What Causes Leg Ulcers?

A leg ulcer is a condition where open wounds or sores that develop on an individual's leg that may be chronic and causes the ulcers to develop frequently. An individual affected by leg ulcers may experience symptoms such as pus in at the ulcer site, increasing wound size, enlarged veins, pain at the ulcer site, heaviness in the legs, and swelling in the legs. Medical history, physical examination, CT scan, MRI scan, vascular ultrasound, and x-rays may be used to diagnose leg ulcers. The main concern when it comes to leg ulcers is the risk of developing an infection in the wound that progresses to a life-threatening blood infection. Treatment of leg ulcers includes the use of antibiotics, compression bandages, topical ointments, orthotics or braces, circulation-improving medications, acetylsalicylic acid, diet changes, and other measures that help prevent complications.

There are numerous causes of leg ulcers. Get the details on this now.

Venous Insufficiency

An individual affected by venous insufficiency can develop leg ulcers as a complication. Chronic venous insufficiency is a condition where an individual's venous valves in the legs do not function well enough. The valves in the veins of the legs function to move blood back to the heart so it can be reoxygenated. However, chronic venous insufficiency patients tend to experience pooling of the blood in the legs because it gets backed up. When the blood pools in an individual's legs, fluid in the blood is forced into the surrounding tissues, causing edema. Edema left untreated can compress the capillaries responsible for blood delivery to the skin and its underlying fatty tissues. When these tissues become deprived of oxygen, the skin cells begin to die and form a sore or an ulcer. The ulcers caused by venous insufficiency can also be relatively painless due to the lack of nerve cell function in the affected area, which results in delayed treatment and infection of the leg ulcers.

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Hypertension

Leg ulcers may be caused by long-term high blood pressure, which is also referred to as hypertension. Blood pressure is the measurement of the amount of force blood is placing on the blood vessels as it is moving through them. Leg ulcers are a complication that can occur in individuals who have poorly controlled hypertension. The exact mechanism of leg ulcer development from hypertension is not well established, but it is thought to involve the narrowing of the small capillaries responsible for supplying nutrients and oxygen to the skin and underlying fatty tissues. The narrowed capillaries that feed the skin cause an increased amount of resistance to the blood that needs to flow through them, which causes a reduction in the amount of blood affected tissues receive. It is thought to be an ischemic process that occurs in hypertension patients that causes the skin cells to die, resulting in the development of sores and ulcers in the legs.

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Poor Circulation

An individual who experiences issues with poor circulation in their legs can develop leg ulcers. Someone may experience poor circulation in their legs due to several mechanisms that can involve the function of their heart, problems with the blood vessels, clotting problems, blood pressure issues, and numerous others. Poor circulation describes where blood is not moving through the veins back to the heart and through the arteries to be recirculated as fast and efficiently as it should. Leg ulcers are caused by a lack of oxygen and nutrients to the skin cells that causes them to die. The blood in the body has to move at a sufficient pace and carry an adequate amount of oxygen to the distant tissues in the legs for the skin cells to survive and function. Individuals who have chronic problems with the structure or function of their connective tissues, nerve function, muscle function, and blood vessel function can experience an inadequate amount of circulation in the legs. Regardless of the underlying cause, the necrosis of skin tissues due to oxygen starvation is the most common way leg ulcers develop.

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Diabetes

Leg ulcers are commonly found in diabetes patients. Diabetes is a disease where an individual's body does not produce a hormone called insulin, or the body does not respond to the insulin the body does produce. Insulin is a hormone secreted by the pancreas when an individual's blood sugar begins to rise. This mechanism in the body is essential because high blood sugar is known to cause progressive damage to the kidneys, blood vessels, nerves, and other tissues. In diabetes, the body cannot effectively regulate blood sugar due to a malfunction of the natural blood sugar regulation process that takes place in healthy individuals. High blood pressure induced by poorly managed diabetes can cause leg ulcers to develop due to an ischemic process that occurs in the skin tissues. Neurotrophic ulcers are a type of leg and foot ulcer that can develop in a diabetes patient as a result of diabetes-precipitated neuropathy. The nerves become damaged from unregulated high blood sugar, which can lead to circulation problems and reduced pain signals. A diabetes patient may develop a small ulcer from secondary causes that can become enlarged and infected due to the unintentional neglect that occurs with an inability to sense pain.

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Heart Disease

A heart disease patient may develop leg ulcers as a complication of the effects the disease has on their body. Heart disease refers to a condition where the arteries in an individual's body become hard and narrowed due to the buildup of a substance referred to as plaque. The blood vessels in healthy individuals have walls that are flexible and able to accommodate the higher pressure and increased blood volume temporarily. However, patients who have developed heart disease as a result of the accumulation of plaque in their arteries have blood vessels that cannot compensate under challenging conditions. Plaque buildup occurs when long-term high blood pressure has damaged the lining of the arteries, allowing cholesterol and other fatty substances to penetrate and calcify in the vessel. As more plaque accumulates, the total amount of space blood can pass through becomes progressively reduced. This mechanism causes a shortage of oxygenated blood in distant tissues of the body like the subcutaneous tissues of the legs and feet. Without an adequate blood supply in these tissues, the cells can necrotize and cause open ulcers to develop.