Arterial Ulcers vs. Venous Ulcers: Know the Difference
Understanding whether your leg ulcer is arterial or venous is critical—they require completely different treatments.
Leg ulcers may look similar, but arterial and venous ulcers have very different causes and require opposite treatment approaches. Getting the diagnosis right is the first step to healing.
Side-by-Side Comparison
| Feature | Arterial Ulcers | Venous Ulcers |
|---|---|---|
| Cause | Blocked arteries (poor blood flow TO the leg) | Faulty vein valves (poor blood flow FROM the leg) |
| Location | Toes, heels, bony areas of feet | Inner ankle, lower leg |
| Appearance | Deep, "punched out" look with pale/gray base | Shallow, irregular edges, red base |
| Pain | Severe, worse with elevation | Aching, improves with elevation |
| Leg Temperature | Cool or cold | Normal or warm |
| Pulses | Weak or absent | Normal |
| Key Treatment | Restore blood flow (revascularization) | Compression therapy |
Critical Warning
Never apply compression to an arterial ulcer! Compression can cut off remaining blood supply and cause tissue death. This is why proper diagnosis is essential before starting treatment.
Treatment Differences
Arterial Ulcer Treatment
- • Vascular assessment (ABI, angiogram)
- • Revascularization (angioplasty, stent, bypass)
- • Gentle wound care—no compression
- • Smoking cessation critical
- • Control diabetes and cholesterol
Venous Ulcer Treatment
- • Compression therapy (stockings, wraps)
- • Leg elevation
- • Wound care and dressings
- • Consider vein procedures (ablation)
- • Lifelong compression for prevention
Mixed Ulcers
Some patients have both arterial and venous disease, creating "mixed" ulcers. These require careful evaluation to determine the safest treatment approach—often modified compression with close monitoring.
Not Sure What Type of Ulcer You Have?
Our vascular specialists can diagnose your ulcer and create the right treatment plan.