If you’ve developed an ulcer on your foot or ankle, it’s essential to begin treating it immediately. Even with rapid professional intervention, ulcers can take weeks or months to heal fully. Foot and ankle ulcers that aren’t detected and addressed promptly and effectively may result in more serious issues, including hospitalization and amputation. Here’s what you need to know about treating foot and ankle ulcers.
Types of Foot and Ankle Ulcers
At Annapolis Foot & Ankle Center, we work with patients to treat the following ulcers.
These ulcers are the most common type that occurs on the lower body and especially the ankles. They’re the result of decreased blood flow to the lower legs. Venous stasis ulcers most often appear on the inside of the leg, just above the ankle.
People with diabetes or others who have reduced feeling in their feet usually develop neurotropic ulcers. They can happen anywhere on the lower extremities but are most often found on the parts of the feet and toes that are most sensitive to weight. The borders of this ulcer are thin and punched out, making it rise higher than the surrounding tissue.
These ulcers are the result of reduced circulation. Anyone can develop these but they’re more common among people who smoke, have diabetes, high blood pressure, or high cholesterol. Areas where these ulcers develop include:
- Heels of the feet
- Tips of the toes
- Between toes, where the toes rub together
- On bony parts of the feet and toes that rub on socks or shoes
- On the nail bed, where the nail has dug into the skin, been trimmed too low, or was removed
Warning Signs for Ulcers
Knowing the signs of an impending ulcer will allow you to manage them before they become complicated open sores or lesions. Keep an eye out for:
- Unusual sensations like aching, itching, or burning
- Warm to the touch
- Skin discoloration—yellow, pink, red, gray, and black are common
- Dry, cracked, scaly, or rashy skin
Additionally, as an ulcer grows worse, it may begin to leak fluid.
Caring for Foot and Ankle Ulcers
Proper self care is always important for foot health, and even more so if you exhibit symptoms of ulcers. Here are some of our tips:
- Cleaning. Wash the area with mild soap and water. Avoid applying harsh chemicals, including peroxide and alcohol. If your podiatrist has recommended an antiseptic, apply it as directed.
- Bandaging. Apply a clean, dry bandage or dressing after cleaning. Keep these clean and dry and change them regularly. Adhesive bandages should not be applied directly to wounds.
Seek out professional medical care for any wounds that are deep, infected, or not healing on their own. The amputation prevention experts at our Chesapeake Amputation Prevention Center, with locations in Annapolis, Stevensville, and Glen Burnie, provide exceptional wound care.
Specialist Diagnosis of Foot Ulcers
While a primary care doctor can diagnose a foot ulcer, they may send you to a specialist for treatment, such as a podiatrist or a wound specialist. Foot and ankle ulcers are diagnosed based on:
- Patient symptoms
- Appearance of the ulcer
- Location of the wound
- Appearance of the borders of the ulcer
- Appearance of the skin around the wound
To determine the depth of the ulcer and to identify if the bone has become infected, it may be necessary to complete the following:
- CT Scan
Options for Treating Foot and Ankle Ulcers
There are several different ways that a foot or ankle ulcer might be treated, and which solutions are recommended depend on your specific situation. If the ulcer is caught early, the following options might be effective:
- Topical treatments
- Medications to prevent clotting
- Special footgear
- Use of a wheelchair or crutches to keep weight off of the foot
Should less invasive treatment fail, it might be necessary to consider surgical options.
Causes of Foot and Ankle Ulcers
Although foot and ankle ulcers are fairly common, especially in people with diabetes, they can often be avoided by understanding what causes them.
Individuals with diabetes may experience damage to the nerves in their feet and legs, leading to decreased sensation. This is called neuropathy and is the result of prolonged high blood sugar levels. People with neuropathy may not realize they have been injured, leading to untreated wounds, which can grow worse over time.
High blood sugar levels can also lead to decreased blood supply in the lower extremities. Decreased blood flow also makes it harder for the body to heal properly when it’s injured.
Patients on dialysis are particularly at high risk.
Both high blood pressure and heart disease endanger individuals to develop ulcers on their feet and ankles.
Minor scrapes, cuts, and areas where the skin has become irritated from rubbing may not heal properly and instead become ulcers, especially for people with diabetes.
Preventing Foot and Ankle Ulcers
Prevention is really the best option to avoid needing to treat ulcers. Here are some lifestyle tips to help you manage foot and ankle health more effectively.
- Avoid smoking. Smoking narrows blood vessels and can further decrease lower body circulation.
- Eat a low-cholesterol diet. Keeping your heart healthy is important to improve circulation throughout your body.
- Manage your blood sugar. Controlling your sugar intake and utilizing diabetes medications as prescribed can reduce your chances of developing neuropathy so that you can detect injuries to your feet and ankles before they become severe.
- Exercise regularly. Exercise improves circulation and blood pressure, which are both risk factors for developing foot ulcers. If you are not used to exercising, it is important to discuss your plans for getting active with your doctor.
- Inspect your feet daily. By checking your legs and feet every day for blisters, cuts, wounds, or redness, you ensure that any injuries you develop do not have the opportunity to become ulcers before you are aware of their existence. Also check for redness, unusual warmth, ingrown toenails, and calluses. It may be helpful to use a mirror or ask a family member to check areas you cannot see easily.
- Wear appropriate foot gear. It’s important to avoid walking barefoot or in shoes that fail to meet your needs. We should all have shoes that:
- Offer plenty of toe space
- Have secure heels that won’t rub
- Don’t squeeze the feet
- Are free of a lot of seams that irritate feet
- Offer good arch support
Special socks and custom orthotics may also be helpful.
See a Podiatrist Regularly
If you have diabetes, see your podiatrist at least annually to ensure you’re taking the best possible care of your feet, as well as any time that you have concerns about the condition of your feet. The podiatrists at Annapolis Foot & Ankle Center can advise you about a wide range of foot and ankle conditions and prevent minor issues from becoming life-changing problems.