Skin Ulcers Specialist

What is a skin ulcer?

A skin ulcer is an open wound on the skin. It can be caused by infections, by a pressure sore, or by vein problems. Treatments will depend on the cause of the ulcer. Venous skin ulcers, the most common, are shallow wounds which occur when the leg veins don't return blood back toward the heart properly. These ulcers usually form on the lower leg, above the ankle, and beneath the calf.

What causes a skin ulcer?

Venous skin ulcers are caused by inadequate blood circulation, namely venous insufficiency. In venous insufficiency, the valves have been damaged and blood is now backing up and pooling inside the vein. Fluid can then leak out and into the surrounding tissues, resulting in the breakdown of the tissue and an ulcer. Factors that can increase a person’s risk for ulcers include:

• Deep vein thrombosis
• Obesity
• Smoking
• Lack of physical activity
• Standing for many hours a day

What other types of skin ulcers are there?

Aside from venous skin ulcers, the others that can occur include:

• Arterial skin ulcers occur when artery disease is present. These ulcers can be very painful. They are typically on the feet and toes.
• Neuropathic skin ulcers are also referred to as diabetic neuropathic ulcers. They develop in those who have little or no feeling in the feet because of diabetic nerve damage.

How are they treated?

Initially, improving blood circulation can help. Patients can try:

• Lifting the legs above the heart level frequently.
• Wearing compression stockings or bandages to prevent blood from pooling in the legs.
• Walking daily to improve blood circulation.

The doctor often performs a debridement to excise dead tissue from the wound. After the ulcer has healed, compression stockings should still be worn, taken off for bathing and sleeping. The doctor may advise additional treatments if needed such as:

• Medication to hasten to heal or for an infection such as antibiotics.
• Skin grafting, for deep or hard-to-heal ulcers.
• Vein surgery, which can keep ulcers from returning.