Treatment consists of:

1. Recognition there may be a problem
2. Assessment by a Specialist Vascular Surgeon
3. Special tests - usually Duplex Ultrasound and often PPG
4. Discussion of the results with patient
5. Surgery if possible (approx 60% of patients)
6. Long term compression in the 40% who cannot be helped

What should be avoided at all costs:

• Patients with leg ulcers being condemned to dressings and compression bandages/stockings without assessment by a Specialist Vascular Surgeon (unless patient is immobile, has poor ankle movement, is very unwell for any other reason or has a very short life expectancy) 

• Patients with skin changes at the ankle being given creams (particularly steroid creams) before venous causes have been excluded by a Specialist Vascular Surgeon

• Patients with varicose veins being told that it is a cosmetic problem only and to "wait until there is a problem before having anything done"

• Patients with skin changes at the ankle or varicose veins being given long term support stockings without a cause being found and the possibility of a cure being offered.