What Are Arterial Wounds?

Medically Reviewed by Debra Jaliman, MD on July 20, 2023
Written by WebMD Editorial Contributors
4 min read

Arterial wounds, also known as arterial ulcers, are painful injuries in your skin caused by poor circulation. ‌

Arterial ulcers typically happen when blood is unable to flow into the lower extremities, like the legs and feet. When the skin and underlying tissue are deprived of oxygen, the tissue starts to die off and form an open wound. 

Arterial wounds tend to be extremely painful and uncomfortable. ‌

Due to poor circulation, arterial wounds may heal slowly. The lack of circulation can also make it difficult for the red blood cells to deliver the nutrients needed to heal. Without oxygen-rich blood, white blood cells may not be able to fight off bacteria, making the wound more likely to become infected.‌‌

If left untreated, arterial ulcers can lead to more serious diseases or complications, including infection, tissue necrosis, and, in extreme cases, amputation.

Arterial wounds typically have a “punched-out” look. They may be round in shape with well-defined margins — meaning the sore may be deeper in the skin than the surrounding area of healthy skin.
They’re often found on the outer ankle, on the heels, on the toes, or in between the toes. They can also happen in areas where there’s pressure from walking, exercising, or wearing footwear.‌

Arterial ulcers also tend to have a distinct color. The wound itself typically doesn’t bleed and may be black, grey, brown, or yellow. ‌

The limb may turn red when dangled downward, and become pale when propped up or elevated.‌

In addition, you might have: 

  • There is little to no hair growth on the affected limb.
  • The limb feels cold to the touch with little to no pulse.
  • Your skin and nails appearing shiny, thin, and dry 
  • Your skin feels tight or taut.

‌Arterial wounds are most often caused by blocked arteries. This may prevent nutrient-rich blood from flowing to the extremities, creating an open wound. ‌

Other potential causes include: 

Other disorders may also lead to arterial wounds, including high cholesterol, heart disease, high blood pressure, or sickle cell anemia. 

Several risk factors may also contribute to arterial ulcers, including: 

Arterial ulcers and venous ulcers are both open sores found on the lower extremities, like the legs and feet.‌

Arterial ulcers are often the result of damage to the arteries due to poor circulation and blood flow. Venous ulcers develop from damage to the veins due to insufficient blood flow to the heart. ‌

Because they both form on the lower leg, it can be difficult to differentiate them. While they’re very similar, there are some differences you can use to identify each.‌

Arterial Ulcers. Arterial ulcers have a distinct “punched out” appearance and are typically circular with a red, yellow, or black coloration. They are usually extremely painful. 

Venous Ulcers. Venous ulcers tend to vary in appearance. They are usually deep red and may have an irregular shape. The wound itself may be more shallow.‌

Venous ulcers are often painless unless they are infected. Other distinguishing characteristics might include: 

  • Inflammation 
  • Swelling
  • Itchy skin
  • Scabbing or flaking 
  • Brown or black skin 
  • Discharge

While your body can heal arterial wounds on its own, the natural healing process will be significantly slower due to circulation issues. Many people with arterial ulcers experience chronic pain and sores that take months or years to fully heal. ‌

Treatment for arterial ulcers will depend on the severity of the arterial disease. Your physician may conduct diagnostic tests to assess possible forms of treatment, as well as the potential for wound healing. ‌

Goals for healing include: 

  • Improving circulation
  • Treating the underlying cause with antibiotics 
  • Removing contact irritation and pressure on the affected limb 
  • Dressing the wound to keep it dry and clean 

During recovery, you may be asked to wear special shoes or orthopedic devices to relieve pressure on the sore. ‌

Doctors may use surgery, including angioplasty, to restore blood flow to tissues in organs. In rare cases where blood flow can’t be restored, they may recommend amputation of the affected limb.

Your doctor will give you instructions to care for your wounds at home. These may include:

  • Keeping the wound clean and dry by changing the dressing
  • Taking all prescribed medications
  • Drinking plenty of water
  • Following a healthy diet 
  • Exercising regularly, as directed by your doctor
  • Wearing orthopedic shoes 
  • Wearing compression wraps if needed

To prevent ulcers from developing again — or the current ulcers from getting worse — there are some ways you can lower your risk factor. These include managing your blood pressure and cholesterol, quitting smoking, exercising regularly (if appropriate), and watching your intake of sodium.