Foot ulcers form as a result of tissue breaking down and exposing the layers of tissue underneath. They are most commonly found under the big toe and ball of your feet, and they can affect your skin down to the bones.
They are a common complication of poorly controlled diabetes, and result in unusual swelling, drainage of fluid from the feet, irritation, redness, and odors from one or both feet. Signs of foot ulcers are not always obvious, and often these signs will not present themselves until the ulcer has become infected.
Causes of Foot Alcers
Diabetic ulcers are most commonly caused by:
- Poor circulation
- Nerve damage or trauma
- Irritated or wounded feet
- High blood sugar
Poor blood circulation is a form of vascular disease that could have many causes. This can also make it more difficult for ulcers to heal, while also making it easier for them to become infected. In severe cases, decreased nerve sensitivity from years of damage can result in an inability to feel an ulcer develop.
Always consult a podiatrist if you suspect that you have experienced any of the signs of a foot ulcer.
The most visible sign of a developed foot ulcer is black tissue (eschar) surrounding the area. This forms due to the absence of healthy blood flow to the area around the ulcer. Partial or complete gangrene, which refers to tissue death around infections, can appear around the ulcer. In this case, odorous discharge, pain, and numbness can occur.
There are four stages of foot ulcer progression in severity:
- No ulcer, at risk
- Ulcer present, no infection
- Deep ulcer, exposing joints and tendons
- Extensive ulcer
Foot Ulcers Treatment Options
Off-loading, or staying off your feet, is the easiest way to prevent pain and allow your feet the ability to heal.
In addition, aiding blood flow to the area through a healthy diet and stretching can help ease symptoms and progression.
Pressure from walking can make an infection worse and cause the ulcer to expand.
Doctors can remove diabetic foot ulcers through a procedure called debridement, where dead skin, foreign objects, and infections that may have caused the ulcer are removed.
An infection is a serious complication and requires immediate treatment. Depending on your case, a specific medication regimen may be required. Tissue surrounding the ulcer may be sent to a lab to determine which antibiotic will help. If your doctor suspects a serious infection, he or she may order an X-ray to look for signs of bone infection.
Infection of a foot ulcer can be prevented with:
- Foot baths
- Disinfecting the skin around an ulcer
- Keeping the ulcer dry with frequent dressing changes
- Enzyme treatments
Your doctor may recommend that you seek surgical help for your ulcers. A surgeon can help alleviate pressure around your ulcer by shaving down the bone or removing deformities that may have developed, such as bunions or hammertoes.
You will likely not need surgery on your ulcer. However, if no other treatment option can help your ulcer heal or progress further into infection, surgery can prevent your ulcer from becoming worse or leading to amputation.