Hi Treatment for constant leg and hand ulcers in a scleroderma patient consist of Treatment for venous leg ulcers should be carried out by a trained healthcare professional such as a practice or district nurse. In most cases, ulcers heal within 3 months. Treatment usually involves: Removing dead tissue, called debriding the wound Cleansing the area Dressing the wound with a simple, non-sticky bandage Compression bandages Once the ulcer is dressed, your nurse may apply a firm, compression bandage over the affected area. This puts pressure on your legs to encourage blood flow up towards your heart. Compression may involve two or three layers of bandages and is a skilled procedure that should be carried out by a trained person. Initially, this may make the area more painful and you may be given painkillers to manage the pain. Pain usually recedes as the wound heals, which can take up to 12 days. If the pain is too much for you, seek medical advice. If you get severe pain, or your toes turn blue, remove the bandage, and seek medical advice. You should also keep the leg elevated. In some case, people develop severe itching around the affected skin area. This can be an allergic reaction to bandages or ointments. It’s important not to scratch the affected area as this can make ulceration worse. Treating infected ulcers As above, an infected ulcer should be cleaned and dressed, but you may have to avoid wearing a compression bandage until the infection has cleared. You may also be told to: Keep your leg elevated whenever possible Take a course of antibiotics Antibiotics do not heal the ulcer. They are used to control the infection, so are usually only used in short courses. You are more at risk of developing a leg ulcer if you: Are elderly Have varicose veins (swollen or enlarged veins) Have had a blood clot in the leg ( deep vein thrombosis DVT) Have had several pregnancies Stand for long periods of time in your job You have mobility issues like a leg fracture, obesity or paralysis You’re recovering from surgery such as knee or hip replacement Have a history of leg ulceration Have leg ulcer problems in the family Preventing ulcers Once you have had a leg ulcer, you are more prone to developing another one. This can happen within months or years. Wearing compression stockings at all times (except when in bed) can help reduce your risk of a recurrence. A nurse can help you find a compression stocking that fits correctly. Regards DR DE