Foot Ulcer

Foot ulcers can have a big impact on people, especially those with conditions like diabetes or poor circulation. Foot ulcers can cause pain and make it hard to walk. Working closely with health care professionals, such as doctors, podiatrists, or wound care specialists, is essential if you are at risk of foot ulcers.

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On this page

• What Causes Foot Ulcers?
• What Are the Symptoms of Foot Ulcers?
• How Do You Diagnose Foot Ulcers?
• How Do You Treat Foot Ulcers?

What Is a Foot Ulcer?

Foot ulcers are open sores or lesions that will not heal or that return over a long period of time. These sores result from the breakdown of the skin and tissues of the feet and ankles and can get infected. Symptoms of foot ulcers can include swelling, burning, and pain.

Types of foot ulcers

Foot and ankle ulcers often fall into one of three major types, based on appearance, location, and effect on the skin:

• Venous ulcers affect the legs below the knees, often in people with a history of leg swelling and related vein conditions.
• Neurotropic (diabetic foot) ulcers often occur on the bottom of the feet in those with diabetes.
• Arterial (ischemic) ulcers develop all over the feet in those with poor circulation.

What causes foot ulcers?

Foot ulcers can result from diabetic neuropathy, a condition where nerve damage due to diabetes reduces sensation in your feet, making it harder to detect injuries that may progress to ulcers. Additionally, cellulitis, infections, trauma, poor circulation, and abnormal foot anatomy contribute to ulcer formation.

Older men have the highest risk for developing foot ulcers.

What are the risk factors and complications of foot ulcers?

Because of the correlation with poor circulation, you are more likely to get foot ulcers if you have:

• Diabetes
• Diabetic neuropathy (diabetic foot disease)
• Other circulation issues

Additional health conditions and factors that often increase your risk of foot ulcers include:

• Heart disease
• Kidney disease
• Obesity
• Nerve damage
• Wounded feet
• Alcohol use
• Tobacco use

Left untreated, a foot ulcer can:

• Increase in size and depth.
• Become infected, which can spiral into other foot conditions.
• Lead to reduced functioning in the feet and, in some cases, even require amputation.

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What Are the Symptoms of Foot Ulcers?

Foot ulcers may present almost as a wound on the flesh of the foot.

Based on related conditions — like trouble with circulation and nerve damage — you may not feel certain symptoms.

General foot ulcer symptoms may cause:

• Swelling
• Burning
• Itching
• Skin discoloration
• Rashes
• Redness
• Dry, scaly skin
• Pain

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How Do You Diagnose Foot Ulcers?

People at a higher risk for foot ulcers, and those with recent foot injuries or trauma, should closely examine their feet on a regular basis.

Be sure to report any changes to your doctor right away so he or she can conduct an in-depth foot exam.

Based on your symptoms and the results of your exam, your doctor may order other tests such as:

• Radiograph tests collect accurate images based on different views and angles.
• Magnetic resonance imaging (MRI) offers a look into the soft tissues of the foot.
• Bone scans use nuclear medicine techniques, like white blood cell marking, to assess the presence of a bone infection.

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How Do You Treat Foot Ulcers?

The many treatment options for foot ulcers aim to:

• Preserve limb function
• Manage the spread of infection
• Reduce pain
• Increase limb mobility

Types of foot ulcer treatment

Your doctor might prescribe both surgical and nonsurgical treatments for foot ulcers.

Nonsurgical treatments for foot ulcers may include:

• Wound care
• Casting
• Compression
• Off-loading
• Orthotics

If nonsurgical treatment options don't work over time, your doctor may advise surgery.

Common surgical procedures for treating and correcting foot ulcers range from more routine wound care procedures like surgical debridement, to amputation if the ulcer becomes infected.

In addition to nonsurgical and surgical treatments, doctors may prescribe rounds of anti-inflammatory medications and antibiotics to help the healing foot ulcers.

Benefits and risks of foot ulcer treatment

Following treatment for foot ulcers, a period of off-loading of the feet is often necessary. This can be as long as four months after a surgical procedure.

With prompt evaluation and treatment, doctors can appropriately manage foot ulcers and minimize the spread of infection.

To identify cases of foot ulcers as quickly as possible, monitor your feet regularly and go to the doctor for a total foot exam if you have any predisposing medical conditions.

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