appearance such as raised or unusual edges

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a healed ulcer with intact, cared-for skin, and an understanding of the cause so it is less likely to return. For venous ulcers, proper compression heals many within about 6 months, though some take longer.

Healing is not the end of the story. The underlying vein or artery problem usually remains, the skin stays vulnerable, and ulcers commonly return. This is why wearing compression stockings after healing and treating the cause are so important. An ulcer that does not heal as expected should be reassessed, occasionally with a biopsy, to rule out other causes.

How long it lasts

Leg ulcers have a strong tendency to come back, sometimes years later, because the underlying circulation problem persists. The most effective way to reduce recurrence after a venous ulcer heals is to wear compression stockings whenever you are up and about, alongside skin care and treating the underlying vein problem where possible. Ongoing attention to the skin and early treatment of any new breakdown helps keep the leg healthy.

Related tests, treatments or support

Leg ulcer treatment often goes hand in hand with treating the cause — for example, treatment of varicose veins for a venous ulcer, or improving the artery blood supply (such as angioplasty or bypass) for an arterial or mixed ulcer. Care for swelling, skin conditions and, in people with diabetes, specialist foot care, may all be part of the plan.

Follow-up & long-term care

You are reviewed at each dressing change, with the ulcer monitored for healing and any problems. If an ulcer is not healing as expected — often by around 6 months — you should be referred for specialist assessment of the veins or arteries, and sometimes a biopsy. After healing, follow-up focuses on compression stockings, skin care and watching for recurrence.

Wear compression stockings as advised after the ulcer heals
Look after the skin around the ankle and moisturise regularly
Elevate the leg when resting and stay active
Treat the underlying cause, such as varicose veins, where possible
Report any new or returning skin breakdown early
Do not smoke, especially if the arteries are involved

Repeat, follow-on and what comes next

Treatment is adjusted as the ulcer responds, with different dressings or compression tried.
An ulcer not healing as expected is reassessed, sometimes with a biopsy.
Treating the underlying cause may be needed to achieve and keep healing.
Ulcers that recur are common and may need repeated courses of treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A clear, regular schedule of dressing and bandage changes by trained staff.
Circulation checked before compression and monitored during treatment.
A plan to treat the underlying cause and to prevent recurrence with stockings.
Clear warning signs (numb or discoloured toes, spreading redness) and who to contact.
Easy referral for specialist review or biopsy if the ulcer does not heal.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Assessment to find the cause, including circulation tests (ABPI) and sometimes scans
The type and frequency of dressings and compression bandaging
How long the ulcer takes to heal and how many appointments are needed
Treatment of the underlying cause, such as varicose veins
Compression stockings for after healing
Specialist review or biopsy if the ulcer does not heal

Make sure your written quote includes

What the assessment includes, especially circulation testing before compression
The cost and frequency of dressings and bandaging over time
Whether treatment of the underlying cause (such as varicose veins) is included or separate
Compression stockings for after healing
Follow-up arrangements and who provides ongoing care
What happens — and what it costs — if the ulcer does not heal or becomes infected

On the NHS? Leg ulcers are routinely treated on the NHS, usually by community or practice nurses; private care is sometimes used for the underlying cause such as varicose veins.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What is the cause of my ulcer — is it venous, arterial or mixed?
Has my circulation (ABPI) been checked, and is compression safe for me?
What type of compression will I have, and who will apply it?
Can the underlying cause, such as varicose veins, be treated?
What should I do if my toes become numb or discoloured under the bandage?
What is the plan if the ulcer does not heal as expected?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Is leg ulcer treatment available on the NHS?

Yes. Leg ulcers are routinely treated on the NHS, usually by community or practice nurses, including assessment, compression and wound care. Private treatment exists, often for the underlying cause such as varicose veins, but the core wound care is the same.

Why do I need my circulation checked before bandaging?

Firm compression helps venous ulcers but can be harmful if the leg arteries are too narrowed, by further reducing blood flow. Checking the ankle-brachial pressure index (ABPI) makes sure compression is safe before it is applied.

How long will my ulcer take to heal?

It varies. With proper compression, many venous ulcers heal within about 6 months, but some take longer. Healing is gradual and depends on the cause, your circulation and keeping up regular dressing changes.

Why does the bandage feel so tight?

Compression is meant to be firm to help blood drain from the leg, so it can feel tight or uncomfortable at first, and simple pain relief may help. But if your toes become numb, painful or discoloured, remove the bandage, raise the leg and contact your team.

Will my ulcer come back?

Leg ulcers commonly return because the underlying circulation problem remains. Wearing compression stockings after healing, looking after the skin and treating the cause, such as varicose veins, all reduce the chance of recurrence.

What if it doesn't heal?

An ulcer that is not healing despite proper treatment should be reassessed. This may mean checking the veins and arteries again and, occasionally, taking a small sample (biopsy) to make sure there is no other cause such as skin cancer.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Venous leg ulcer: treatment NHS — Venous leg ulcer (overview) NICE CKS — Leg ulcer (venous) British Association of Dermatologists — Venous leg ulcers Circulation Foundation — Patient information

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.