Leg Ulcers: What They Are
and How We Heal Them
A wound on your leg or ankle that will not heal is not something to live with. In most cases, it is the visible result of an underlying vein problem — and treating that cause is what finally lets the ulcer close. At Coastal Vascular Center, Dr. Ayar finds the source and treats it with precision.
Board Certified Specialist
Duplex Ultrasound Diagnosis
Treats the Cause, Not Just the Wound
Pearland & Lake Jackson
80%
of Leg Ulcers Are Venous
CVI
Most Common Underlying Cause
Non-Invasive
Duplex Ultrasound Diagnosis
20+
Years Experience
Overview
What Is a Leg Ulcer?
A leg ulcer is an open wound on the lower leg or ankle that fails to heal in the normal timeframe — usually defined as lasting longer than a few weeks. Unlike a cut or scrape that closes on its own, an ulcer persists because the tissue beneath it cannot repair itself properly.
In the legs, the overwhelming majority of ulcers are venous. They happen when chronic venous insufficiency allows blood to pool in the lower legs, raising the pressure inside the veins so high that fluid and pressure build in the surrounding tissue. Over time, the skin becomes discolored, thickened, and fragile — until it breaks down into an open wound.
This is the part that matters most: a venous leg ulcer is not just a skin problem. It is the final, visible stage of a vein problem that has been building for years. Treat the vein, and the ulcer can finally heal.
WHY PATIENTS CHOOSE COASTAL VASCULAR
A Physician-Owned Practice, Not a Corporate Chain
Dr. Ayar Handles Your Care
Dr. Ayar personally does every consultation and procedure. You will not be handed off to a PA or NP, as at many clinics.
Two Locations, One Physician
Many clinics have many locations and few doctors. At our Pearland and Lake Jackson offices, you always see Dr. Ayar.
Physician-Owned
Coastal Vascular Center is physician-owned, not corporately owned. Your care is guided by your doctor.
Most Insurance Accepted
We accept most insurance plans. Call our office to confirm your coverage before your visit.
Causes & Types
Not All Leg Ulcers Are the Same
Getting the type right changes everything about the treatment. As an interventional radiologist, I take the time to determine exactly what is causing your ulcer before recommending anything.
Venous Leg Ulcers (Stasis Ulcers)
The most common type I see — roughly 80% of all leg ulcers. They develop when chronic venous insufficiency causes blood to pool in the lower legs, raising pressure so high that the skin begins to break down. These ulcers usually form around the inner ankle and are often surrounded by discolored, thickened skin.
Arterial Ulcers
Caused by peripheral arterial disease — narrowed arteries that starve the skin and tissue of oxygenated blood. These ulcers tend to form on the feet, toes, or outer ankle, and the surrounding skin is often cool, pale, and hairless. They require a different treatment path than venous ulcers.
Diabetic Foot Ulcers
In patients with diabetes, nerve damage and poor circulation can lead to ulcers on pressure points of the feet. These are managed in close coordination with your primary care provider and wound care team, because they involve factors beyond the veins alone.
An honest note about the full picture
Some leg ulcers have an arterial or diabetic component that falls partly outside a pure vein specialty. If your evaluation points in that direction, I will make sure you are connected to the right provider — my goal is always for you to have the correct answer, not just the answer I happen to specialize in.
When to Seek Care Immediately
Signs Your Ulcer Needs Urgent Attention
An open wound carries a real risk of infection, and an infected ulcer can become serious quickly. If you notice any of the following alongside your leg ulcer, seek care the same day — or go to an emergency department if needed:
Increasing redness, warmth, or swelling spreading beyond the ulcer
Foul-smelling drainage or a change in the color or amount of fluid
Fever, chills, or a general feeling of being unwell
Pain that suddenly worsens or becomes constant
Red streaks radiating outward from the wound
I want to be direct: an infected leg ulcer is a medical emergency. Do not wait to see if it improves on its own. Early treatment is what keeps a manageable wound from becoming a serious complication.
Diagnosis
How I Diagnose a Leg Ulcer
The first thing I do is listen. How long has the ulcer been there? Is it painful? What have you already tried, and what other medical conditions are you managing? The history matters enormously — it often points me in the right direction before any test does.
