Arterial vs Venous Ulcer: Difference and Comparison

Leg ulceration is a common condition among the old and also among people with certain risk factors, as will be discussed below.


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An ulcer is a wound developing due to cracking or breaking of the skin that takes a long time to heal. Around 5-6 days. Leg ulcers are generally of two kinds: arterial and venous.

Key Takeaways

  1. Arterial ulcers develop due to insufficient blood flow, while venous ulcers result from poor blood return.
  2. Arterial ulcers appear on the feet or toes and have a punched-out appearance, whereas venous ulcers tend to form around the ankles and are irregular.
  3. Treatment for arterial ulcers focuses on improving blood flow, while venous ulcer management involves compression therapy to aid blood return.

Arterial vs Venous Ulcer

Arterial ulcers develop as the result of damage to the arteries due to lack of blood flow to tissue and affect toes/shin/pressure points, while venous ulcers develop from damage to the veins caused by an insufficient return of blood back to the heart and occur above the medial or lateral malleoli.

Arterial vs Venous Ulcer

An arterial ulcer is a type of chronic wound developed due to the damaging of skin tissue as a result of ischemia. Ischemia is a condition in which there is a lack of blood flow to the tissues from the heart.

Since bringing blood to the different parts of the body is the work of the arteries thus, the name arterial ulcer is given to this type of wound.

Venous ulcer is a type of chronic wound development due to the damaging of skin tissue as a result of lack of proper circulation of the blood back to the heart or due to stagnation of the blood, mostly associated with added pressures.

Since veins are responsible for bringing blood back to the heart hence, this wound is called a venous ulcer.

Comparison Table

Parameters of ComparisonArterial UlcerVenous Ulcer
CauseArterial ulcers are caused due to a lack of blood supply from the heart.Venous ulcers are caused due to a lack of blood returning to the heart.
OccurrenceThey occur in areas of the leg that have to bear the weight of the person.They occur mainly on the medial side of a leg of a person.
BleedingArterial ulcers do not bleed profusely.Venous ulcers are known to bleed heavily.
Type of WoundThe wound is well defined in the case of arterial ulcers.The wound is irregular in the case of venous ulcers.
PainArterial ulcers are very painful.Venous ulcers show periodicity in pain.

What is Arterial Ulcer?

The identifying feature of an arterial ulcer is its punched-out appearance. The wound of an arterial ulcer has well-defined edges and is pale in colour, and has necrotic tissue around it.

This wound is chronic and takes days to heal. The long time it takes to heal is because of the lack of blood supply to this area.

Ulcers are caused due to underlying regions like lack of oxygenated blood to the tissue causing it to break and cause the wound. This wound is also known to bleed heavily and is associated with pain.

Leg pain is common and is the most at night. The wound occurs in weight-bearing areas of the body like the tips of toes, heels, phalangeal head and so on.

The leg turns cold at this spot, the skin turns dry, and in extreme cases can also turn into infected gangrene. Sometimes exudate may come from these wounds in case there is an infection, or else there is no exudate at all.

The risk factors of an arterial ulcer include diabetes, improper footwear, atherosclerosis, inborn foot deformity, smoking, vascular disease, obesity and any such disease that may prevent blood flow to the body.

The leg is the most commonplace occurrence of an ulcer as it is a peripheral part of the blood where the blood reaches the last.

What is Venous Ulcer?

The identifying feature of a venous ulcer is its irregular appearance. The wound is granular in appearance and itchy, unlike arterial ulcers. This is caused when the blood from the leg is not returned to the heart and remains stagnant in the affected area.

The underlying cause thus does not always allow oxygenated blood to reach this area and hence causes tissue to almost undergo oxygen starvation and hence crack up and bleed continuously.

Usually, the site of occurrence of venous ulcers is the medial side of the leg and aspects such as the gaiter of the leg.

Sometimes hair may develop from the wound. Usually, they are also painless however show periodicity of pain. Usually, the pain is during the nighttime only. The affected area, however, remains warm, unlike arterial ulcers that occur cold to touch or perceive.

The risk factors of venous ulcers are pregnancy, diabetes, obesity, thrombosis, malnutrition, vein surgeries, varicose vein, and any such reason causing the blood to be stagnant in the area. Dilation of veins occurs at the leg, which is a common symptom of venous ulcers.

Main Differences Between Arterial and Venous Ulcer

  1. Arterial ulcers occur due to a lack of oxygenated blood to a certain body from the heart, whereas venous ulcers occur due to a lack of blood going to the heart.
  2. Arterial ulcers do not bleed as such, but venous ulcers bleed a lot.
  3. Arterial ulcers have a distinctive wound. Venous ulcers do not have a distinct wound.
  4. Pulse beat is sometimes absent in a leg with an arterial ulcer, whereas in the case of a venous ulcer, the pulse beat of the leg can be felt as normal.
  5. The leg appears cold in the case of arterial ulcers, whereas in the case of venous ulcers, the leg stays warm.
Difference Between Arterial and Venous Ulcer

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