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Chronic leg wounds can be painful, slow to heal, and difficult to manage without proper care. Two of the most common types are arterial and venous ulcers. Although they may appear similar, their causes, symptoms, and treatments are very different.

This article explains the key differences between arterial and venous ulcers, how to recognize each type, and what treatment options are available. You will also learn when to seek medical help and how proper management can improve healing.

Understanding Ulcers and Why They Occur

An ulcer is an open sore that develops when blood flow to the skin is reduced. Without adequate circulation, tissue breaks down and struggles to heal.

Leg ulcers are most often caused by poor blood circulation. Depending on whether arteries or veins are affected, the ulcer is classified as arterial or venous.

Identifying the correct type is critical because treatments differ greatly.

What Are Arterial Ulcers

Arterial ulcers develop when arteries fail to deliver enough oxygen-rich blood to the tissues. This condition is often linked to peripheral artery disease.

Poor circulation leads to tissue damage and slow healing. These ulcers usually form on the feet, toes, or outer ankle.

They are often painful and worsen when blood flow is further reduced.

What Are Venous Ulcers

Venous ulcers occur when veins cannot return blood properly to the heart. Blood pools in the lower legs, increasing pressure in the veins.

This pressure damages the skin and leads to open sores, usually around the inner ankle or lower leg.

Venous ulcers are the most common type of leg ulcer and often recur without proper care.

Arterial vs Venous Ulcers: Key Differences

Understanding arterial vs venous ulcers helps guide correct treatment. Arterial ulcers are caused by poor blood supply, while venous ulcers result from poor blood return.

Arterial ulcers are typically dry, deep, and painful. Venous ulcers are usually shallow, moist, and less painful unless infected.

Skin color and temperature also differ between the two conditions.

Appearance and Location Differences

Arterial ulcers often appear small, round, and deep. The surrounding skin may look pale or bluish and feel cool to the touch.

Venous ulcers tend to be larger with irregular edges. The surrounding skin often appears swollen, warm, and discolored.

These visual clues are important for early identification.

Pain Patterns in Arterial and Venous Ulcers

Pain is usually severe with arterial ulcers, especially at night or when the leg is elevated. This happens because blood flow is further reduced.

Venous ulcers cause mild to moderate pain that improves when the leg is elevated. Swelling and heaviness are common symptoms.

Pain behavior is a key indicator when comparing arterial vs venous ulcers.

Causes and Risk Factors

Arterial ulcers are commonly caused by atherosclerosis, diabetes, smoking, and high blood pressure. These conditions reduce blood flow through arteries.

Venous ulcers are linked to chronic venous insufficiency, varicose veins, obesity, and prolonged standing.

Age, inactivity, and previous leg injuries increase the risk for both types.

How Arterial vs Venous Ulcers Are Diagnosed

Doctors diagnose ulcers through physical examination and medical history. Blood flow tests such as ankle-brachial index help determine circulation problems.

Ultrasound imaging is often used to assess vein or artery function. Accurate diagnosis ensures the correct treatment approach.

Misdiagnosis can delay healing and worsen the condition.

Treatment Options for Arterial Ulcers

Treatment focuses on improving blood flow. This may include medications, lifestyle changes, or surgical procedures.

Smoking cessation and blood sugar control are critical. In some cases, revascularization procedures are required.

Wound care is gentle, and compression is usually avoided unless approved by a doctor.

Treatment Options for Venous Ulcers

Venous ulcers are treated with compression therapy to improve blood return. Elevating the legs reduces swelling and pressure.

Wound dressings keep the area clean and moist. Exercise and weight management also support healing.

Consistent treatment is essential to prevent recurrence.

Wound Care and Infection Prevention

Keeping ulcers clean is essential to prevent infection. Dressings should be changed as advised by a healthcare provider.

Signs of infection include redness, warmth, pus, or increased pain. These require immediate medical attention.

Proper wound care speeds healing and reduces complications.

Lifestyle Changes That Support Healing

Healthy circulation supports recovery. Staying active, eating a balanced diet, and managing chronic conditions are important.

Avoid smoking and prolonged sitting. Elevate your legs regularly if you have venous disease.

Good skin care also helps prevent new ulcers from forming.

When to Seek Medical Help

You should seek medical care if an ulcer does not heal within two weeks, becomes more painful, or shows signs of infection.

Sudden severe pain, color changes, or numbness may indicate a circulation emergency.

Early treatment prevents complications and improves outcomes.

Final Thoughts on Arterial vs Venous Ulcers

Understanding arterial vs venous ulcers helps you take the right steps toward treatment and recovery. Although both cause open wounds, their causes and treatments are very different.

Recognizing symptoms early and seeking medical care improves healing and prevents serious complications. Proper diagnosis, consistent care, and lifestyle changes play a vital role in long-term management.

Frequently Asked Questions

Are arterial ulcers more serious than venous ulcers

Yes. Arterial ulcers indicate poor blood supply and can lead to tissue death if untreated.

Can venous ulcers heal on their own

Rarely. They usually require compression therapy and proper wound care.

How can I tell if my ulcer is arterial or venous

Location, pain level, and skin appearance provide important clues, but medical tests confirm the type.

Are arterial ulcers painful

Yes. They often cause severe pain, especially at night or when legs are elevated.

Do venous ulcers bleed

They may ooze fluid but usually do not bleed heavily unless injured.

Can diabetes cause arterial ulcers

Yes. Diabetes damages blood vessels and increases the risk of arterial ulcers.

Is walking good for venous ulcers

Yes. Walking improves circulation and supports healing.

Can ulcers come back after healing

Yes. Without lifestyle changes and proper care, recurrence is common.

How long do venous ulcers take to heal

Healing can take weeks to months depending on severity and treatment.

When should I see a doctor for an ulcer

If the ulcer is painful, infected, or not healing after two weeks, seek medical care.