What Causes a Skin Ulcer?

An ulcer develops when skin breaks down and fails to repair normally. Long-lasting pressure or friction can damage tissue, while reduced blood flow can slow healing, especially around the lower leg or foot. Stasis dermatitis may accompany swelling and venous circulation problems. Some inflammatory conditions, including pyoderma gangrenosum, can create painful ulcers with an unusual border. A sore that crusts, bleeds, repeatedly breaks down, or changes without healing can also need assessment for basal cell carcinoma or squamous cell carcinoma. The appearance alone cannot identify the cause.

Protect the area with a clean, non-stick dressing and wash gently with clean water unless a clinician has given different instructions. Keep pressure off the sore, avoid picking the crust, and do not use harsh antiseptics or leftover antibiotics. Note its size, depth, drainage, pain, and surrounding colour. Medical assessment is useful because treatment may involve wound care, pressure relief, circulation review, infection management, or a sample of tissue.

Seek prompt care for increasing pain, spreading redness, warmth, swelling, pus, foul odour, fever, or red streaks. Urgent assessment is needed if the ulcer is deep, rapidly enlarging, exposes deeper tissue, follows a serious injury, or occurs with a cold, pale, numb foot. Any ulcer that is not healing or keeps returning deserves clinical review.

What factors may be slowing healing in this location? How should I dress and protect the wound? Do I need checks for circulation, infection, inflammation, or an abnormal skin growth?