Foot ulcers are a common complication of diabetes that is not being managed through methods such as diet, exercise, and insulin treatment. Ulcers are formed as a result of skin tissue breaking down and exposing the layers underneath.
They’re most common under your big toes and the balls of your feet, and they can affect your feet down to the bones.
All people with diabetes can develop foot ulcers, but good foot care can help prevent them. Treatment for diabetic foot ulcers varies depending on their causes.
Discuss any foot concerns with your doctor to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected.
One of the first signs of a foot ulcer is drainage from your foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms.
The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because of an absence of healthy blood flow to the area around the ulcer.
Partial or complete gangrene, which refers to tissue death due to infections, can appear around the ulcer. In this case, odorous discharge, pain, and numbness can occur.
Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected.
Talk with your doctor if you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated.
Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 5 using the Wagner Ulcer Classification System:
Ulcers in people with diabetes are most commonly caused by:
Poor blood circulation is a form of vascular disease in which blood doesn’t flow to your feet efficiently. Poor circulation can also make it more difficult for ulcers to heal.
Nerve damage is a long-term effect and can lead to a loss of feeling in your feet. Damaged nerves can feel tingly and painful. Nerve damage reduces sensitivity to foot pain and results in painless wounds that can cause ulcers.
Ulcers can be identified by drainage from the affected area and sometimes a noticeable lump that isn’t always painful.
All people with diabetes are at risk for foot ulcers, which can have multiple causes. Some factors can increase the risk of foot ulcers, including:
Diabetic foot ulcers are also most common in older men.
Stay off your feet to prevent pain from ulcers. This is called off-loading, and it’s helpful for all forms of diabetic foot ulcers. Pressure from walking can make an infection worse and an ulcer expand.
Your doctor may recommend wearing certain items to protect your feet:
Doctors can remove foot ulcers with a debridement, the removal of dead skin or foreign objects that may have caused the ulcer.
An infection is a serious complication of a foot ulcer and requires immediate treatment. Not all infections are treated the same way.
Tissue surrounding the ulcer may be sent to a lab to determine which antibiotic will help. If your doctor suspects a serious infection, they may order an X-ray to look for signs of bone infection.
Your doctor may prescribe antibiotics, antiplatelets, or anticlotting medications to treat your ulcer if the infection progresses even after preventive or antipressure treatments.
Many of these antibiotics attack Staphylococcus aureus,bacteria known to cause staph infections, or ß-haemolytic Streptococcus, which is normally found in your intestines.
Talk with your doctor about other health conditions you have that might increase your risk of infections by these harmful bacteria, including HIV and liver problems.
Your doctor may recommend that you seek surgical help for your ulcers. A surgeon can help alleviate pressure around your ulcer by shaving down the bone or removing foot abnormalities such as bunions or hammertoes.
You will likely not need surgery on your ulcer. However, if no other treatment option can help your ulcer heal, surgery can prevent your ulcer from becoming worse or leading to amputation.