Treatments
Understanding Chronic Ulcers: Common Types, Causes, and Treatment Options
Learn about the most common chronic ulcers, what causes them, how they appear, and why early wound care is important for healing and prevention.
Ulcers, or ulcerations, are open sores caused by a breakdown of the skin or underlying tissue that do not heal normally. In wound care, we most often treat chronic lower-extremity ulcers that develop slowly and can be difficult to heal. These wounds are commonly linked to diabetes, poor circulation, pressure, or injury, and they require a careful, personalized treatment approach.
At Oregon Coast Wound Center, we help patients understand what type of ulcer they have so we can create the most effective plan for healing. Not all ulcers are the same, and each one has a different cause, appearance, and treatment strategy. Getting the right diagnosis is the first step toward better outcomes.
Diabetic Foot Ulcers
Diabetic foot ulcers are one of the most common and serious types of chronic wounds. They often develop because of nerve damage from diabetes, along with poor circulation and repeated pressure or trauma. Since many patients with diabetes cannot feel pain in the foot the same way others can, small injuries may go unnoticed and become worse over time.
These ulcers often appear on the bottom of the foot, especially on pressure points such as the heel, ball of the foot, or toes. They may look like a crater or punched-out wound and can have callused edges, drainage, or redness if infection is present. Because diabetic ulcers can lead to serious complications, early treatment is very important.
Treatment may include pressure relief, wound cleaning, debridement, infection control, blood sugar management, and advanced therapies when needed.
Venous Ulcers
Venous ulcers happen when the veins in the legs do not return blood properly to the heart. This causes blood to pool in the lower legs, leading to swelling, pressure, and skin breakdown. Venous ulcers are commonly found around the lower leg, especially near the inner ankle.
These wounds are often shallow with irregular borders and may have a moist or weeping appearance. The surrounding skin may look discolored, irritated, or swollen. While they may not always be as painful as some other ulcer types, they can still be slow to heal and often come back if the underlying venous problem is not managed.
Compression therapy is usually a major part of treatment, along with leg elevation, wound care, and addressing the circulation issue behind the ulcer.
Arterial Ulcers
Arterial ulcers are caused by reduced blood flow to the feet or legs. When the arteries cannot deliver enough oxygen and nutrients to the tissue, the skin may begin to break down and form a painful wound. These ulcers are often found on the toes, feet, heels, or outer ankle.
They may look deep, have clearly defined edges, and sometimes appear pale or dark if the tissue is not getting enough blood. Arterial ulcers are often very painful, especially at night or when the legs are raised. They can become dangerous quickly if circulation is not improved.
Treatment usually starts with a vascular assessment to determine how much blood flow is reaching the area. Depending on the findings, patients may need referral for procedures that help restore blood flow. Wound care, pain management, and protective dressings are also important. Compression should only be used if it is specifically appropriate after circulation has been evaluated.
Pressure Ulcers
Pressure ulcers, also called pressure injuries or bedsores, develop when constant pressure is placed on one area of skin for too long. They often happen over bony areas such as the heels, hips, tailbone, or elbows. These wounds are more common in people with limited mobility, poor nutrition, or other health issues that increase risk.
Pressure ulcers can range from early redness of the skin to deeper wounds that affect muscle or bone. They may also have slough or dead tissue. Because they can worsen quickly and lead to infection, prevention and early treatment are critical.
Treatment focuses on relieving pressure, repositioning, improving nutrition, keeping the wound clean, managing moisture, and using advanced wound care when needed.
Why the Right Diagnosis Matters?
Although all ulcers are open sores, each type has a different cause and needs a different treatment plan. A wound caused by poor circulation should not be treated the same way as a wound caused by pressure or diabetes. That is why a full evaluation is so important.
At Oregon Coast Wound Center, we begin with a comprehensive assessment that may include wound measurement, circulation checks, medical history review, and other testing when needed. This helps us understand what is causing the wound and how to treat it correctly.
Prevention and Early Care
Some ulcer risk factors can be reduced with good daily habits. Patients, especially those with diabetes or circulation concerns, should check their feet regularly, wear proper footwear, manage blood sugar, stay active when possible, and seek care early if a wound is not healing.
The sooner an ulcer is evaluated, the better the chance of preventing complications. Even a small wound can become a serious problem if it is ignored too long.
If you have a chronic wound or think you may have an ulcer, the team at Oregon Coast Wound Center is here to help with compassionate, specialized care focused on healing and recovery.
