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HealthInfo Canterbury

Foot ulcers

Kōmaoa waewae

Important

If you have diabetes and think you could have a foot ulcer, contact your general practice team or podiatrist immediately.

Also seek help if you've been diagnosed with a foot ulcer and you have a patch of skin around your ulcer that's red, warm and seems to be getting bigger. These could be signs of an infection (cellulitis). See your general practice team or after-hours healthcare service as soon as possible.

A foot ulcer is a break in your skin. It can be quite shallow and only involve the very top layer of your skin (a superficial ulcer) or involve deeper skin layers (a full thickness ulcer). If the ulcer gets too deep, it may reach the bone, tendons and other parts of your foot.

Foot ulcers can easily get infected.

Causes of foot ulcers

You can get foot ulcers for many reasons, but they're often caused by serious conditions such as diabetes, peripheral vascular disease or rheumatoid arthritis.

Poorly fitting footwear can cause foot ulcers.

Ulcers can also be caused by an injury like stubbing your toe or burning your skin on a hot surface – anything that can result in your skin breaking open.

Foot ulcers can often be hidden under a thick layer of discoloured skin (callus). See your general practice team or podiatrist if you notice a callus on your foot.

Diabetes and foot ulcers

Diabetes can cause muscle and nerve damage in your feet, which can change the shape of your feet. This can cause foot deformities, such as bunions or hammertoes. Your footwear can rub the skin on these deformities, making it break open.

Also, if you have diabetes, you may have little or no feeling in your feet. This loss of sensation, caused by the nerve damage from diabetes, means it may be harder for you to tell when your footwear is rubbing.

With diabetes, you may have a reduced blood supply (peripheral vascular disease) going to your feet and the site of the ulcer. This means the wounds will take longer to heal.

Your risk of developing ulcers is even higher if you've previously had a foot ulcer, or if you also have other diabetes complications, such as eye problems or kidney problems.

If you have diabetes, it's very important that you keep your diabetes under as much control as possible while you're being treated. This will affect how well your ulcer heals and reduce the risk of infection. Keeping your diabetes under control includes closely monitoring your blood sugar levels and eating well. You should also practise good foot care. See the advice on keeping your feet healthy in Self-care for your feet.

Treating foot ulcers

Talk to your health professional about assessing your feet and developing a plan for treating them. They may refer you to a specialist to speed up the healing process. This could be a vascular surgeon, orthopaedic surgeon, orthotist, infection expert, diabetes specialist nurse or dietitian.

Your podiatrist or practice nurse will remove any hard, dead or infected skin that's stopping the ulcer from healing. They'll apply dressings and if needed, a temporary pad to help keep pressure off your wound while it heals. They'll give you advice about footwear and ways to keep pressure off your ulcer.

They'll also tell you how to keep the dressings clean and dry and arrange follow-up appointments. They may arrange for a nurse to change your dressings or advise you how to change them yourself.

If there's any infection, you may need a course of antibiotics.

Written by HealthInfo clinical advisers. Last reviewed June 2022.

Sources

Page reference: 306237

Review key: HISKW-128569