Arterial and Venous Ulcers: What’s the Difference?

Medically reviewed by Elaine K. Luo, MD on February 7, 2018Written by Kiara Anthony on February 7, 2018

Overview

Arterial and venous ulcers are two kinds of open sores found on the body. They often form on the lower extremities, such as the legs and feet.

Arterial ulcers develop as the result of damage to the arteries due to lack of blood flow to tissue. Venous ulcers develop from damage to the veins caused by an insufficient return of blood back to the heart.

Unlike other ulcers, these leg wounds can take months to heal, if they heal at all. Though similar, they require different treatments to ensure proper healing and a speedy recovery.

How do symptoms differ?

Common symptoms of ulcer formation include pain and . Other symptoms can differ between arterial and venous ulcers.

Arterial ulcers

Arterial ulcers often form on the outer side of the ankle, feet, heels, or toes. They can form in other areas, too. These ulcers are painful and have a “punched out” appearance.

Other symptoms or characteristics of arterial ulcers include:

  • red, yellow, or black sores
  • deep wound
  • tight, hairless skin
  • leg pain at night
  • no bleeding
  • affected area is cool or cold to touch from minimal blood circulation
  • leg reddens when dangled and turns pale when elevated

Venous ulcers

Venous ulcers usually form below the knee and on the inner area of the ankle. There’s sometimes little or no discomfort, unless the ulcer is infected. In other cases, venous ulcers can be painful.

The affected area may also be accompanied by the following symptoms:

What causes these ulcers?

Poor blood circulation often causes ulcers. When there’s reduced blood flow, skin and tissues in the affected areas are deprived of oxygen and nutrients. These areas will become inflamed and form an open wound.

Though ulcers can form anywhere on the body, arterial and venous ulcers are more commonly found on the legs and feet.

Arterial ulcers

Blocked arteries are common causes of arterial ulcers. They’re also referred to as ischemic ulcers. The arteries are responsible for delivering nutrients and oxygen to different tissues. Clogged arteries prevent nutrient-rich blood from flowing to the extremities. This results in an open wound.

Other potential causes of arterial ulcers include:

Venous ulcers

Venous ulcers are the type of leg ulcer. They’re caused by damage to the veins. The veins are responsible for bringing blood from various parts of the body to the heart through one-way valves. These valves prevent blood from flowing away from the heart.

If blood doesn’t flow correctly, it could pool in one area of the body. This results in damage to the vein and leakage of fluid and blood cells, causing edema, or swelling. This is thought to prevent adequate blood flow to the tissue in the leg. As a result, this tissue will die, and ulcers will begin to form.

Other potential causes of venous ulcers include:

For either type of ulcer, seek immediate medical attention if your symptoms worsen and are accompanied by:

In more severe cases, these symptoms could be signs of an infection. If left untreated, amputation may be necessary.

How are leg ulcers treated?

Before suggesting treatment, your doctor needs to identify the underlying cause. Ulcers can be treated with proper care and antibiotics, but diagnosing the underlying cause can ensure ulcers heal and don’t recur.

Some conditions that contribute to ulcers include:

As with any ulcer, primary treatment focuses on increasing blood circulation to the affected area. Additional treatment goals include:

  • reducing pain
  • healing the wound effectively
  • speeding the recovery process

Treating arterial ulcers

To treat arterial ulcers, your doctor will try to restore blood circulation to the affected area. Treating the underlying cause with antibiotics can help reduce symptoms, but it won’t heal the ulcer completely. Doctors may use surgery to restore blood flow to tissues and organs in addition to antibiotics.

There are a number of surgical options to treat arterial ulcers, including angioplasty. This procedure uses a balloon to open the affected artery to improve blood flow. When blood flow is restored, your symptoms will go away.

If blood flow can’t be restored, or if the wound has become heavily infected, your doctor may recommend amputation.

Arterial ulcers need to be kept dry, clean, and bandaged to prevent infection and making the wound bigger. Discuss with your doctor how often you need to change your bandages and any additional treatment recommendations or lifestyle changes.

Treating venous ulcers

Venous ulcers can take months to heal. In some rare cases, they may never heal. Similar to arterial ulcers, treatment focuses on improving blood flow to the affected area.

Your doctor may recommend antibiotics to treat the underlying cause, prevent infection, and prevent recurrences. However, antibiotics alone cannot heal a venous ulcer.

Your doctor will show you how to properly clean and bandage your wound. They may also recommend compression therapy. This entails applying a compression bandage or stocking to the affected area. This pressure improves blood flow and reduces symptoms.

Your doctor may prescribe painkillers to reduce your discomfort. They may also encourage you to keep your leg or other affected area elevated.

What’s the outlook?

Arterial and venous ulcers are the result of irregular blood flow and circulation. Left untreated, these ulcers can cause serious complications. If you begin to experience irregular symptoms or notice pain in your lower extremities, seek immediate medical attention.

Don’t self-diagnose. Your wound or symptoms could be indicators of a more serious condition. Discuss your options and concerns with your doctor to ensure you receive the best treatment.

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