Ulcers, wounds in your skin that can get infected and take a long time to heal, are sometimes found on your feet and toes. People with diabetes who have neuropathy are most likely to get these ulcers. Ulcers can get infected and sometimes require amputation of your foot or toes. Healing the ulcer might include nonsurgical and surgical treatments.
1. What are foot and toe ulcers?
An ulcer is an open wound or sore that will not heal or keeps returning. When you have ulcers on your feet and toes, it can be related to diabetes — specifically, a complication called neuropathy that causes you to lose feeling in your feet. A scrape, cut or puncture in your skin can turn into an ulcer, but you might not know it’s there if you have neuropathy.
Ulcers can lead to infections. Sometimes, the infection won’t go away and you may need to have part of your foot or toe surgically removed (amputated). About 15% of people with diabetes will get a foot or toe ulcer.
2. Who gets foot and toe ulcers?
Foot and toe ulcers can happen to many people but might be more common in Black, Native American and Hispanic people. If you have an eye, kidney or heart disease related to diabetes, you’re also at a higher risk. About 15% of people with diabetes will get an ulcer, typically on the bottom of their foot. Some of those people will be hospitalized because of complications.
You’re also at a higher risk of getting foot and toe ulcers if you have any of the following conditions:
- Blood circulation issues.
- Heart disease.
- Obesity.
- A foot condition like a bunion or hammertoe.
- Kidney disease.
- Lifestyle behaviors like using tobacco and alcohol can also increase your risk of developing ulcers on your feet or toes.
3. What do foot and toe ulcers look like?
Ulcers are open wounds in your skin that can take on almost any shape. Some shapes are more common than others on specific parts of your body. For example, ulcers on your foot or toe might be shaped like a crater or a wedge.
Foot and toe ulcers vary in color. The most common colors are:
- Yellow.
- Pink.
- Red.
- Grey.
- Black.
If your ulcer is black, that means cells in the tissues have died. This is called necrosis (gangrene).
4. How are foot and toe ulcers treated?
The treatment of all ulcers begins with careful skin and foot care. Inspecting your skin is very important, especially for people with diabetes. Detecting and treating foot and toe sores early can help you prevent infection and keep the sore from getting worse.
The goal of treating a foot or toe ulcer is to heal your wound and relieve any pain. Your treatment plan will be individualized based on what medical condition is causing your ulcers. If you can’t correct the cause of your ulcer, it’s likely to come back after treatment.
There are both surgical and nonsurgical treatments for foot and toe ulcers. For early-stage foot and toe ulcers, nonsurgical treatments might work. More advanced ulcers — especially ones that are infected — might require surgery.
Nonsurgical treatments include:
- Topical wound care. (Ulcers have less of a risk of infection and heal faster if they’re kept covered and moist.)
- Antibiotics.
- Antiplatelet or anticlotting medications.
- Compression clothes.
- Draining.
- Prosthetics.
- Orthotics.
- Removing pressure from the area by wearing a cast, a certain shoe or braces. You might need to use crutches or a wheelchair. This is called nonsurgical off-loading.
- Elevation of the foot.