Symptom Details

People with peripheral vascular disease (PVD) may start out with mild symptoms, or no symptoms. Without treatment, conditions such as varicose veins, tired heavy legs and pain at rest can eventually turn into more severe complications as the disease progresses.

More than 500,000 to 2 million people in the United States suffer from leg ulcers, or non-healing wounds.8 Conditions such as superficial venous insufficiency (SVI) and deep venous disease (DVD) can reduce blood flow to the extremities and can make it difficult for the body to heal itself. These sores usually develop on the leg above the ankle.2

Arterial disease such as critical limb ischemia (CLI) can also cause wounds to heal slowly. This advanced form of arterial disease can result in ulcers below the ankle as well as kissing ulcers, or non-healing wounds between toes.

Non-healing wounds are almost always accompanied by redness, swelling and pain. Left untreated, these sores are at risk of developing an infection, which can lead to serious, long-term health complications, including amputation of the limb.3

Symptoms can range depending on the progression of the underlying PVD disease and how far it has progressed.4,5,6 If you are experiencing any of these symptoms consistently, it is important to take the step and seek help from your doctor right away.

Venous Causes and Symptoms

More than 80 percent of leg ulcers are caused by venous disease.9 When the veins in your legs are not working efficiently to carry blood back to the heart, the valves have become damaged and blood flows the wrong way. This back-up of fluid causes blood to pool in the leg and builds increased pressure on the vein walls. This condition can lead to skin damage and non-healing wounds.

Venous wounds develop above the ankle when the blood pools in the ankles. The leaky veins result in pooling of inflammatory substances in the blood, which in turn irritate the skin chronically and lead to wounds.

  • The skin may thicken and become hard
  • Changes in color, usually black or dark bluish color, around the wound area
  • Swelling and redness may develop
  • Fluid may discharge from the wound
  • A foul-smelling odor may happen

Arterial Causes and Symptoms

Arterial disease can also cause non-healing wounds. As fatty plaque builds up inside the artery, it narrows and restricts blood flow to the limbs. This damage to blood vessels can result in non-healing wounds.

  • Legs that feel fatigued
  • Pain in the affected limb may be felt while sleeping or resting
  • Persistent and increasing pain around the wound area
  • Skin may be cool to touch and hairless
  • Gangrene, or black toe, may also occur

Risk Factors

Not all people with PVD disease will develop non-healing wounds. But there are certain risk factors that can increase the chances of developing the severe condition.

These risks include:7,8

  • Obesity or being overweight can put pressure on your legs and restrict healthy blood flow. Over time skin damage and leg sores may occur
  • Certain medical conditions such as high cholesterol, high blood pressure and diabetes can increase the likelihood of developing non-healing wounds
  • Smoking can damage the veins and their ability to transport blood
  • History of varicose veins can predispose you to developing these types of sores
  • Being older than 60 can increase the likelihood of developing arterial or venous disease

What to Look For

Non-healing wounds usually do not begin on their own. A person may notice swelling, varicose veins, or many other symptoms relating to PVD disease. As the condition advances open sores can develop.

Arterial Signs

The Rutherford Classification is a common system that is widely used to diagnose and identify the severity of arterial disease as it progresses.

Rutherford Classification

Stage 0

No symptoms

Stage 1

Some exercise pain after walking long distances

Stage 2

Exercise pain that occurs more frequently at shorter distances

Stage 3

Severe exercise pain that happens frequently after a short distance

Stage 4

Pain in the legs, calves, buttocks that occurs despite rest

Stage 5

Leg ulcers begin to develop

Stage 6

Severe non-healing wounds can lead to gangrene or tissue loss

non healing wounds

Arterial Ulcer

non healing wounds

Arterial Ulcer

Venous Signs

Non-healing venous wounds, caused by Venous Disease, may present these signs

  • Thick, lumpy skin near the sore
  • Redness or discoloration around the area can develop
  • Swelling in the leg may occur and worsen as the day progresses
  • Ankles may be swollen
  • White colored scarring near the sore
  • Varicose veins may also be present
non healing wounds

Venous Ulcer

non healing wounds

Venous Ulcer

When to See a Doctor

If you have a wound that persists and fails to improve, it is crucial to take the step and seek help. These wounds will not heal on their own without medical treatment. It is important to get properly diagnosed, especially to reduce the risk of infection and long-term complications.

Talk to your doctor, or use our tool to locate a doctor to consult for a diagnosis.

Helpful Resources

PVD Doctor
Discussion Guide

Get helpful tips and advice on how to talk to your doctor about a PVD screening.

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Third-Party Resources



A mobile app built by cardiologists, to simplify understanding of most cardiac and peripheral vascular conditions and treatments.

