Understanding Arterial Ulcers: Basics, Causes, and Prevalence

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Santa Ana, CA 92701

What is an Arterial Ulcer? 

Wound Dehiscence wound careArterial ulcers are wounds that worsen due to reduced blood circulation within the arteries. Arteries are crucial since they carry oxygen-rich blood from the heart to different parts of the body. When blood flow is inadequate, tissues suffer damage, leading to the formation of ulcers. Ulcers can happen anywhere on the body but they are especially bad when they happen in the lower extremities, including the feet and legs. This is where arterial ulcers are generally found. For elderly and diabetic populations, this is of the utmost concern. Many times, ulcers become chronic or difficult to manage. 

What is Peripheral Arterial Disease? 

Peripheral Arterial Disease (PAD) is a condition that impacts the arteries beyond the heart and brain, and commonly manifests in the lower extremities, especially the legs and feet. This disease is triggered by the narrowing of or blockage of the arteries. It is attributed to atherosclerosis, which is a buildup of fatty deposits.

Atherosclerosis is a condition that affects a variety of different people, with risk factors including age, family history, obesity, high blood pressure, cholesterol, smoking, type 1 and 2 diabetes, a sedentary lifestyle/lack of exercise, unhealthy/fatty diet, gender, and specific ethnic backgrounds may also be susceptible. Embracing a healthy lifestyle and effectively managing these factors can diminish the risk and progression of atherosclerosis, consequently reducing the likelihood of PAD development.

Why are Arterial Ulcers Problematic?

Wound Dehiscence wound care ocArterial ulcers carry significant concerns for several reasons. They frequently become prone to infection and can even lead to tissue necrosis. Healing is impeded due to limited circulation. Moreover, they often indicate an underlying issue. Read on to understand more.

Problems with Arterial Ulcers

Delayed Healing: Arterial ulcers don’t heal quickly and frequently become chronic due to diminished blood circulation. This deprives them of essential oxygen and nutrients that are necessary for proper healing. This not only stops the healing process but also heightens the risk of infection.

Potential Tissue Necrosis: While tissue necrosis is rare, it’s crucial to acknowledge it. In severe cases, insufficient blood flow can result in tissue death, known as necrosis. Surgical intervention becomes necessary to prevent infection propagation. During surgery, all of the necrotic tissue is cut off. 

Risk of Infection: The risk of infection is real when it comes to arterial ulcers. That’s why vigilance against infection is absolutely paramount.  Weakened tissue and compromised blood flow are what make these ulcers susceptible to infections and lead to further complications.

Underlying Health Issue: The presence of arterial ulcers often signals an underlying cardiovascular concern.

Pain: Arterial ulcers may cause pain at the site of the wound, during movement, or when pressure is applied to the wound. Of course, if diabetic neuropathy is involved, this simply isn’t so. In that case, the wound would have no pain at all. 

What Causes Arterial Ulcers? What Makes them Worse?

Wound Dehiscence wound care orange countyArterial ulcers are the result of constricted or reduced blood flow caused by narrowed or blocked arteries. In the next section, we’ll explore the two factors that make these ulcers even worse. 

  1. Atherosclerosis: The primary cause of arterial ulcers is atherosclerosis, which, again, occurs when fatty deposits accumulate on artery walls. Reduced blood flow limits oxygen and nutrients reaching the affected tissues, leading to tissue damage and ulcer formation.
  2. Peripheral Arterial Disease (PAD): PAD is a disease characterized by a blockage of the arteries. It can be caused by atherosclerosis or other factors. 

Does Diabetes Cause Arterial Ulcers? 

In many cases, diabetes can cause arterial ulcers or make them worse. Both Type I and Type II Diabetes have a significant impact on blood vessels and nerves. People with diabetes are more prone to developing ulcers and chronic wounds, including arterial ulcers. 

Effect on Blood Vessels

Scar Tissue wound careDiabetes is a chronic condition that causes a person to have either dangerously low or elevated blood sugar levels. When blood sugar levels spike it gradually damages the blood vessel walls over time. This process reduces vessel flexibility and heightens vulnerability to plaque buildup. Consequently, diabetics can develop atherosclerosis, a condition that narrows arteries and contributes to arterial ulcers. Furthermore, compromised blood supply impairs the body’s ability to fend off infections, therefore raising the risk of ulceration.

An Impact on Nerves

Neuropathy is an unfortunate side effect of diabetes. For diabetics, it’s vital to understand the connection between neuropathy and the formation of ulcers. Nerves are pivotal for sensing pain, infection, etc. For people without diabetic neuropathy, injuries are detected through feeling and sensing. However, diabetes-induced nerve damage reduces sensitivity. This diminishes the ability to notice minor injuries like cuts or blisters. Wounds worsen when they’re unnoticed. They can also evolve into chronic wounds, eventually becoming arterial ulcers. Reduced sensation also delays infection detection, which makes things even worse. 

Preventing Arterial Ulcers in Diabetes

Diabetics should, as always, focus on stable blood sugar levels through glycemic control. Regular medical check-ups are necessary, especially foot assessments. Diabetic neuropathy often affects the feet and therefore foot wounds can become chronic and ulcerative. Daily self-foot inspections are important. Asking a family member to help is great as well. Ask a wound care specialist to take a look at your feet as well. Make appropriate footwear choices, and have excellent foot hygiene. Embracing a healthy lifestyle with regular physical activity, a balanced diet, and no smoking also strengthens vascular health and reduces the risk of arterial ulcers.


Wound care specialist Dr. Faried BanimahdIn conclusion, arterial ulcers are a concern for the elderly, bedridden, and diabetics in particular. This type of wound happens because of reduced blood circulation within the lower extremities. For diabetics, this type of wound happens because elevated blood sugar causes constriction of the blood vessels and diabetic neuropathy makes it impossible to sense that there is a wound. 

Contact Wound Care OC for wound treatment in Orange County, CA

Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.

To make an appointment

1533 E 4th St,

Santa Ana, CA 92701

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