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What kind of skin ulcer is it?

Updated on December 4, 2013

Skin changes in Seniors

As with many things that change as a person ages into their senior years, so does skin. Often seniors are at increased vulnerability to developing skin disorders such as infections, wounds and even different types of wound ulcers. Why is this occur? Overall changes in the body from thinning of the skin, increased skin fragility, as well as decrease elasticity in skin can cause seniors and the elder to be at increased risk for developing skin complications. Furthermore, loss of subcutaneous fat and chronic conditions and illnesses such as cardiovascular disease, diabetes, and circulatory disorders. These conditions and illnesses can lead to different types of skin conditions including ulcerations. These types of ulcers include: venous ulcers, arterial ulcers and diabetic ulcers. After reading this article you will gain a basic understanding and signs of different types of ulcers that occur and the signs associated with them.

Venous Ulcers

Seniors and the Elderly are at risk for development of venous ulcers or "venous stasis ulcers" because of underlying health conditions such as venous insufficiency that can causes swelling and decreased venous circulation with swelling of the vessels leads to poor blood perfusion. This happens because adequate oxygen rich blood and nutrients are not perfused to the tissue causing tissue death resulting in the development of venous ulcers.

What do venous ulcers look like?

  • Most often appear below the knee on the inner aspect of the ankle.
  • May have associated varicose veins.
  • Swelling or edema may be present.
  • Skin around the ulcer may be red, itchy, or dry
  • The around around the ulcer may also be hardened and could include the majority of the lower leg

Prevention of infection is vital to healing and maintaining blood flow and skin health. Elevation of legs can help with decreasing the edema.

Arterial Ulcers

If arterial insufficiency is present, oxygen rich blood supply may have difficulty reaching arms and legs. In many patients, especially seniors, a build up of lipids and cholesterol occlude the arteries known as atherosclerosis. Smoking can also increase the risk of aerial insufficiency.

What does an arterial ulcer look like?

  • Most often occur on feet, heels, or toes.
  • Often are very pain, particularly when feet are elevated.
  • Absence of hair growth on lower legs.
  • The borders of the culler are clean and appear "punched out".

Classic symptom of arterial disease is intermittent claudication: pain in the calf muscle when walking or exercising and is relieved with cessation of exercise.

Dangling the legs can help to encourage arterial blood flow to the arm or leg that is affected.

Diabetic Ulcers

Diabetes is a disorder of metabolism and circulation. We know that chronic metabolic irregularities linked to poor perfusion (blood flow) often affect multiple organs including the skin.

Arteries in chronic diabetes are prone to plaque buildup inside the arteries. Diabetics have an unusually high rate of abnormal blood lipids and these proteins adhere to vessel walls and cause occlusions resulting in less oxygenation to the tissue.

Diabetes is correlated with peripheral nerve dysfunction. We know that higher levels of blood sugar promote stress in neurons. Diabetic neuropathy translate to loss of feeling, pain, loss of reflex, muscle weakness, and inability to assist blood through vessels.

Chronic and repetitive pressure on the skin can decrease tissue perfusion causing diabetics to be at increased risk for the development of diabetic ulcers.

Diabetic ulcers often occur in several areas.

  • The bottom of the toes.
  • The ball of the foot
  • The heel of the foot.

Ulcers in Seniors

Careful monitoring of the skin can help detect any early signs of breakdown or development of ulcers in seniors, especially those with cardiovascular disease and diabetes. Seniors should check their skin frequently for irritations or changes in color.

Any sign of changes should be reported to a health care professional so that it can be address before it turns into an advanced wound. The smallest cut or skin irritation such as cellulitis and other skin infections can erupt into skin ulcerations and can lead to complications and even the loss of a limb.


This article was written by James Constanzer, registered nurse and owner of an online retail senior care company for seniors that sells medical supplies, mobility equipment, vitamins and supplements in order to need to maintain a healthy, independent lifestyle.


Though the author of this information is a licensed nurse, the information provided above is FOR EDUCATIONAL USE ONLY, and DOES NOT CONSTITUTE MEDICAL ADVICE/OPINION, is not meant to diagnose or treat any illness or disease, and is not a substitute for the medical advice of your (or your loved one's) primary care physician or other medical professional. While striving to be factual and exact, no warranties are made with regards to the accuracy of the information provided above. You are always advised to talk with your (or your loved one's) doctor about any health concerns that you have and about any of the information provided above. Sole reliance on the information provided above is not advised and would be solely at your own risk and liability.


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