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Consult your doctor to learn more about non-healing wounds and how to maintain your vein health. You can also use our tool below to find a specialist near you.

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Andrew Olinde

5131 O'Donovan Drive 301 | Baton Rouge, LA, 70808

Allison Barone

250 Engle Street | Englewood, NJ, 7631

Thomas Lutz

15 Tower Ct Suite 200 | Gurnee, IL, 60031

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2775 Laurel Street, Room 4203 | Vancouver, BC, V5Z1M9

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495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

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915 W Monroe St | Jacksonville, FL, 32004

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600 North Cattlemen Rd | Sarasota, Florida, 34232

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501 Dr. Michael DeBakey Drive (3rd Floor) | Lake Charles, LA, 70601

Thomas Lee

131 Madison Avenue 2nd Floor | Morristown, NJ, 7960

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3109 Stirling rd. Suite 100 | Fort Lauderdale, FL, 33312

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15825 John J Delaney Dr | Charlotte, NC, 28277

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960 N 16th Street Suite 108 | Springfield, OR, 97477

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75 Kings highway Cutoff, Suite 4B | Fairfield, CT, 6824

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2200 Park bend | Austin, TX, 78757

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8767 Perimeter Park Blvd | Jacksonville, FL, 32216

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4400 W 95th Street, Suite 306 | Oak Lawn, IL, 60453

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200 S. Orange Ave | Livingston, NJ, 7039

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2800 S Seacrest Dr. Suite 200 | Boyton Beach, FL, 33435

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800 Biesterfield Road | Elk Grove Village, IL, 60007

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1879 Nightinglae Ln | Tavares , Florida, 32778

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10837 South Cicero Avenue Suite 200 | Oak Lawn, IL, 60453

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1501 S Miami Ave. | Miami Beach, FL, 33129

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800 Biesterfield Road | Elk Grove Village, IL, 60007

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5325 Elliot Drive, Suite 101 | Ypsilanti, MI, 48197

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12720 McManus Blvd, Suite 303 | Newport News, VA, 23602

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300A Faunce Corner Rd N | Darthmouth, MA, 02908

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Suite #160, FL, 32256

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316 Manatee Ave W | Bradenton, FL, 34205

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601 N Flamingo Rd. Suite 408 | Pembroke Pines, FL, 33028

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2315 Broadway 4th floor | New York, NY, 10024

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1135 116th Avenue NE, Suite 305 | Bellevue, WA, 98004

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101 Bodin Circle 60 SGCS/SGCH | Travis AFB, CA, 94535

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880 Munson Ave, Suite A | Traverse City, MI, 49686

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1920 SW 20th Place | Ocala, Florida, 34471

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7011 AC Skinner Parkway | Jacksonville, FL, 32256

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4801 College Blvd | Leawood, KS, 66214

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3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

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9434 Medical Center Dr. | La Jolla, CA, 92037

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6637 State Route 30 | Jeannette, PA, 15644

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8200 east Belleview Ave Suite 600e | Greenwood Village, CO, 80111

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1783 Troup Highway | Tyler, TX, 75701

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55 Fruit St | Boston, MA, 02114

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1212 York Road | Lutherville, MD, 31093

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85 Old Kings Highway North | Darien, CT, 6820

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725 American Ave | Waukesha, WI, 53188

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2232 Wilborn Avenue | South Boston, VA, 24592

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1401 Harrodsburg Rd Ste A300 | Lexington, KY, 40509

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6375 W US 6 | Portage, IN, 46368

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43700 Woodward Avenue, Suite 207 | Bloomfield Hills, MI, 48302

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3400 Spruce Street | Philadelphia, PA, 19104

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23101 Sherman Place | West Hills, CA, 91307

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19189 N Dale Mabry Hwy | Lutz, FL, 33548

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3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

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630 13th Street Suite 250 | Augusta, GA, 30901

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9850 Genesee Ave | La Jolla, CA, 92037

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6420 Dutchmans Pkwy Suite 180 | Louisville, KY, 40205

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4740 Mile Stretch Drive | Holiday, FL, 34690

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10123 SE Market Street | Portland, OR, 97216

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8900 North Kendall Drive | Miami, FL, 33176

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2710 Alameda Ave | Burbank, CA, 91505

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6633 Forest Ave Ste 302 | New Port Richey, FL, 34653

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8075 N Shadeland Ave Ste 200 | Indianapolis, IN, 46037

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1301 Sigman Road, NE Suite 130 | Conyers, GA, 30012

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8200 east Belleview ave Suite 600 E | Greenwood Village, CO, 80111

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1746 Cole Boulevard | Lakewood, CO, 80401

