A foot ulcer is an open sore on the foot. A foot ulcer can be a shallow red crater that involves only the surface skin. A foot ulcer also can be very deep. A deep foot ulcer may be a crater that extends through the full thickness of the skin. It may involve tendons, bones and other deep structures. People with diabetes and people with poor circulation are more likely to develop foot ulcers. It can be difficult to heal a foot ulcer. In people with these conditions, even a small foot ulcer can become infected if it does not heal quickly. If an infection occurs in an ulcer and is not treated right away, it can develop into:

• An abscess (a pocket of pus)
• A spreading infection of the skin and underlying fat (cellulitis)
• A bone infection (osteomyelitis)
• Gangrene. Gangrene is an area of dead, darkened body tissue caused by poor blood flow.

Among people with diabetes, most severe foot infections that ultimately require some part of the toe, foot or lower leg to be amputated start as a foot ulcer.

Causes and Symptoms:

A foot ulcer looks like a red crater in the skin. Most foot ulcers are located on the side or bottom of the foot or on the top or tip of a toe. This round crater can be surrounded by a border of thickened, callused skin. This border may develop over time. In very severe ulcers, the red crater may be deep enough to expose tendons or bones. Foot ulcers can be caused by a vascular disease, namely chronic venous insufficiency (venous ulcers), Peripheral Arterial Disease (arterial ulcers), and nerve damage. Arterial Ulcers - Arteries carry blood from the heart to the rest of the body.  There are many causes of an ulcer. The most common foot ulcer is below. Foot ulcers can be caused by a vascular disease, namely chronic venous insufficiency (venous ulcers), Peripheral Arterial Disease (arterial ulcers), and nerve damage.

Arterial Ulcers - Arteries carry blood from the heart to the rest of the body. In some cases the arteries become narrowed by plaque. This condition is called peripheral arterial disease, or PAD. Severe PAD prevents the skin and tissues from healing properly due to a lack of blood supply. Even minor skin damage like an accidental cut or callus can result in an arterial ulcer.
Venous Ulcers - Veins return blood to the heart from the legs and the rest of the body. Veins can be damaged, blocked, or allow the backward flow of blood. Severe venous insufficiency causes blood to pool, instead of circulate, resulting in open sores that are slow to heal.
Neurotrophic ulcers - These wounds are the result of nerve damage caused by diabetes. These wounds typically occur on the bottoms of the feet and are hard to see and feel.

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