Then I examine the wound itself and the surrounding skin. The location, color, temperature, and surrounding tissue all help me distinguish a venous ulcer from an arterial one. A venous ulcer typically sits around the inner ankle with warm, discolored skin, while an arterial ulcer tends to form on the foot with cool, pale skin.
In most cases, I perform a duplex ultrasound right in our office to check your veins for reflux and rule out or confirm a clot. When I need to be certain about arterial flow, I also use an ankle-brachial index (ABI) — a simple pressure test that tells me whether your arteries are the problem. Together, these give me a clear picture of exactly what is driving your ulcer.
Depending on what I find, I may coordinate with your primary care physician, a wound care specialist, or other providers. But in the majority of cases, a careful history, physical exam, and duplex ultrasound give me the answer — and a plan.
Treatment
Treatment Options at Coastal Vascular Center
Healing a leg ulcer takes two things working together: caring for the wound itself, and treating the underlying vein problem that caused it. Here is how I approach both.
Compression Therapy
The cornerstone of venous ulcer healing. Graduated compression wraps or stockings counter the high venous pressure in your legs, helping the ulcer close and dramatically reducing the chance it comes back.
Ongoing care
Wound Care & Dressings
Proper wound management — gentle debridement, the right dressing, and infection control — creates the environment an ulcer needs to heal. We coordinate this closely with your wound care team when needed.
As needed
Endovenous Ablation (RFA / EVLA)
Treating the underlying vein is what heals the ulcer for good. Radiofrequency or laser energy closes the faulty vein, blood reroutes through healthy vessels, and the pressure driving the ulcer is relieved.
About 1 hour
Sclerotherapy
For smaller refluxing veins contributing to the problem, a solution is injected to close them. Used alongside ablation to fully address the source of the elevated pressure.
In-office, 30 min
Medical Management & Referral
When an ulcer has an arterial or diabetic component, I coordinate care with your primary care physician, wound care specialist, or other providers so nothing gets missed.
Coordinated care
Why treating the vein matters more than the wound
A wound dressing alone rarely heals a venous ulcer, because the pressure inside your veins keeps breaking the skin back down. Close the faulty vein, and the ulcer finally has the chance to heal — and stay healed.
Your Specialist
Meet Dr. Ayar
Board-Certified Interventional Radiologist
Dr. Ayar is a fellowship-trained interventional radiologist with over 20 years of experience treating vein disease, including varicose veins and chronic venous insufficiency, using the latest minimally invasive techniques.
His diagnostic-first philosophy means you will receive a thorough evaluation and honest options — never a push toward cosmetic treatments that do not address your actual vein health.
Board Certified by the American Board of Radiology
Fellowship-Trained in Interventional Radiology
Member, Society of Interventional Radiology (SIR)
Serving Pearland & Lake Jackson, TX
Patient Stories
What Patients Say About Dr. Ayar
Real Google reviews from patients at our Pearland and Lake Jackson offices.
FAQS
Frequently Asked Questions About Leg Ulcers
Why will not my leg ulcer heal?
Is a leg ulcer dangerous?
Do spider veins mean I have a vein problem?
What is the difference between a venous ulcer and an arterial ulcer?
Can leg ulcers be cured?
How long does a leg ulcer take to heal?
Is spider vein treatment covered by insurance?
What should I expect at my first appointment?
Learn More
Related Articles on Vein Health
You pull your socks off at night, and one ankle has a deep ring pressed into it. The other one doesn't. Maybe the calf on that side looks a little fuller too. Swelling in one leg...
It's late, your calf aches, and you type “why does my leg hurt” into an AI chatbot. Suddenly, you are flooded with a list of potential causes: muscle strain, dehydration,...
You book a visit at a vein clinic. You fill out the forms, get your ultrasound, and sit down to talk about your legs. Then the person who walks in isn't the vein doctor at all....
Why Call Coastal Vascular Center
A leg ulcer can feel like a wound you are just expected to live with — but in my experience, patients who get the underlying cause treated are often surprised by how quickly and completely it heals. Whether the cause is something I can treat directly or something I can help you navigate toward the right specialist, you deserve to know what is actually happening in your leg.
At Coastal Vascular Center, I bring interventional radiology training and a focused vascular practice to every patient I see. I do not rush consultations, and I do not just dress the wound and send you home. What I do is find the source of the problem and offer you the most effective, least invasive path to healing.