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Prevalence of skin problems and leg ulceration in a sample of young injecting drug users

Coull, Alison F; Atherton, Iain; Taylor, Avril; Watterson, Andrew E


Alison F Coull

Avril Taylor

Andrew E Watterson


Drug users suffer harm from the injecting process, and clinical services are reporting increasing numbers presenting with skin-related problems such as abscesses and leg ulcers. Skin breakdown can lead to long-term health problems and increased service costs and is often the first indication of serious systemic ill health. The extent of skin problems in injecting drug users has not previously been quantified empirically, and there is a dearth of robust topical literature. Where skin problems have been reported, this is often without clear definition and generic terms such as ‘soft tissue infection’ are used which lack specificity. The aim of this study was to identify the range and extent of skin problems including leg ulceration in a sample of injecting drug users. Definitions of skin problems were developed and applied to descriptions from drug users to improve rigour.

Data were collected in needle exchanges and methadone clinics across Glasgow, Scotland, from both current and former drug injectors using face-to-face interviews.


Two hundred participants were recruited, of which 74% (n = 148) were males and 26% (n = 52) were females. The age range was 21–44 years (mean 35 years). Just under two thirds (64%, n = 127) were currently injecting or had injected within the last 6 months, and 36% (n = 73) had previously injected and had not injected for more than 6 months.

Sixty per cent (n = 120) of the sample had experienced a skin problem, and the majority reported more than one problem. Most common were abscesses, lumps, track marks and leg ulcers. Fifteen per cent (n = 30) of all participants reported having had a leg ulcer.


This is an original empirical study which demonstrated unique findings of a high prevalence of skin disease (60%) and surprisingly high rates of leg ulceration (15%). Skin disease in injecting drug users is clearly widespread. Leg ulceration in particular is a chronic recurring condition that is costly to treat and has long-term implications for drug users and services caring for current or former injectors long after illicit drug use has ceased.

Journal Article Type Article
Acceptance Date Aug 7, 2014
Online Publication Date Aug 13, 2014
Publication Date Aug 13, 2014
Deposit Date Feb 11, 2015
Publicly Available Date Feb 11, 2015
Journal Harm Reduction Journal
Electronic ISSN 1477-7517
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 11
Issue 1
Pages 22
Keywords Leg ulceration; skin; prevalence; drug injecting
Public URL
Publisher URL
Contract Date Feb 11, 2015


HRJ_Prevalence.pdf (266 Kb)

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Copyright Statement
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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