Venous Ulcer Pictures

Venous leg ulcer location shape, color, & size explained

Venous leg ulcer picture

Venous leg ulcers come in many different shapes, colors, and sizes on patient’s legs, ankles, and feet. The visual features of venous ulcers can vary quite significantly depending on severity of disease, comorbidities, and lifestyle factors. In this brief review, our venous ulcer specialists share an extensive gallery of venous ulcer pictures, and explain the many visual features of venous ulcers. While we advise patients against self-diagnosis, having a better understanding of what venous ulcers can look like may help you identify the care you need.

Venous Ulcer Specialist Dr. Michael Lalezarian in Los Angeles, California

Venous Ulcer Specialist

Dr. Michael Lalezarian

Vein problems? We can help you get your legs back. Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in venous ulcer care and minimally invasive vein treatments. He is a committed partner in the battle against the devastating consequences of venous insufficiency.
5-Star vein treatment in Los Angeles
“I can not express enough the gratitude I have for Dr. Lalezarian and his entire staff. I came in for a ruptured vein on my ankle and Varicose veins to both of my legs. Each visit was met with extreme professionalism and care. Dr. Lalezarian, Jennifer, and the rest of the staff answered every question and concern with compassion. I felt like I was in really good hands. Each procedure was painless with minimal recovery time. If you have any type of vein issues, I would highly recommend Dr. Lalezarian and his staff at ProVascularMD.” John L, March 2022

Venous Ulcer Pictures

The specialists at ProVascularMD have compiled an extensive gallery of venous ulcer pictures to help you better understand what’s going on with your legs ankles, and feet. We provide more explanation on the different visual features of venous insufficiency in more detail below the gallery. You can also check out our gallery of venous insufficiency pictures to learn more about the stages of disease that happen before ulcers form.

Venous Ulcer Treatment in Los Angeles
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Venous Ulcer Visual Features

Venous Ulceration

An ulcer is an open sore caused by a break in the skin which fails to heal. Venous leg ulcers can form when blood flow is severely impaired in the veins of the leg, marked by excessive pressure and the slowing or pooling of blood flow. Venous ulcers are often described as shallow, irregularly shaped wounds, often accompanied by visible skin changes surrounding the broken skin. Many venous leg ulcers have a red base that oozes, although the presentation of the wound can vary depending on medical history and stage of healing.

Venous Ulcer Location

A venous ulcer’s location can form anywhere between the knee and the ankle. However, as the gallery above shows, venous ulcers are most common in the “gaiter” region of the leg, which spans from the mid-calf to the ankle bones. Venous ulceration in this region is usually indicative of severe vein disease.

Skin Discoloration

Skin surrounding a venous ulcer is often discolored. The skin may be pale, hyperpigmented, purple, red, dark brown, speckled with dark spots, and/or covered with spider veins. Visible varicose veins may also be present. As the venous ulcer picture gallery shows, there are many different patterns of skin discoloration that can occur with venous leg ulcers, and they occur for many different reasons. For example, when blood cells leak out of damaged veins, they release a chemical called hemosiderin, which has a red-brown color. Melanoctyes are also activated, producing brown melanin pigment. On the other end of the discoloration spectrum, healed ulcers often leave behind white scarring called atrophie blanche.


Lipodermatosclerosis refers to changes in the skin caused by inflammation of the layer of fat under the skin. Fibrin is a key structural component of the vein, but as the veins are damaged, fibrin can leak out and deposit into the skin. This leads to thickening and scar-like formation, making the skin feel tough and inflexible.


One of the major causes of vein disease is excessive pressure in the veins. When veins stretch and fill with blood, excess fluid leaks out of the vein and into the tissues surrounding the vein, causing the tissue to swell. Swelling (edema) can cause the leg to feel heavy and uncomfortable, and the skin may indent temporarily if you press into it with a single finger. Venous ulcers are often accompanied by swelling throughout the leg, indicative of underlying vein disease.


Damaged veins also causes inflammatory cells to leak from the vein and into the surrounding tissues, causing the skin to become red, irritated, and itchy, consistent with the symptoms of eczema.
Venous Ulcer Treatment in Los Angeles
See a Venous Ulcer Specialist
More Resources
Venous leg ulcer treatment

Venous Leg Ulcer Treatment

Learn how minimally invasive vein treatments can help accelerate healing.
Stages of venous insufficiency

Stages of Venous Insufficiency

Learn about the stages of venous insufficiency, from spider veins to venous leg ulcers.
Los Angeles Vascular Specialist Dr. Michael Lalezarian

Vascular Specialist in Los Angeles

Learn more about Los Angeles Vascular Specialist Dr. Michael Lalezarian.

References [1] Lurie F. Passman M. Meisner M, Dalsing M, Masuda E, Welch H, Bush RL, et al. The 2020 Update of the CEAP classification system and reporting standards. J Vasc Surg: Venous and Lym Dis 2020;8:342-52. [2] Vasquez MA, Rabe E, Mclafferty RB, et al. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg. 2010;52(5):1387-96. [3] Agale SV. Chronic Leg Ulcers: Epidemiology, Aetiopathogenesis, and Management. Ulcers. 2013;2013:1-9. [4] Hedayati N, Carson JG, Chi Y-W, Link D. Management of mixed arterial venous lower extremity ulceration: A review. Vasc Med. 2015;20(5):479-486. [5] Salcrido, R. C. Arterial vs Venous Ulcers: Diagnosis and Treatment: Advances in Skin & Wound Care. 2001;14(3):146-147. [6] Grey JE, Harding KG, Enoch S. Venous and arterial leg ulcers. BMJ. 2006;332(7537):347-350. [7] Dean SM. Cutaneous Manifestations of Chronic Vascular Disease. Progress in Cardiovascular Diseases. 2018;60(6):567-579.

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