Ulcers are wounds, or sores, that do not heal.
Often, foot and leg ulcers are a result from a heart or vascular condition, or other health problem.
On this page:
What Are Foot and Leg Ulcers?
An ulcer is a type of wound or sore that doesn't heal or that returns over and over again.
Leg ulcers and foot ulcers often result from cardiovascular or other health conditions.
They may appear:
- On the inside of your leg below the knee.
- On the bottoms of your feet.
- Where your feet rub together.
The most common type of foot and leg ulcer (venous) affects 500,000 to 2 million Americans every year.
Wound care specialists at the UPMC Heart and Vascular Institute are a vital part of the ulcer treatment team.
What are the types of foot and legs ulcers?
- Venous ulcers – happen when the veins in your legs don't adequately push blood back up to your heart. This causes a backup in the veins, leading to an open sore. These are the most common type of ulcers. They occur in people with a history of blood clots in the legs, leg swelling, or varicose veins.
- Neurotrophic ulcers – most commonly occur on the bottoms of your feet and in people with diabetes.
- Arterial – also called ischemic, neurotrophic foot ulcers usually show up on your heels or toes and can be painful. They occur in people with a history of poor circulation or who have medical conditions that raise their risk of ulcers.
What causes foot and leg ulcers?
Causes of ulcers in your feet and legs often include:
- Poor circulation or arteriosclerosis.
- Diabetes.
- Kidney failure.
- High blood pressure.
- Heart disease.
- Lymphedema (a condition that causes swelling in the feet and legs).
- Clotting or circulation disorders.
- Inflammatory diseases.
- Smoking or history of smoking.
- Varicose veins.
- Impaired venous return.
Foot and leg ulcer risk factors
Certain conditions may increase your risk of developing venous foot and leg ulcers, including:
- Blood clotting disorders.
- Deep vein thrombosis.
- Heart failure.
- High blood pressure.
- Obesity.
- Pregnancy.
- Trauma, such as fractures or injuries to your veins.
- Varicose veins.
Certain conditions may increase your risk of developing arterial foot and leg ulcers, including:
- Atherosclerosis (hardening of the arteries).
- Diabetes.
- High blood pressure.
- High cholesterol.
- Kidney failure.
- Older age.
- Smoking.
- Trauma, such as fractures or injuries to your veins.
- Vasculitis.
Complications of foot and leg ulcers
If left untreated, venous and arterial foot and leg ulcers can cause serious complications, including:
- Amputation.
- Gangrene.
- Infection.
- Reduced mobility due to pain.
- Sepsis.
How can I prevent foot and leg ulcers?
The best way to prevent ulcers is to manage chronic health conditions, quit smoking, and keep a healthy lifestyle.
What Are the Signs and Symptoms of Foot and Leg Ulcers?
Not all foot and leg ulcers are painful.
Depending on the type, foot and leg ulcers may:
- Appear red, yellow, brown, or gray.
- Drain fluid.
- Look swollen or bleed when irritated.
Early signs that an ulcer is forming include:
- Leg swelling or cramping.
- Hardened skin that is purple, dark red, or brown.
- Itching and tingling.
- Dry, scaly skin.
- Fluid-filled blisters.
- Rash or redness.
How Do You Diagnose Foot and Leg Ulcers?
A doctor will first discuss your medical history and take a close look at the wound. He or she may refer you to a wound care specialist as well.
You'll likely have imaging tests — such as an ultrasound and leg blood pressures — to help your doctor design your treatment plan.
How Do You Treat Foot and Leg Ulcers?
The goals of treatment are to lessen your pain and symptoms, prevent future ulcers, and heal the wound.
Ulcers may require the expertise of a wound care specialist, as they're hard to heal. He or she will show you how to care for the wound at home and promote healing.
You will need to keep a clean bandage on the wound and change the dressing regularly.
Other foot and leg ulcer treatments may include:
- Compression garments, such as socks or wraps.
- Blood thinners.
- Debridement (removing infected tissue).
- Orthotics or special shoes.
Your doctor will also show you how to properly care for your feet, especially if you have diabetes.
