The Difference Between Venous and Arterial Ulcers

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What is an Ulcer?

Ulcers are defined as abnormal breaks in the skin or mucous membrane. This long-lasting sore or wound is typically characterized as slow-healing or non-healing when it has taken more than 5-6 weeks to heal. Although leg ulcers can develop anywhere on the leg or foot, they usually develop on the inside of the calf,  just above the ankle.

Ulcers are the result of poor circulation in the affected area of your body, and most commonly occur in the legs and foot. Poor circulation may occur due to a variety of reasons including, but not limited to, vein disease and peripheral artery disease (PAD). Due to poor circulation, the affected area is deprived of its adequate supply of oxygen and nutrients which causes the area to become inflamed, forming an open wound.

How Long Does it Take an Ulcer to Form? How Long Will it Take to Heal?

Because ulcers are caused by venous or arterial disease, it is safe to say that it takes a great amount of time for the ulcers to actually form. So, do not be alarmed if it takes time for the ulcers to fully heal. But, you should consult with your doctor to ensure you do not need any antibiotics as an infection could slow down healing even more.

Types of Ulcers

There are many different types of ulcers; however, we are going to focus on two, main ulcers that primarily affect the lower extremities.

  • Arterial ulcers – These occur in arteries that carry oxygen and nutrients rich blood from the heart to all body organs and tissues while venous ulcers develop in the veins that bring back blood to the heart from body tissues for purification.
  • Venous ulcers – These are more common than arterial ones, in fact, a high majority (80%) ulcers of the lower limb are venous ulcers.

Venous Ulcers vs. Arterial Ulcers

Venous ulcers most commonly occur in the lower leg or upper part of the ankle. People who have a sedentary lifestyle may develop ulcers due to pooling of blood in the legs. Venous ulcers occur due to damage to the veins that have one-way valves to prevent the blood flow back from the heart. When these one-way valves get damaged due to some reason, this causes the leakage of fluid through the veins, resulting in swelling or edema. This swelling further prevents the flow of blood to the tissue in the leg, causing it to die and the ulcer forms. An ulcer is an example why treating underlying venous insufficiency is crucial.

Symptoms of Venous Ulcers

  • Shallow wound
  • Usually appear on the lower leg or ankle
  • Discharge
  • Itchy, dry skin
  • Swelling, especially in the affected area
  • Inflammation and redness before the wound progresses
  • Achy, heavy feeling in the affected leg
  • Skin discoloration
  • The wound is flaky, but may continue to reopen

How to minimize venous ulcer complications:

  • Examine feet, ankles, and legs regularly for non-healing wounds or discoloration
  • Schedule an appointment with a vein specialist
  • Tell your doctor if you’re taking heart medications that may increase your risk of swelling
  • Exercise regularly and as frequently as comfortable
  • Losing weight can help relieve excess pressure from the legs
  • Quit smoking
  • Practice leg exercises if you have to stand or sit for a long period of time
  • Elevation can help temporarily relieve leg pain and discomfort related to venous ulcers

Arterial ulcers

Arterial ulcers are formed due to blockage in arteries, mostly due to plaque buildup in them. Plaque consists of fat and cholesterol which often builds up in arteries due to sedentary lifestyle, unhealthy eating habits, smoking and obesity. As the process of plaque buildup (atherosclerosis) accelerates, arteries become narrower due to which the affected area doesn’t get nutrients which prompts the development of an ulcer. This condition is commonly known as Peripheral Artery Disease (PAD).

These painful ulcers are often found between or on the tips of toes, on the outer ankle or in the areas where you experience pressure while walking. Left untreated, the ulcers can cause infection or death of tissue (necrosis). In extreme cases, amputation of the leg may be needed.

Arterial ulcers often occur at the pressure points of the foot and affect toes or shin. They need to be kept dry, dry and clean in order to prevent the spreading of infection.

Symptoms of arterial ulcers

  • Deep wound, sometimes through several layers of skin
  • Wound edges are smooth
  • Loss of hair on the legs
  • Tenderness around the wound
  • Red, yellow, or brown sores
  • Leg may turn pale when elevated
  • Affected area is cool to the touch
  • Wound does not bleed

How to minimize arterial ulcer complications:

Ulcer Treatment

Both arterial and venous ulcers are extremely prone to infection. It is important to contact a vein specialist if you notice a wound that is slow-healing or non-healing. A vascular or wound specialist should treat venous and arterial ulcers. Be careful about utilizing home remedies or ointments because these can sometimes make ulcers worse.

Putting off treatment or waiting for your wound to heal naturally can be unsafe and may cause the ulcer to become infected. After a professional treats the wound, it is important to fix the underlying condition, or else ulcers may continue to develop in the future.

Treatment Options

In order to properly treat a venous ulcer, you will first need to relieve any high pressure in the leg veins. You can do this by wearing compression stockings or bandages, walking daily to improve blood circulation, and taking medication as directed. Treatment may also include debridement (the removal of infected or damaged tissue), compression therapy, and elevating your feet above your heart, which can help relieve swelling and discomfort.

Additionally, cleaning and dressing the wound according to your health care provider’s instructions is essential. The skin around the ulcer should be protected from any fluid drainage, otherwise the epidermis may break down and increase the size of the ulcer. Keeping the wound clean and bandaged can prevent infection.


Lifestyle changes and healthy habits may help prevent venous ulcers from forming. Various preventative measures include:

  • Get regular exercise
  • Maintain a healthy body weight
  • Avoid smoking
  • Eat a healthy diet
  • Manage blood pressure and cholesterol levels

Healing skin ulcers can take a long time — anywhere from several months to a few years. In some cases, underlying venous insufficiency — a vein disease — can keep ulcers from healing or cause them to recur. If the ulcer becomes infected or cannot heal properly on its own, more aggressive treatments may be needed.

What Are Some Things You Can Do to Increase Blood Circulation Naturally?

Elevating your legs is one of the simplest ways of getting blood to circulate more through your legs, as it will stop it from pooling. But, you can also use tight compression socks that can also make a major difference. You should also ensure that you do not spend extended periods of time sitting still or standing without moving. Meaning, exercising regularly will improve your body’s overall circulation.

What Are the Surgical Methods Used to Treat Circulation?

There are a number of minimally-invasive surgical treatments that can be used to improve blood circulation. In many cases, these procedures work by cutting off blood flow entirely in the damaged artery so that it can eventually be reabsorbed by the surrounding tissue, and allowing blood flow to continue in the healthy veins.

Whether it’s varicose veins, spider veins, or venous ulcers, our clinics treat a variety of vein disease conditions. Varicose treatments take between 15-30 minutes depending on the number of veins affected. If you believe you are suffering from vein disease, contact us at 888.768.3467 to learn more about which treatment would work best for you.

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