Leg Ulcers and Foot Ulcers

When the blood vessels in your legs don’t function as they should, your legs and feet may not get the oxygen or nutrients they need. As a result, blood can begin to pool and cause pressure to build. These problems can lead to the development of ulcers.

Ulcers are open sores that are long-lasting, keep returning, and are resistant to treatment (non-healing wounds). These sores may cause swelling, itching, burning, or dry and scaly skin. Left untreated, these can lead to severe infections that may need limb-saving surgery or amputation, in some cases.

That's why it's crucial to seek medical care if you develop an ulcer that doesn't heal on its own after two weeks. At MedStar Health's Wound Healing Institute, our wound care specialists are experts at managing, treating, and preventing leg and foot ulcers caused by diabetes or venous conditions. We take a team approach, working closely with heart and vascular surgeons, plastic and reconstructive surgeons, and other specialists to identify and treat the cause of the ulcer so that you can heal completely and return to the things you enjoy.

Types of leg ulcers and foot ulcers

The three most common types of leg and foot ulcers are:

Arterial ulcers, or ischemic ulcers, which often develop on the heels, tips of the toes, or between the toes in people with poor circulation, diabetes, or high blood pressure.
Neurotrophic ulcers, also known as diabetic ulcers, which usually develop on the pressure points of the bottom of the feet but can occur anywhere on the foot. They can affect people who have diabetes, nerve problems, or trauma to the legs or feet.
Venous stasis ulcers, which are found on the inner part of the leg near the ankles. Venous ulcers most commonly develop in people with varicose veins or deep vein clots.

Symptoms, causes, and risk factors

This type of condition is often caused by diabetes or poor blood circulation. Vascular conditions include:

In addition, you have an increased risk of developing ulcers in the foot or leg if you smoke, are aging, or if you have a family history of ulcers.

Symptoms may include the following:

Pain in the leg or foot
Rashes or redness
Dry, itchy skin
A heavy sensation in the leg or foot
Discoloration, discharge, or other signs of infection
Large varicose veins

If you notice any signs or symptoms, talk to your doctor right away, especially if you have diabetes. Getting medical care early can help to lower your risk of limb loss or amputation.

Prevention

There are several things you can do to prevent ulcers from developing or worsening:

Elevate your legs at night
Wear good shoes
Exercise regularly
Check your feet daily (if you have diabetes)
Eat a variety of fruits and vegetables
Maintain a healthy weight
Drink water
Avoid standing on your feet for a long time
Wear compression stockings

Learn more about preventing leg or foot ulcers from diabetes

Diagnosis

Our specialists may recommend one or more diagnostic and imaging procedures to diagnose your condition, along with any underlying disorders that may be causing them.

Angiogram (Angiography) - An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.

Arterial Duplex Ultrasound for Arms and Legs - Arterial duplex ultrasound uses Doppler and traditional ultrasound to assess blood flow in the arteries of your arms and legs.

Computerized Tomography (CT) Scan - The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

Fluoroscopy - A fluoroscopy is an imaging technique that uses a continuous X-ray beam passed through the body to create real-time, moving images of your internal structures.

Magnetic Resonance Imaging (MRI) - Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets and computer technology used to create images of your heart and blood vessels.

Treatments

Our heart and vascular teams work together with wound care specialists to develop and implement individualized plans to prevent and treat a variety of these ulcers. Treatment may vary based on the underlying cause and may include lifestyle modifications, medication, or more advanced treatments, including:

Limb Salvage - Limb salvage is a form of treatment our vascular surgeons use as an alternative to amputation for patients with severe peripheral artery disease, or PAD.

Vascular Disease Treatments - Vascular disease treatments address conditions that affect the blood vessels, which can cause blood flow to become decreased, interrupted or slowed.

Venous Disease Treatments - Venous disease treatment may include medications, minimally invasive and surgical procedures to improve blood flow and circulation.

Wound Care - Our comprehensive wound care services promote healing for complex and hard-to-heal wounds like foot and leg ulcers using advanced approaches, including hyperbaric oxygen therapy.

Frequently asked questions

How long do venous ulcers and other ulcers take to heal?

Many venous leg ulcers heal within three to four months with compression therapy and other nonsurgical approaches under the care of a highly-trained wound specialist. However, some take years to heal. Talk to your doctor about what you can do at home to help your ulcer heal faster.
Can foot or leg ulcers lead to amputation?

Yes, in rare, severe cases, amputation may be the best treatment option for infected foot or leg ulcers that pose a risk to your life. That's why it's important to seek care early at the first sign of an ulcer or infection, especially if you have diabetes or peripheral arterial disease.
Can I shower with a leg or foot ulcer?

Yes, you can safely shower with an ulcer. However, do not directly apply soap or shower gel directly to your healing wound. You will need to dry it and, in some cases, apply dressing over the area following your shower.
How can I prevent an ulcer from coming back?
Once your condition heals, you should wear compression stockings to stop the ulcer from returning. Your care team will provide specific instructions on how and when to wear them. You can also adopt healthy lifestyle changes, including:

Eating a nutritious diet with lots of produce

Elevating your leg while sitting

Exercising regularly

Wearing well-fitting shoes

Washing and moisturizing your feet and legs regularly

Monitoring your skin for any changes
What are the signs that my ulcer is infected?
You should contact your doctor right away if you notice any of the following signs of infection:

An unpleasant smell

Fever

Thick discharge coming from the wound

Redness around the wound

Increased pain near the wound

A hot sensation or swelling around the wound