Arterial Ulcer vs. Venous Ulcer

Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs. CVI causes blood to “pool” or collect in these veins, and this pooling is called stasis.

CVI can lead to a number of complications, ranging from varicose veins to changes in the skin on the legs and ankles. In some patients, damage to the tissues can become so bad that an area of skin can be lost. When an area of skin is lost the raw area left behind is called an ulcer. There are several types of leg ulcers, but the two that are mostly confused for each other are arterial and venous. In today’s post, we are going to discuss the differences between these two types.

Venous ulcers account for at least two thirds of all leg ulcers. A venous leg ulcer can develop after a minor injury if there’s a problem with the circulation of blood in your leg veins due to CVI. If this happens, pressure inside the veins increases. This constant high pressure can gradually damage the tiny blood vessels in your skin and make it fragile. As a result, your skin can easily break and form an ulcer after a bump or scratch. Unless you have treatment to improve the circulation in your legs, the ulcer may not heal.

When the blood doesn’t flow through the veins as intended, it can back up or settle in the veins, causing a buildup of toxins in the tissue, as well as pressure that can cause the veins to bulge and become distended. Venous ulcers are typically found just above the ankle, but can occur on the leg anywhere below the knee. They can cause the skin around the ulcer to itch and became dry, and can also cause the leg to swell and the surrounding skin to turn brown.

Arterial ulcers, on the other hand, are caused by insufficient blood supply, most commonly by atherosclerosis, which is a buildup of fatty plaque within the arteries. Most people who suffer from arterial ulcers have cardiac or cerebrovascular disease. Because the blood supply is inadequate, any wound, however minor, can cause an ulcer on the leg simply because it will be unable to heal properly.

For example, even a seemingly small scratch or cut can develop into an ulcer because of the compromised blood supply. Arterial ulcers are most often found on the feet – often on the heels, tips of toes, between the toes where the toes rub against one another or anywhere the bones may protrude and rub against bed sheets, socks or shoes. They also occur commonly in the nail bed if the toenail cuts into the skin or if the patient has had recent aggressive toe nail trimming or an ingrown toenail removed.

Who is at Risk of Venous Ulcers:

  • Varicose veins
  • History of leg swelling
  • History of blood clots in deep veins, i.e. deep vein thrombosis (DVT) causing post-thrombotic syndrome (in 5% of cases)
  • Sitting or standing for long periods
  • High blood pressure
  • Multiple pregnancies
  • Previous surgery
  • Fractures or injuries
  • Obesity
  • Increasing age and immobility

Who is at Risk of Arterial Ulcers:

  • Diabetes
  • Smoking
  • High blood fat/cholesterol
  • High blood pressure
  • Renal failure
  • Obesity
  • Rheumatoid arthritis
  • Clotting and circulation disorders
  • History of heart disease, cerebrovascular disease or peripheral vascular disease

Venous insufficiency is the most common cause of lower-leg ulcers, accounting for nearly 80% of all cases. Of the approximately 7 million people in the United States with venous insufficiency, approximately 1 million develop venous leg ulcers.

If you are suffering from leg ulcers, consult the vein experts at Alpha Vein Clinic today. Dr Sassan Kaveh and his staff can determine which kind of leg ulcer you’re suffering from and diagnose the underlying cause. We can then create a treatment plan customized for your specific needs.

Alpha Vein Clinic


3150 N. Tenaya Way Ste. 400

Las Vegas, NV, 89128

(702) 430 7661

Dr. Sassan Kaveh

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