Arterial Vs Venous Ulcers: Causes and Treatment

The comparison between arterial vs venous ulcers has attracted the attention of young American citizens especially those in the medical field. Ulcers as you know are not only limited to the stomach, there are different types of ulcers that affect other parts of the body.

Arterial and venous ulcers are examples of ulcers that can happen to the body. Unlike stomach ulcers that are wound on the stomach, arterial and venous ulcers are open wound that can be found on the lower part of the body like the legs and feet. 


arterial vs venous ulcers

While arterial ulcer occur due to lack of blood flow to tissue causing damage to the arteries, venous ulcers are caused by insufficient return of blood back to the heart due to damage to the veins. These wound do not heal most times but if they do, they take time.

Let us try to explain both types of ulcers before considering the differences and similarities. Arterial ulcers, also known as arterial wound injuries or sores on the skin which are very painful and can make you very uncomfortable.

These sores happen when blood is not circulated or unable to get to the lower part of the body mostly the legs and feet. As the skin and tissues of these body parts do not get enough oxygen and blood, they start to wear and die off causing open wound. 

Because these parts do not get enough oxygen, this wound takes time to heal sometimes years. The lack of circulation can also make it difficult for the red blood cells to deliver the nutrients needed to heal ( WebMD, 2018 ). When oxygen-rich blood are not circulated, there is no way the white blood cells will help fight against the bacteria making the wound to become more infected and fresh. The more the wound are left untreated, the more they cause complications like tissue necrosis, further infections and amputation of the affected limb.

Venous ulcers are also open sores on the leg caused by weak blood circulation around the leg. This wound takes so much time to heal, they are slow in healing and very painful. 
When the veins that are meant to send blood from the leg back to the heart do not function like they should, this can increase the pressure in the end of the limb.

This can weaken the skin and can make it harder for the wound to heal. These injuries mostly occur in bony areas like the ankles. Venous ulcers usually occur in those who smoke, obesed, have leg injuries or other circulation problems. It also occur in older people especially women.


These ulcers both attack the lower limb especially the legs and feet. There are differences and also similarities between them. Both of them are open wound. We will differentiate both by their causes, symptoms and treatment methods. Arterial and venous ulcers are more dangerous than stomach ulcer


Both ulcers are caused by poor blood circulation to the parts of the body. When the tissues and skin around the areas are deprived of nutrients, it may lead to an open wound. 
Arterial ulcers are caused when the arteries are blocked and nutrient-rich blood are not taken to the different tissues. Another name for arterial ulcer is ischemic ulcers.


The most common of these ulcers are:

  • Trauma
  • Age
  • High blood pressure
  • Smoking
  • Diabetes
  • High cholesterol
  • Kidney failure
  • Atherosclerosis , or thickening of the arteries
  • Vasculitis
  • Heart disease
  • Poor footwear
  • Foot deformity

Venous ulcers, on the other hand are caused by damage done to the vein. The veins as we know is very important because they carry blood to the heart from the various part of the body through one-way valves. These valves prevent blood from flowing away from the heart. 

When the blood does not flow as it should, it could result to pooling in one area of the body causing leakage of fluid and blood cells. With time, this leads to damaging of the veins and swelling, the tissues will begin to die and ulcers will form. Other causes of venous ulcer are:

  • Obesity
  • Blood clotting disorders
  • Deep vein thrombosis
  • Heart failure
  • Pregnancy
  • Fractures or injuries
  • Varicose veins
  • High blood pressure
  • Trauma


Arterial ulcers have “punch out look “, and often appear on the heel, feet, toes and ankles. The wound do not bleed too. Apart from the location, other symptoms are:

  • Pain especially at night
  • Deep wound
  • Pale look when the leg is lifted and the leg turns red when brought down
  • Yellow, black or red sores
  • Tight, hairless skin
  • The affected area is cool or cold to touch from minimal blood circulation
  • The skin and nail around the affected area appears dry and shiny.

Venous ulcers can be painless when they are not infected but very painful when they are infected. They most times form on the inner area of the ankle or below the knee. Other symptoms are:

  • Swelling and redness of the skin
  • Fever
  • Foul smelling fluid coming out of the wound
  • Dry skin
  • Itching
  • Pus and brownish discoloration
  • Intense pain when infected
  • Numbness in extreme cases


These ulcers look the same including some of their symptoms, so you should see a doctor to identify the type and the underlying cause. If the wound is being treated without the cause, the problem will still continue.
The first treatment for this type of ulcer is to restore blood circulation, if this is not done, the wound will continue even if you take medications. The medicines will only help you reduce the symptoms you feel but the wound will still remain. The doctor will help your blood circulation to resume again through surgery.

One of the surgical procedure is angioplasty among others. Angioplasty is a surgical procedure whereby blocked coronary arteries are opened to restore blood flow using a balloon.

After the blood starts flowing round the body, the symptoms will start going away. Another option is to amputate the affected limb. This is only done when the blood flow cannot be restored to that part or the wound has become heavily infected thereby posing risk to other parts.


Like the arterial ulcer, the most important treatment for venous ulcer is to improve on blood flow to the affected area. This wound takes time to heal, sometimes months or years, most times it does not heal.
Antibiotics can also be given if the ulcers are infected, the antibiotics are used to kill the bacteria. The drugs can also help to prevent reoccurrence. Surgeries are most times recommended to help with blood flow and circulation.

Your doctor may prescribe painkillers to reduce your discomfort. They may also encourage you to keep your leg or other affected area elevated for blood circulation. To help with the wound, a moist dressing can be given on the wound to help with the healing.


Although these wound have similar major cause which is poor blood circulation, there are ways of preventing these wound.


There are ways to lower the chances of you having this ulcer or to prevent them from becoming worse or recurring, some of them are :

  • Watching your intake of sodium and limiting it.
  • Quitting smoking
  • Managing your blood pressure
  • Exercising regularly
  • Managing your cholesterol


There are certain lifestyles and diet you can change to prevent venous ulcers. These are:

  • Losing weight
  • Reducing the amount of salt in your diet
  • Quitting smoking
  • Wearing compression stockings
  • Keeping your legs elevated when you can
  • Exercising regularly
  • Controlling chronic conditions such as high blood pressure or diabetes
  • Taking aspirin to prevent blood clots.


  • Arterial ulcers have dry wound while venous ulcers wound are moist, that is fluid comes out from it.
  • With venous ulcers, there is moderate to little pain but arterial ulcers are extremely painful.
  • The wound of an arterial ulcer is well defined, venous ulcers have uneven edges.
  • Venous ulcers have a dark reddish or brownish discoloration while venous ulcers just have deep pale look.
  • The tissue around an arterial wound is black or necrotic, venous ulcers has pale dead tissues.
  • Venous ulcer leg is mostly warm whereas that of a venous may be cold.
  • There may be other skin changes such as dark brown areas around the ankle, itching, eczema for venous ulcers while the skin around an arterial ulcer may be dry shiny skin, hair loss.


The similarities between these ulcers are how to care for the wound. 

  • The wound should be clean and dry always and the dressing changed daily.
  • Drink plenty of water.
  • Take all prescribed medicines, they will help to relieve the pain.
  • Wear compression socks if they are necessary.
  • Wearing orthopedic shoes can help.
  • Eat healthy foods to help your wound heal faster.


In this post titled “arterial vs venous ulcers” we realised that both wound are mostly caused by poor blood circulation, so to treat them, the blood flow should be restored. The most important treatment is to find out the underlying cause and fight it before treating the wound. Follow doctor’s instructions on how to care for the wound.

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