When you have venous insufficiency, what’s going on? It’s not a problem with blood flow, it’s a problem with blood return. When the blood can’t get back up to the heart, it pools in the lower legs.

With that in mind, what will you notice when looking at a venous ulcer? For starters, there will be scaly skin around the wound, and weepy edema from the pooling of fluids. The extra blood also pushes red blood cells out of the capillaries, and as those red blood cells release iron, they cause the purplish/brown color.

As for the ulcer, you will see irregular wound margins and a shallow wound on the mid to lower leg, where the valves fail to allow the return of blood. They seldom occur below the ankle or above the knee, there will be moderate to heavy drainage. The viable tissue in the wound bed will be red, because again, the blood pools in that area. The bottom line? If you’re able to pause and envision the whole process, then a red wound with plenty of drainage makes perfect sense.


Ok so now let’s talk about arterial ulcers, which are the opposite of venous ulcers. When you suffer from arterial disease, blood return is not the issue. Instead, we have a problem with the (flow) – blood that can’t get down to the area in question. As a result, the surface will look more like a “wasteland.” Think of it as a garden: if you can’t transport water and nutrients to the plants (in this case, tissues), everything will dry up and die.

Keeping the garden analogy in mind, what will you notice when looking at an arterial ulcer? You’ll see areas where necessary fluids and nutrients just aren’t getting through, and the surrounding skin is more likely to be cool to the touch, pale, also bluish in color, and hairless.

Within the wound bed, you may find (dead) tissue as well as tissue that is pale because of the lack of blood. The wound itself will be deep and regular in shape, with a round, “punched-out” look. Arterial ulcers most often occur on the outer ankle, and around the toes including the tips, between the toes and areas that are subject to trauma and rubbing. The bottom line? If you recall that a lack of blood flow is the issue (through visualization), it’s easier to remember that this type of ulcer occurs on the farthest extremities.

Certain conditions have been linked with the development of venous and arterial leg ulcers.

Venous Ulcers  

Arterial Ulcers  

  • Varicose veins
  • History of leg swelling
  • History of blood clots in deep veins (deep vein thrombosis–DVT) causing post-thrombotic syndrome
  • Sitting or standing for long periods
  • High blood pressure
  • Multiple pregnancies
  • Previous surgery
  • Fractures or injuries
  • Obesity
  • Increasing age and immobility
  • Clotting and circulatory disorders
  • Diabetes
  • Smoking
  • High blood fat/cholesterol
  • High blood pressure
  • Renal failure
  • Obesity
  • Collagen-vascular
  • disorders
  • Clotting and circulation disorders
  • History of heart disease, cerebrovascular disease or peripheral vascular disease


So if you feel you have one of these ulcers or this could be a condition you are dealing with please call us today at the Las Vegas Alpha Vein Clinic at (702) 430 7661 to get back your vein and leg health.

Alpha Vein Clinic


3150 N. Tenaya Way Ste. 400

Las Vegas, NV, 89128

(702) 430 7661

Dr. Sassan Kaveh

You Can Now Call Us 24/7