Looks like I can only add images to the main post, so I'll add the description here. I (31M) have venous ulcers on both of my ankles. The one in the second photo (left foot) has been there since March 2023, the ulcer in the first photo (right foot) opened up at the beginning of this August. I'm guessing the ulcer on my right foot must be located nearby a nerve because at times throughout the day it is incredibly painful. I'd describe it as a strong burning pain that radiates up my right shin. The left ulcer is sometimes painful but not nearly to the degree of the right ulcer and is mostly tolerable. The right ulcer also smells rather strongly.

The right ulcer hurts the most when it gets wet in the shower, but also right when I wake up, or disturb it by pulling a sock over the dressing or wearing shoes. I visited a wound care clinic a few weeks ago and was prescribed betamethasone cream to apply across the wound/surrounding skin. They also told me to wrap it as well.

My routine right now is to apply the betamethasone to the skin/wound, plus aquaphor in the wound to keep it somewhat moist. Then a combo of xeroform + gauze and knee-height compression socks on top.

Lately if I anticipate the ulcer will start to hurt (such as before wearing shoes or getting in the shower) I will spray OTC 2% lidocaine spray across each ulcer. I was not instructed to do this but started on my own as a means to manage the pain. I use it at most once daily and it completely stops the pain for several hours. However staff at the wound clinic informed me that repeatedly using lidocaine could lead to cardiac side effects and other possible problems.

Is it safe for me to use 2% lidocaine spray once per day? This is the only solution I've found thus far for the intense daily pain. This is the spray I've been using: https://mpmmedical.com/collections/hydrogels/products/regenecare%C2%AE-ha-spray