Our Grapevine and Keller Podiatrists Explain Ischemic Ulcers and Treatment Options
If you have a painful sore on one of your feet, toes, ankles, or legs that doesn’t seem to be healing, it’s possible you have an ischemic ulcer or another type of foot wound that may require medical intervention. To heal the wound and reduce the risk of it developing into something more serious, it’s important to get to a podiatrist right away. 
Any open wound can become infected and pose a risk to your health, and the experienced foot doctors at Alliance Foot & Ankle Specialists in Tarrant County, Texas know that it’s important to treat them promptly. Here, we explain ischemic ulcers and discuss how a podiatrist can help.
Understanding Ischemic Ulcers
Ischemic ulcers, also referred to as arterial ulcers, are painful, often hard-to-heal wounds caused by poor blood supply to the legs. This leads to compromised circulation to the feet, toes, ankles, or legs, which can cause tissue to die and an open sore to appear. The lack of circulation that causes this type of wound to develop also impairs healing.
Who’s at Risk for Developing an Ischemic Ulcer?
People with peripheral artery disease (PAD), diabetes, and arterial clogging or blockages have an elevated risk of developing ischemic ulcers because these conditions lead to circulatory problems. However, ischemic ulcers are not limited to individuals with these conditions. Other people who are at risk of ischemic ulcers include:
- Men. They are typically at a higher risk of developing these ulcers than women.
- Seniors. Because arteries become stiffer and narrower as people age, seniors are at a higher risk for ischemic ulcers.
- People with sedentary lifestyles. Individuals who don’t get enough exercise or find it difficult to move around are at a higher risk of ischemic ulcers.
- People who smoke. Tobacco chemicals may damage the lining of the arteries and promote the build-up of plaque. Smoking also decreases oxygen in the blood.
Characteristics of Ischemic Ulcers
There are different types of foot and ankle ulcers, but the characteristics of this particular type of wound often include the following:
- Skin surrounding the wound may look thin, pale, shiny, and tight.
- The wound is a gray, yellow, dark red, or black sore that doesn’t bleed.
- The wound has a punched-in appearance with well-defined borders.
- Ankle pulses are faint or absent.
Additionally, the affected area may be cool or cold to the touch. This is due to minimal blood circulation.
The Dangers and Complications of Ischemic Ulcers
An ischemic ulcer can be dangerous if not treated promptly and properly. The lack of blood flow that causes this condition also impairs healing, resulting in chronic pain, reduced mobility, and a significant decrease in quality of life.
Ischemic ulcers are also highly susceptible to infection. Without proper treatment, an ischemic ulcer can potentially lead to cellulitis, osteomyelitis, bone infection), sepsis, or gangrene and could result in amputation of a limb.
When to See a Podiatrist for an Ischemic Ulcer
The sooner you seek help for an ischemic ulcer, the better, especially if you have PAD or diabetes or are at risk of other circulatory problems. Early intervention is the key to managing an ischemic ulcer and minimizing the risk of dangerous complications.
You should see a podiatrist right away if you experience any of the following conditions on any of your feet, toes, ankles, or legs:
- An ulcer or open sore that does not heal within a few days
- An open sore or ulcer that is painful, particularly at night or when elevating your leg
- Any discoloration, coldness, or changes in the texture of the skin surrounding the ulcer
- Any signs of infection, such as redness, swelling, drainage, pus, or a foul odor
How Our Texas Podiatrists Can Help With an Ischemic Ulcer
Your podiatrist will conduct an individualized evaluation to determine whether your wound is ischemic or if you have a different type of ulcer. They will visually assess the wound and review your medical history. Their assessment of your wound may also require imaging tests. Your treatment plan may include the following:
Wound Care and Hygiene
Whether your wound is an ischemic ulcer or not, your podiatrist will likely provide specialized wound care, such as removing dead tissue from the area around the ulcer, applying dressings, and using topical antibiotics or other treatments to promote healing and prevent infection. They will also work with you on a plan to maintain proper wound care and hygiene and help prevent future ulcers from developing.
Offloading Pressure
Since reducing pressure on an ulcerated area is critical to healing, your podiatrist may advise you to utilize offloading devices to help relieve pressure from the ulcer and aid recovery. These devices may include custom footwear, orthotics, or a removable cast.
Referral for Vascular Care
Since ischemic ulcers are caused by poor blood flow, a podiatrist might refer you to a medical diagnostician or vascular specialist who can determine if you have an underlying medical condition impairing your circulation and can provide treatment for that condition. Any medical treatment that helps improve your circulation will also promote the healing of your ischemic ulcer and may reduce the likelihood of a recurrence.
Ongoing Care as Needed
If you have a chronic condition such as PAD or diabetes that puts you at an elevated risk of ischemic ulcers, your podiatrist will recommend preventive strategies, such as lifestyle changes. They may also suggest ongoing monitoring via regular checkups to reduce the risk of new ulcers forming and to quickly detect any that do form.
Seek Podiatric Care Without Delay
You should never ignore a foot ulcer or delay seeking treatment. Early and specialized care is essential in treating ischemic ulcers to avoid serious complications, which can include infection and amputation. If you have an ulcer or other wound on your feet, toes, ankles, or legs that don’t heal after a few days, it’s critical to get evaluated by a skilled podiatrist. This is true whether you have a known circulatory issue or not.