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What’s this red spot on my foot?

Possible Reasons Why You May Have Developed a Non-Healing Foot Ulcer

First, we want to explain what an ulcer looks like to you.

Ulcers usually begin as an area of redness on the skin. The area may have a different firmness or temperature than the surrounding skin, or may be painful to the touch (Stage I), similar to a blister. Over time, the skin will break down, exposing a shallow wound bed (Stage II), followed by a layer of fat beneath the skin (Stage III), until bones, tendons, or muscles are exposed (Stage IV). Alternatively, the ulcer may be covered with discolored tissue (ranging from yellow to green to brown or black), making it impossible to determine the extent of the damage simply by looking at the ulcer.

Four Common Causes of Non-Healing Foot Ulcers
An ulcer may be caused by underlying medical conditions or personal habits.

1.  Circulatory Problems
Your circulatory system carries oxygen-rich blood and nutrients to your entire body. These nutrients maintain healthy tissue. The feet are frequently the first place to show signs of trouble when circulation is impaired, which is why they should be inspected regularly. Even if there is no sign of an ulcer upon examination, if there are any irregularities, such as pain, numbness, hair loss, or discoloration on the legs or feet, it could be indicative of a condition called peripheral artery disease (PAD). PAD can lead to severe pain, ulcers, amputation, and even death if left untreated.

2. Nerve Damage
Nerve damage can occur in patients with circulatory problems, diabetes, alcoholism, or atherosclerosis (hardening of arteries). When nerves are intact, they send signals to the brain when an object is causing pain or discomfort. For instance, when walking, a feeling of pain will cause a person to remove a stone from their shoe, or seek out better-fitting footwear. However, in cases of damaged nerves, they are no longer able to properly signal the brain if an object is causing harm to the tissue. This failure to signal the brain can result in a person not fixing an issue with footwear. The pressure and irritation can, over time, develop into an ulcer.

3. Prolonged Pressure On The Feet
As mentioned in the previous example, when shoes fit poorly, ulcers can occur in people without nerve damage, this is usually due to severe atherosclerosis, or a deformity such as a fracture. Elderly patients often have difficulty or find it uncomfortable to examine their feet, ignoring moderate pain from pressure on the feet, which may result in the development of an ulcer.

4. Lifestyle Factors Such As Smoking Or A Sedentary Lifestyle
Smoking increases the risk for multiple diseases, including peripheral artery disease, due to its restrictive effects on the circulation. Ulcers occur when there is consistent pressure on one area for long periods of time. Prolonged periods of bed rest, or a sedentary lifestyle, can cause this type of pressure, and encourage the formation of ulcers. At any stage, an open wound can become infected and emit a strong odor and pus. When left untreated, ulcers can lead to severe complications such as gangrene and amputation. Frequent examination of your feet is recommended to help detect the presence of an ulcer in its earliest stage.If you discover a wound that will not heal on your feet, contact your doctor immediately. ​

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates  and schedule an appointment today.
To learn more about foot ulcers, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates.


Francis J. Smith, D.P.M., A.B.F.A.S.
Board certified in Foot Surgery and Michael A. Klein, D.P.M. A.B.F.A.S.
Board certified in Foot Surgery​

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