What Is a Skin Ulcer?
A skin ulcer is an open sore that forms on the skin from an injury or trauma, poor blood circulation, or continuous pressure on the area. Skin ulcers often affect the legs. But they can also involve other areas, such as hands, feet, back, and hips. Once these ulcers become infected, they should be treated as they can spread throughout the body. Skin ulcers are frequently seen in older people. The symptoms, treatment, and recovery of skin ulcers depend on their specific causes. However, several treatments can help heal and prevent further complications from skin ulcers.
What Does a Skin Ulcer Look Like?
In the early stages, the affected area is usually discolored. It may look red and feel warm. As the skin ulcer gets worse, it often creates a crater-like depression in the skin, which may weep clear fluid or blood. The other skin ulcer symptoms depend on the type and severity of the ulcers.
The other symptoms may include:
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Swollen.
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Red, pink, brown, gray, or black-colored.
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Tender.
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Itchy.
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Painful.
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Changes in skin texture.
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A strong odor.
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Yellow or green pus discharge due to an infection.
What Are the Causes of Skin Ulcers?
A disruption in the blood flow mainly causes skin ulcers. The common causes of skin ulcers are as follows:
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Diabetes: Diabetes causes high blood sugar that can lead to nerve damage, called peripheral neuropathy. In peripheral neuropathy, a person may lose the sense of touch in the feet and legs. Since pain or pressure is lost, the person may not feel injuries on their legs or feet. If left untreated, these injuries can turn into skin ulcers.
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Atherosclerosis: Atherosclerosis occurs when the arteries get narrowed due to fat buildup. The narrowed arteries cannot properly circulate blood. If any part of the body does not get enough blood circulation, the skin tissue breaks down, forming a sore.
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Venous Insufficiency: Venous insufficiency happens when the veins cannot deliver blood from the legs to the heart. This results in blood collection in the leg veins, leading to swelling. If the swelling is severe, it can excessively put pressure on the skin, causing ulcers.
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Constant Pressure: Staying in one position for a long time puts the skin under constant pressure, squeezing the blood vessels. This leads to blockage of blood flow to skin tissue, due to which the skin dies and develops an ulcer.
What Are the Risk Factors for Skin Ulcers?
People are more likely to get skin ulcers if they have certain risk factors, including:
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Pregnancy: Hormonal changes and increased blood volume during pregnancy may cause leg vein problems.
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Cigarette Smoking: Smoking hardens the arteries and disturbs proper blood flow.
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Limited Mobility: Being bedridden, paralyzed, or using a wheelchair for a long time puts the skin under constant pressure.
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Aging: Atherosclerosis and venous insufficiency are linked to increasing age which may cause ulcers.
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High Blood Cholesterol: High cholesterol levels increase narrowing and oxidative stress in the arteries disrupting blood flow.
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Obesity and Overweight: Obesity increases the risk for diabetes, atherosclerosis, and raised pressure in the leg veins.
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Blood clots: People prone to blood clots are more likely to have blood flow problems.
What Are the Types of Skin Ulcers?
There are three common types of skin ulcers:
Arterial or Ischemic Ulcers: These ulcers occur when blocked arteries cause poor blood flow. They affect people with poor blood flow in their legs. These ulcers involve feet, especially heels, toes, the outer side of ankles, and near the nail bed. Pain may aggravate at night or when the legs are resting.
Neurotrophic or Diabetic Ulcers: Neuropathic ulcers or diabetic ulcers are caused by nerve damage and narrow arteries. Neuropathic ulcers occur in 15 % of people with diabetes. The ulcers commonly involve feet, especially on the pressure points of the foot, including heels, toes, and bottom of the feet. Because of nerve damage, these ulcers are not painful.
Venous Stasis Ulcers: Venous stasis ulcers are caused by poor blood flow and account for 80 % to 90 % of all leg ulcers. They are a common problem in people with leg swelling, varicose veins, or a history of blood clots in their legs. They affect the leg between the knee and ankle.
How Is Skin Ulcer Diagnosed?
A doctor can generally diagnose skin ulcers by physical examination and taking a medical history. The doctor may also order a blood test. If the ulcer is infected, a blood panel shows how the body is fighting the infection. A blood test also helps determine underlying problems. In some cases, imaging tests like X-ray, CT scan, or MRI may be performed to look at the tissue and bone under the sore.
How Is Skin Ulcer Treated?
Treatment for a skin ulcer usually depends on what is causing it and its severity. Mild superficial ulcers which do not show signs of infection (swelling, pain, drainage, or a foul odor) can be treated at home.
1) At-Home Care
Treating an ulcer at home involves the following steps:
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Thoroughly clean the ulcer daily with soap and water. Mild ulcers can also be cleaned with sterile salt water, called saline.
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Keep the ulcer covered and protected with a bandage.
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Keep the legs elevated above the heart by propping them up on cushions or pillows to help blood flow out of the leg.
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Take good care of other health problems, such as diabetes, hypertension, or atherosclerosis.
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Wear compression socks to reduce leg swelling by helping blood flow back to the heart.
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Avoid putting pressure on the ulcer, especially if the ulcer is on the foot.
For large or deep ulcers that are incredibly painful, or have any signs of infections, such as redness, pain, swelling, bad odor, or pus, visit a healthcare provider immediately. The treatment for moderate to severe ulcers includes:
2) Dressing: Dressings help clean and protect the ulcer. In addition, it also promotes healing and prevents infection. The type of dressing usually depends on the ulcer. Some types of dressings are available moist dressings, hydrocolloids, hydrogels, collagen wound dressings, and antimicrobial dressings.
3) Antibiotics: If the ulcer is infected, the doctor may prescribe antibiotics to prevent or treat an already infected ulcer.
4) Pain medication: Pain medication can be prescribed if the ulcer is painful.
5) Surgery: For deep ulcers that do not heal after a long time or if other treatments do not work, skin grafts may be needed. Skin grafts help close the wound and promote proper healing.
What Is the Outlook for People With Skin Ulcers?
Skin ulcer recovery generally ranges from a few weeks to three months. However, severe ulcers can take up to two years to fade. Complete recovery of ulcers depends on its type, size, quality of wound care, overall health of the person, blood circulation, and pressure in the affected area. For ulcers that do not heal with time, see a doctor because they can develop gangrene because of insufficient blood flow in the area. In such cases, the doctor may have to remove the affected body part, such as the foot or leg (amputation).
How Is Skin Ulcer Prevented?
A few practical steps can help reduce the risk of ulcers:
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Protect the feet. Never walk barefoot, especially if having diabetes. A foot injury can increase the risk of ulcers. Wear shoes that cover the whole foot instead of sandals or flip-flops.
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Quit smoking. Cigarettes can damage blood vessels, reduce blood flow, and delay wound healing.
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Keep diabetes and blood pressure under control.
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Exercise to increase blood flow.
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Maintain a healthy weight.
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Maintain a healthy diet to avoid nutritional deficiencies and assist in wound healing.
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Keep the cholesterol and triglyceride levels under control by changing the diet.
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If possible, try to change the position every two hours to avoid pressure on the skin.
Conclusion
Skin ulcers are open sores from insufficient blood flow due to underlying health conditions and constant pressure. Treatment depends on the underlying cause and severity of ulcers. Generally, skin ulcers resolve within a few weeks to three months. However, always keep the healthcare provider apprised of any changes occurring in the skin ulcer and follow the ulcer treatment and prevention plan to get the best possible outcome.
