It rarely starts as anything dramatic. A graze from the edge of a car door. A blister from a new pair of shoes. A small crack in dry skin near the ankle. The kind of thing that has healed a hundred times before without you giving it a second thought.
Except this time it does not close. Three weeks later there is still a dressing on it, and the shape of it has barely changed.
A sore on your leg or foot that will not heal is one of the few leg symptoms that is almost never trivial. Not because the sore itself is dangerous at first, but because of what it is reporting about the leg underneath it. That is the part worth understanding, and it is the part most people are never told.
What a sore that will not heal is telling you
Healing is not something skin does passively. It is active work, and it runs on delivery. Closing even a small wound takes a steady supply of oxygen, white cells to keep infection down, and the raw material to build new tissue, all of it arriving through the arteries. It also depends on drainage, because tissue sitting under raised pressure and waterlogged with fluid does not knit together.
So a sore that will not heal is usually not a wound problem at all. It is a plumbing problem, showing up at the one place on the body where the plumbing is under the most strain. Your legs are the furthest point from the heart and the lowest point in the circulation, which is why the failure shows there first and shows there worst.
This is why the standard responses often do so little. Cleaning it more carefully, changing the dressing more often, or trying another cream addresses the surface. If the supply line into the leg is narrowed, or the return line out of it has failed, none of that changes the arithmetic. The National Heart, Lung, and Blood Institute lists it directly among the signs of poor leg circulation: sores or wounds on the toes, feet, or legs that heal slowly or not at all.
None of that means the news is bad. It means the sore is information, and acting on the information is what changes the outcome.
Where the sore sits: three patterns
A sore that will not heal on the leg or foot almost always falls into one of three patterns, and you can get a long way towards telling them apart from where it sits and what the skin around it looks like. This is not a diagnosis. It is a way of knowing what you are probably dealing with before you are seen, and what to say when you are.
1. Around the inner ankle, shallow, with changed skin around it. This is the venous pattern, the end point of years of raised pressure in the leg veins. The sore is typically wide and shallow rather than deep, often weeping, and it sits just above the ankle bone on the inside of the leg. The tell is the surrounding skin: brownish staining, hardening, sometimes an itchy scaly patch, and a leg that has been swelling by the evening for a long time. The ache usually improves when the leg is up. On this site that picture belongs to chronic venous insufficiency, and it is by a distance the most common version.
2. On the toes, the heel, or the outer foot, and painful. This is the arterial pattern, and it is the one that changes the timetable. It sits lower than the venous kind, below the ankle rather than above it, tends to look punched out with a clean edge, and is often dry rather than weeping. The foot may be cool to the touch, the skin thin and shiny, and the pain is frequently worse lying flat at night and eased by hanging the leg out of the bed. That last detail is worth repeating to whoever sees you, because it points squarely at peripheral artery disease. It often arrives alongside cramping in the calf that starts when you walk and stops when you stand still.
3. Under the ball of the foot or on a pressure point, and painless. This is the neuropathic pattern, seen most often with long-standing diabetes. It forms where a shoe or the ground presses hardest, often ringed by thick callus, and the defining feature is that it does not hurt. Nerve damage has removed the warning, so the injury continues while the person carries on walking on it. A sore that will not heal and does not hurt is more concerning than one that does, not less.
These overlap more than the neat descriptions suggest, and mixed pictures are common. If you have diabetes, assume more than one may be in play, and treat the whole thing as more urgent rather than less.
The two-week line, and why it is not arbitrary
The rule of thumb used across this site is two weeks. A sore on your leg or foot that has not clearly improved in two weeks is a reason to be seen, not a reason to wait longer.
Two weeks is not a round number chosen for convenience. An ordinary wound on a leg with a working blood supply is visibly further along by then: smaller, drier, with the edges drawing in. It does not have to be closed. It has to be heading somewhere. A sore that will not heal is one that after a fortnight looks essentially the same as it did at the start, or worse.
There is one mistake that costs people months, and it is worth naming. The clock starts when the sore appeared, not when it last reopened. Many of these break down, scab, look promising for a few days, then open again in the same spot, and each cycle feels like a fresh start. It is not. A patch of skin that has been breaking down repeatedly for six months is a six-month-old problem, and describing it that way to a clinician changes how seriously it is taken.
If you have diabetes, a known circulation problem, or you smoke, treat two weeks as an outside limit rather than a target.
When this is an emergency
Most of what is on this page is urgent rather than immediate. These are the exceptions. Any of them means same-day care rather than an appointment in due course.
- A foot that becomes suddenly cold, pale, numb and painful
- Toes turning blue, purple or black
- Redness spreading out from the sore, or a red streak tracking up the leg
- Fever, shaking chills, or feeling generally unwell alongside the sore
- The sore starting to smell, or discharging pus
- Pain that has changed suddenly, either sharply worse or unexpectedly gone
- Exposed bone or tendon visible in the base of the wound
The last two catch people out. Pain disappearing from a wound that was painful is not automatically progress, and a deep sore is easy to underestimate because the surface opening can look small.
