The Difference Between Venous and Arterial Ulcers

Updated on: August 26, 2019

Vein disease and peripheral artery disease (PAD) are two conditions that can cause poor circulation in the legs and feet. As a result of limited or abnormal blood flow, the limbs become deprived of oxygen and nutrients, causing the area to become inflamed and for open wounds to form (ulcers).

What is an ulcer?

Ulcers are defined as abnormal breaks in the skin or mucous membranes. This long-lasting sore or wound is typically characterized as slow-healing or non-healing when it has taken more than 5 to 6 weeks to heal. Although leg ulcers can develop anywhere on the leg or foot, they usually develop on the inside of the calf, just above the ankle.

Different types of ulcers

There are two main ulcers that primarily affect the lower extremities:

  • Arterial ulcers – These occur in arteries that carry oxygen and nutrient-rich blood from the heart to all body organs and tissues.
  • Venous ulcers – These are more common—a high majority (80%) ulcers of the lower limb are venous ulcers—and they develop in the veins that bring back blood to the heart from body tissues for purification.

Venous ulcers

Venous ulcers most commonly occur in the lower legs or upper part of the ankles when the one-way valves in veins become damaged, causing blood to flow back into the legs rather than move toward the heart.

As the blood and fluid buildup, swelling (edema) develops. This swelling further prevents the flow of blood to the tissue in the leg, causing it to die and ulcers to form.

Treating underlying venous insufficiency early can prevent ulceration or if ulceration is present, improve symptoms and wound healing.

Symptoms of venous ulcers

Signs and symptoms of venous ulcers include:

  • Shallow wound
  • Usually appear on the lower leg or ankle
  • Discharge
  • Itchy, dry skin
  • Swelling, especially in the affected area
  • Inflammation and redness before the wound progresses
  • Achy, heavy feeling in the affected leg
  • Skin discoloration
  • The wound is flaky, but may continue to reopen

How to minimize venous ulcer complications

There are ways to prevent or minimize venous ulcer complications, including:

  • Examining feet, ankles, and legs regularly for non-healing wounds or discoloration
  • Scheduling an appointment with a vein specialist
  • Telling your doctor if you’re taking heart medications that may increase your risk of swelling
  • Exercising regularly and as frequently as comfortable
  • Losing weight can help relieve excess pressure from the legs
  • Quitting smoking
  • Practicing leg exercises if you have to stand or sit for a long period of time
  • Elevating the legs

Arterial ulcers

Arterial ulcers are formed due to blockage in arteries, most often plaque buildup. Plaque consists of fat and cholesterol, which often stores in arteries when you live a sedentary lifestyle, have unhealthy eating habits, smoke or are overweight.

As the process of plaque buildup (atherosclerosis) accelerates, arteries become narrower, affecting how nutrients and oxygen-rich blood reach the limbs. With poor distribution, it prompts the development of an ulcer and brings about a condition commonly known as peripheral artery disease (PAD).

These painful ulcers are often found at the pressure points of the foot—between or on the tips of toes, on the outer ankle or in the areas where you experience pressure while walking. Left untreated, the ulcers can cause infection or death of tissue (necrosis). In extreme cases, amputation of the leg may be needed.

Symptoms of arterial ulcers

Signs of arterial ulcers include:

  • Deep wound, sometimes through several layers of skin
  • Wound edges are smooth
  • Loss of hair on the legs
  • Tenderness around the wound
  • Red, yellow, or brown sores
  • Leg may turn pale when elevated
  • Affected area is cool to the touch
  • Wound does not bleed

How to minimize arterial ulcer complications

Ulcers need to be kept dry and clean in order to prevent the spreading of infection and further complications. Other things to keep in mind:

  • Examine feet, ankles, and legs regularly for sores or discoloration
  • Schedule an ankle-brachial index (ABI) test
  • Exercise regularly and as frequently as comfortable
  • Quit smoking as smoke hardens and clogs your arteries
  • Wear footwear that fits correctly
  • Manage your blood cholesterol, blood pressure, and glucose levels

Treatment for leg ulcers

Both arterial and venous ulcers are extremely prone to infection. It is important to contact a vein specialist if you notice a wound that is slow-healing or non-healing. Putting off treatment, waiting for your wound to heal naturally, or utilizing home remedies or ointments can be unsafe and cause the ulcer to worsen.

You should be treated by a vascular or wound specialist using such modalities as endovenous laser treatment (EVLT) for venous ulcers or stent angioplasty for arterial ulcers. After the wound is treated, it is important to fix the underlying condition to prevent ulcers from redeveloping.

A vascular specialist is able to evaluate your ulcer’s direct cause and create a personalized treatment plan that fits your individual needs. If you think you may have underlying venous insufficiency or peripheral artery disease, call 888-768-3467 or schedule an appointment online today.

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