What are ankle ulcers?
An ulcer is an open sore or lesion on the body that is slow to heal or keeps returning. Ulcers result from skin tissue breakdown and may be painful. There are three different types of ulcers:
- venous stasis
- diabetic (neurotrophic)
Venous stasis ulcers are the most common type of lower body ulcer, especially at the ankles. According to the Cleveland Clinic, venous stasis ulcers account for between 80 and 90 percent of ulcers affecting the lower legs.
Venous stasis ulcers are typically due to a condition called venous hypertension or chronic venous insufficiency. Your blood doesn’t flow from your lower legs back to your heart as it should. This causes a buildup of pressure in your veins. The additional pressure can lead to an ulceration on your skin. These usually form on the inside of your legs, just above your ankle.
It’s unknown exactly how this condition causes ulcers. Many doctors believe it also causes a decrease in blood flow to the capillaries of your legs. This produces a buildup of white blood cells. The accumulation of white blood cells restricts oxygen to your tissue. The lack of oxygen causes damage and forms the ulcer.
Another theory is that venous hypertension causes cells from elsewhere in the body to leak into your skin and influence cellular growth. This process interferes with the repair of damaged tissue.
You may have a higher risk of developing venous stasis ulcers if you have or had:
- previous leg swelling
- a history of blood clots
- varicose veins
- a history of inflammatory diseases
If you have a family history of ulcers, it’s possible you’ll develop them too. Smoking may also raise your risk of developing ankle ulcers because it interferes with the flow of oxygen through your bloodstream.
Venous stasis ulcers aren’t always painful, but they might slightly burn or itch. They’re usually red, with yellowish skin over them. An infected ulcer may leak yellow or green fluid. Your skin may feel warm or hot to the touch and the area surrounding the ulcer may be swollen and discolored. Your legs may ache, and, depending on how swollen your ankle is, your skin may feel tight and look shiny.
Your doctor will begin by asking you about your medical history and symptoms. Make sure to keep a record of all your symptoms since they will help your doctor make a proper diagnosis. If you’ve had the ulcer for a long time, your doctor may want to take a tissue sample to make sure there’s no cancer. MRIs, CT scans, and radiography can also check the depth of your ulcer and if it’s affected bone. Your doctor will also check your ulcer for infection.
The primary goal of venous stasis ulcer treatment is to heal the wound, treat any infection, and relieve pain.
Compression therapy is the usual treatment for venous stasis ankle ulcers. It helps with swelling and helps speed the healing process. Compression also aids in the prevention of repeated ulcers.
Compression stockings, wraps, or even an elastic bandage wrapped around your leg up to your knee can help. You and your doctor can determine the compression method that will work best for you and your type of ulcer.
Your doctor may prescribe medications such as pentoxifylline and aspirin if compression treatment isn’t effective. You may need to take diuretics for a short time if you have significant swelling.
It’s important that you take all prescribed medication as directed.
There are several types of dressings you might use for an ulcer, including antimicrobial, collagen, composite, and skin substitute dressings. Your doctor can explain the advantages of each type and advise you on which is best for you. They may even refer you to a clinic that specializes in treatment of wounds. Keep the ulcer area clean and change the dressing on the ulcer as instructed to encourage healing.
Always drink plenty of fluids, eat a healthy diet, and get adequate rest and exercise. Good overall health will speed your healing process.
One way to prevent the development of venous stasis ulcers is to elevate your legs above your heart for at least 30 minutes, several times per day. Limit prolonged standing or sitting. This helps reduce the pressure and swelling that can cause venous stasis ulcers. It will also aid in blood circulation.
Try to elevate your legs in bed at night if possible. Also, try to limit salt in your diet and check your blood pressure regularly for any changes.
Sometimes losing weight can relieve some of the pressure on your legs. Check with your doctor to see if they believe weight loss is appropriate for you.