They can also cause aching in the calf on standing, which is worse at the end of the day and better when the leg is elevated. Itching often occurs over the affected veins and the leg can become swollen. The veins can bleed or become infected and inflamed. Ulceration can occur, typically on the inside of the leg just above the ankle. This is called venous ulceration and is one of the more serious complications of varicose veins.
Venous ulceration is a result of high venous pressure in the lower leg.
A substance called fibrin leaks from very small blood vessels called capillaries into the surrounding tissue resulting in swelling. The skin does not get enough oxygen and breaks down, and ulcers may form. The diagnosis is made by a physical examination by your doctor who determines the site of the perforator vein that is not working properly. No other tests are usually necessary. Sometimes an ultrasound test is used to observe blood flow in the perforator vein.