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8433 Harcourt Rd. Suite 100 | Indianapolis, IN, 46260

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95 Collier Road NW Suite 5015 | Atlanta, GA, 30309

Windsor Ting

1468 Madison Avenue or 1190 Fifth Avenue | New York, NY, 10029

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705 Jesse Jewell Parkway 125 | Gainseville, GA, 30501

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23120 South LaGrange Road | Frankfort, IL, 60423

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3231 South Euclid Avenue, Suite 207A | Berwyn, IL, 60402

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960 N 16th Street | Springfield, OR, 97477

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4600 Memorial Dr. Suite 240 | Belleville, IL, 62226

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2255 S. Bascom Avenue #200 | Campbell, CA, 95008

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23120 South LaGrange Road | Frankfort, IL, 60423

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4750 Water Avenue, Suite 500 | Savannah, GA, 31410

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18905 Sherman Way | Reseda, CA, 91335

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19189 N Dale Mabry Hwy | Lutz, FL, 33548

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1035 Bellevue Ave #500 | St. Louis, MO, 63117

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200 W Arbor Dr. | San Diego, CA, 92103

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363 Highland Avenue | Fall River, MA, 2720

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24800 S.E. Stark St. | Gresham, OR, 97030

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85 Old Kings Highway N, 1st Floor | Darien, CT, 6820

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4750 Water Avenue, Suite 500 | Savannah, GA, 31410

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11411 Brookshire Ave | Downey, CA, 90241

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2560 Ocean Ave | Brooklyn, NY, 11229

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6633 Forest Ave #300 | New Port Richey, FL, 34653

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725 Jesse Jewell Parkway #125 | Gainesville, GA, 30501

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7777 Alvarado Road, Suite 108 | La Mesa, CA, 91942

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1001 Blythe Blvd., Suite 300 | Charlotte, NC, 28203

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495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

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520 Medical Center Drive | Medford, OR, 97504

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600 North Cattlemen Rd | Sarasota, FL, 34232

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3311 Prescott Road | Alexandria, LA, 71301

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347 Mount Pleasant Ave Suite 100 | West Orange, NJ, 7052

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1035 Southcrest Dr, Suite 250 | Stockbridge, GA, 30281

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350 South 40th Street | Muskogee, OK, 74401

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87 McGregor Street | Manchester, NH, 3102

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1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488

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75 Francis St | Boston, MA, 02115

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600 North Cattlemen Rd | Sarasota, FL, 34232

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5003 Hardy St, Ste 200 | Hattiesburg, MS, 39402

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200 S. Orange Ave | Livingston, NJ, 7052

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6151 South Yale Ave Suite 1304 | Tulsa, OK, 74136

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2010 Health Campus Drive | Harrisonburg, VA, 22801

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1445 East Putman Ave, 1st Floor | Old Greenwich, CT, 6870

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600 N Cattlemen Rd | Sarasota, FL, 34232

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600 North Cattlemen Rd | Sarasota, Florida, 34232

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1. Iqbal et al. “Management of Chronic Non-healing Wounds by Hirudotherapy.World Journal of Plastic Surgery. 2017 Jan; 6(1): 9–17.

2. Hess, Thomas. “Checklist for Factors Affecting Wound Healing.Advances in Skin & Wound Care: April 2011 – Volume 24 – Issue 4 – p 192.

3. Guo et al. “Factors Affecting Wound Healing.J Dent Res. 2010 Mar; 89(3): 219–229.

4. Frykberg et al. “Challenges in the Treatment of Chronic Wounds.Adv Wound Care (New Rochelle). 2015 Sep 1; 4(9): 560–582.

5. “6 Signs You Have an Infected Wound.” Advanced Tissue. n.d.

6. Walshe C. “Living with a venous leg ulcer: a descriptive study of patients’ experiences.J Adv Nurs. 1995 Dec;22(6):1092-100.

7. Grey et al. “Venous and arterial leg ulcers.BMJ. 2006 Feb 11; 332(7537): 347–350.

8. Margolis DJ, Bilker W, Santanna J, et al. “Venous leg ulcer: incidence and prevalence in the elderly.J Am Acad Dermatol 2002;46(3):381-6. PMID: 11862173

9. Simon et al. “Management of venous leg ulcers.BMJ. 2004 Jun 5; 328(7452): 1358–1362.

10. Hardman et al. “Overview of Classification Systems in Peripheral Artery Disease.Semin Intervent Radiol. 2014 Dec; 31(4): 378–388.


The opinions and clinical experiences presented herein are for informational purposes only. Individual results may vary depending on a variety of patient specific attributes and related factors. Dr. Raghu Kolluri has been compensated by Philips for his services in preparing and providing this material for Philips further use and distribution.

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