Arterial and venous ulcers are two kinds of open sores found on the body. They can form on the lower extremities, such as the legs and feet.
Arterial ulcers develop as a result of damage to the arteries due to inadequate blood flow to the tissue. Venous ulcers develop from damage to the veins resulting from an insufficient return of blood back to the heart.
Unlike other ulcers, these leg wounds can take months to heal, if they heal at all. Though similar, they require different treatments to ensure proper healing and a speedy recovery.
Common symptoms of ulcer formation include pain and swelling. Other symptoms can differ between arterial and venous ulcers.
Arterial ulcers
Arterial ulcers can form on the outer side of the ankle, feet, heels, or toes. They can also form in other areas. These ulcers are painful and have a “punched out” appearance.
Other symptoms or characteristics of arterial ulcers include:
Venous ulcers
Venous ulcers usually form below the knee and on the inner area of the ankle. There’s sometimes little or no discomfort, unless an infection is present. In other cases, venous ulcers can be painful.
The affected area
- inflammation
- swelling
- aching
- itchy, hardened skin
- scabbing or flaking
- brown or black stained skin
- discharge
Issues with blood circulation cause ulcers. Reduced blood flow to the skin and tissues means the affected areas do not receive oxygen and nutrients. These areas will become inflamed and form an open wound.
Though ulcers can form anywhere on the body, arterial and venous ulcers are more commonly found on the legs and feet.
Arterial ulcers
Blocked arteries are a common cause of arterial ulcers. They’re also referred to as ischemic ulcers. The arteries are responsible for delivering nutrients and oxygen to different tissues. Clogged arteries prevent nutrient-rich blood from flowing to the extremities. This results in an open wound.
Other potential causes of arterial ulcers include:
- age
- diabetes
- smoking
- high blood pressure
- high cholesterol
- kidney failure
- trauma
- atherosclerosis, or thickening of the arteries
- vasculitis
Venous ulcers
Venous ulcers are the most common type of leg ulcer. They result from damage to the veins. The veins are responsible for bringing blood from various parts of the body to the heart through one-way valves. These valves prevent blood from flowing away from the heart.
If blood doesn’t flow correctly, it could pool in one area of the body. This results in damage to the vein, leading to leakage of fluid and blood cells, and subsequently causing edema, or swelling. This is thought to prevent adequate blood flow to the tissue in the leg. As a result, this tissue will die, and ulcers will begin to form.
Other potential causes of venous ulcers include:
For either type of ulcer, seek immediate medical attention if your symptoms worsen and include:
- fever
- a foul-smelling odor
- discharge
- numbness
In more severe cases, these symptoms could be signs of an infection. If left untreated, amputation may be necessary. You should also seek care if chronic ulcers of any type appear to be worsening rapidly.
Before suggesting treatment, your doctor needs to identify the underlying cause. They can treat them with proper care and antibiotics, but diagnosing the underlying cause can ensure ulcers heal and don’t recur.
Some conditions that contribute to ulcers include:
As with any ulcer, primary treatment focuses on increasing blood circulation to the affected area. Additional treatment goals include:
- reducing pain
- healing the wound effectively
- speeding the recovery process
Treating arterial ulcers
To treat arterial ulcers, your doctor will try to restore blood circulation to the affected area. Treating the underlying cause with antibiotics can help reduce symptoms, but it will not completely heal the ulcer. Doctors may use surgery to restore blood flow to tissues and organs in addition to antibiotics.
Several surgical options are available to treat arterial ulcers, including angioplasty. This procedure utilizes a balloon to dilate the affected artery, thereby improving blood flow through the affected area. Symptoms will subside when blood flow resumes.
If a healthcare professional cannot restore blood flow or if the wound has become heavily infected, your doctor may recommend amputation.
Arterial ulcers require keeping them dry, clean, and bandaged to prevent infection and prevent the wound from worsening. Discuss with your doctor how much you need to change your bandages and any additional treatment recommendations or lifestyle changes.
Treating venous ulcers
Venous ulcers can take months to heal. In some rare cases, they may never heal. Similar to arterial ulcers, treatment focuses on improving blood flow to the affected area.
Your doctor may recommend antibiotics to treat the underlying cause, prevent infection, and reduce the likelihood of recurrence. However, antibiotics alone cannot heal a venous ulcer.
Your doctor will show you how to properly clean and bandage your wound. They may also recommend compression therapy. This entails applying a compression bandage or stocking to the affected area. This pressure improves blood flow and reduces symptoms.
Your doctor may prescribe pain medication to help reduce your discomfort. They may also encourage you to keep your leg or other affected area elevated.
Usually, arterial ulcers are more painful than venous ulcers. Venous ulcers however, may be larger.
Signs of a venous ulcer include discoloration on the skin, swelling, and itching in the area.
Yes, a leg ulcer without treatment can turn into sepsis. It is important to contact a healthcare professional if you have a leg ulcer.
Arterial and venous ulcers result from irregular blood flow and circulation. Left untreated, these ulcers can cause serious complications. If you begin to experience irregular symptoms or notice pain in your lower extremities, seek immediate medical attention.
Don’t self-diagnose. Your wound or symptoms could be indicators of a more serious condition. Discuss your options and concerns with your doctor to ensure you receive the best treatment.