The obvious sign of a leg ulcer is the wound on your lower leg or foot, but you may have early signs before the ulcer appears. There are two types of leg ulcers with different appearances.
As a vascular specialist, Kishore Arcot, MD, at Memphis Vein Center quickly determines the cause of your ulcer, provides the wound care needed to promote healing, and treats the underlying cause to prevent dangerous ulcers from recurring.
Types of leg ulcers
You can develop two types of leg ulcers, arterial and venous. Though they have different causes, they both pose a serious threat to your health.
Leg ulcers never heal on their own. And even with intensive wound care, they usually don’t heal for months. If the underlying cause isn’t treated, they recur or never fully heal.
Nonhealing ulcers can easily develop an infection that spreads to your skin and bones. A nonhealing arterial ulcer may cause gangrene (tissue death) and require an amputation.
How arterial ulcers develop
Arterial ulcers (ischemic ulcers) begin due to peripheral artery disease. This condition occurs when cholesterol builds up in a leg artery. As the plaque enlarges, blood flow becomes increasingly limited.
An ulcer may appear if you have a small cut or bruise in the area deprived of blood. Without blood, the tissues don’t get the oxygen and nutrients needed to heal, and a small wound quickly turns into an ulcer.
Or you could also end up with an ulcer if the affected tissues become inflamed or die due to the lack of blood.
How venous ulcers develop
Venous ulcers (venous stasis ulcers) are caused by faulty valves inside your leg veins. The valves normally keep blood flowing in one direction: up your leg. If a valve weakens or becomes stretched, it lets blood flow down your leg, a condition called chronic venous insufficiency.
When the refluxing blood reaches the next healthy valve, it stops flowing in the wrong direction. Then it builds up in the vein, causing an engorged, bulging, twisted varicose vein.
Chronic venous insufficiency also raises the blood pressure in the vein. The pressure pushes fluids out of the vein in your lower leg. Venous ulcers develop as the fluids break down the surrounding tissues.
Early signs of arterial ulcers
Before an arterial ulcer appears, you may have signs of advanced peripheral artery disease. The most common sign is leg pain that occurs when you walk or get active and feels better when you rest.
You may also notice less hair growth on your lower leg together with shiny skin and/or skin that appears blue or purple. Additionally, the leg with arterial disease may feel colder than your other leg.
Five qualities of an arterial ulcer
Arterial ulcers appear around your ankle or on your feet, heels, or toes, especially in areas that sustain pressure. Five primary characteristics of arterial ulcers include:
- Painful wound
- Round shape (with well-defined margins)
- May appear red, black, or yellow
- Area is cool or cold to the touch
- Deep wound with a punched-out appearance (like a hole)
Arterial ulcers seldom bleed or ooze, but you may notice that your leg reddens when dangled down and looks pale when elevated.
Early signs of venous ulcers
Varicose veins are the earliest sign of the underlying condition responsible for a venous ulcer. Over time, high venous pressure causes other skin problems that often occur before an ulcer, including:
- Itchy red rash (stasis dermatitis)
- Reddish-brown skin (hyperpigmentation)
- Thick, hard skin (lipodermatosclerosis)
You may also develop an inflamed area with small white, oozing patches. These patches then turn into an ulcer.
Five qualities of venous ulcers
Venous ulcers appear below your knee and above the ankle. The five characteristics of a venous ulcer differ from an arterial ulcer:
- Painless wound (but inflammation around the wound may cause discomfort)
- Irregular edges that enlarge
- Sore appears red
- Skin may feel warm or hot
- Shallow wound
Venous ulcers often bleed or ooze. While arterial ulcers may go deep into the underlying tissues, venous ulcers stay shallow but spread and can get quite large.
It’s vital to seek treatment at the first sign of a problem or as soon as a leg ulcer appears. To schedule an appointment, call our Memphis, Tennessee, center or request an appointment online.