How Help My Legs works
Tell us your symptoms
A short form, in plain language. No account, no cost, and it takes about a minute.
We match you locally
We look for a specialist near you who treats the specific problem you described.
You get seen
You are put in touch directly. What you decide after that is entirely up to you.
How each kind is treated
There is one principle underneath all of it. The circulation gets assessed before the sore gets managed, because that assessment decides which treatments will actually close a sore that will not heal and which will do nothing at all.
First, the supply is checked. An ankle-brachial index compares the blood pressure at the ankle with the pressure in the arm, takes a few minutes, and involves nothing worse than a cuff. An ultrasound scan can then show where a narrowing or a failing valve actually sits. Both are painless, and between them they usually settle which of the three patterns you are dealing with.
Why that order matters more here than anywhere else on this site. Firm compression is the mainstay of treating a venous sore and it is genuinely effective. It is also the wrong thing to apply to a leg whose arterial supply is poor, which is exactly why the pressure test comes before the stocking rather than after it. This is the single most useful reason not to self-treat a sore that will not heal on the basis of an internet description, including this one.
Venous sores. Graduated compression, elevation, and treatment of the failing vein underneath. Closing the faulty vein from the inside, usually under local anaesthetic through a small entry point, addresses the pressure that produced the sore instead of only dressing the result. Healing rates with proper compression are good, and recurrence drops considerably when the underlying vein is dealt with.
Arterial sores. The wound will not close while the supply is inadequate, so restoring flow comes first. That may mean opening the narrowed artery with a balloon or a stent through a small puncture, or in some cases bypassing it. Dressings, antibiotics and rest all have a role, but none of them substitutes for flow. This is the group where delay costs the most, and it is also the group where whether you are a candidate for a procedure gets decided quickly rather than after months of watching.
Neuropathic sores. The pressure has to come off the spot, through specialist footwear, casting or offloading devices, alongside removal of the surrounding callus and close attention to glucose control. Because there is no pain to enforce rest, the offloading has to be built into the shoe rather than left to willpower.
What wound care alone does. Good dressings protect the wound, control moisture and keep infection down, and they matter. What they cannot do is supply blood to tissue that is not receiving enough. If a sore has been dressed for months without closing, the question that has probably not been asked is what the circulation into that leg is actually doing.
Questions people ask about a sore that will not heal
How long should a normal sore on the leg take to heal?
A minor graze or shallow cut on a leg with a healthy blood supply is usually well on its way within a fortnight, and often closed sooner. The useful measure is direction rather than a finish line. If it is getting smaller, drier and tighter at the edges, it is behaving normally. If it looks much the same after two weeks, or keeps breaking down in the same place, that is the point at which it should be looked at rather than watched.
Does a sore that does not hurt mean it is less serious?
No, and it is often the reverse. Painless sores on the foot are commonly associated with nerve damage from diabetes, which removes the protective warning that would normally make someone stop walking on the area. The wound then continues to be loaded every day. Absence of pain also means these are frequently found late, sometimes only when a sock is stained. A painless sore on a pressure point deserves prompt attention, not reassurance.
Which type of doctor should I see about this?
For a sore linked to circulation, a vascular specialist is the person who can both assess the blood supply and treat what is found, and many areas also have dedicated wound or leg ulcer clinics. If you have diabetes, a podiatrist experienced in diabetic foot care is an important part of that team. The practical starting point is anyone who can arrange an ankle-brachial index and an ultrasound quickly, because those two results steer everything that follows.
Can smoking really stop a wound from closing?
It has a direct effect. Smoking narrows blood vessels and reduces the amount of oxygen the blood carries, which are the two things wound healing depends on most. It also raises the risk of infection and of the wound breaking down after surgery. Among all the things that can be changed, stopping is the single one with the largest measurable effect on whether a leg wound closes, and the benefit begins within weeks rather than years.
Will it heal on its own if I just give it more time?
Some do. The difficulty is that the ones which will not are almost indistinguishable from the ones which will during the first few weeks, and the difference lies in the circulation rather than in the appearance of the wound. Time is also not neutral here. A sore that stays open is a route for infection, and in a leg with poor arterial supply the margin for recovering the situation narrows the longer it runs. Getting the circulation checked does not commit you to any treatment, and it converts the question from a guess into a fact.
A sore that will not heal has already given you the useful information. If it has not shifted in two weeks, the sensible next step is not a different dressing. It is finding out what the circulation in that leg is doing. If you are not sure whether it warrants a specialist, a short symptom check that takes about ninety seconds will point you one way or the other.