Arterial Ulcer vs. Venous Ulcer: What’s the Difference?

Written By Center for Vein Restoration
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Wounds of the lower leg are painful and distressing, no matter the cause. But because treatment modalities differ between arterial and venous ulcers, it is essential to get an accurate diagnosis to get the appropriate treatment.

Both arterial and venous ulcers are leg wounds that are difficult to heal and require medical intervention for the best outcomes. At Center for Vein Restoration (CVR), our vein physicians have expertise in the root cause of arterial and venous ulcers. They can accurately diagnose the source of a lower limb wound and treat venous-related ulcers expertly.

We spoke to vein disease physician Christopher M. Bulger, MD, FACS, about the differences between arterial ulcers and venous ulcers. He thoroughly explains what a person should do if they are experiencing a wound of the lower limbs that does not heal. Dr. Bulger is the lead physician at the CVR location in South Windsor, Connecticut, offering state-of-the-art treatment for symptoms of vein disease. He is board-certified in vascular surgery and general surgery with a specialty in wound care.

I have an ulcer on my foot, heel, ankle, or leg. What should I do?

During this video master class on leg ulcers, Dr. Bulger will explain the differences between and causes of arterial and venous ulcers, the treatment options, and what you should do if you have a wound that doesn’t heal on its own in four weeks’ time.

Topics in this video are divided into six sections for ease of viewing, which includes:

What is an arterial ulcer?

When blood cannot flow into the lower limbs, skin and underlying tissue are deprived of oxygen. As tissue starts to die off, a painful open wound can form. This wound is also known as an ischemic ulcer.

In this section, you will learn:

  • The often-minor root cause of an arterial ulcer.
  • Does arterial disease happen suddenly or over time?
  • What is claudication, and how is it an early sign of an arterial ulcer?
  • What happens if the arterial blockage worsens?
  • How is an arterial blockage like a bathroom faucet?
  • What happens when the skin starts to die?

What is a venous ulcer?

Venous ulcers are the most common form of ulceration worldwide.

In this section, you will discover:

  • Where are venous ulcers located on the lower extremities?
  • What causes venous ulcers?
  • Why are venous ulcers difficult to heal?
  • What is venous reflux?
  • Is there any overlap in symptoms between arterial and venous ulcers?
  • What is hypoxia, and how do low oxygen levels in your body tissues contribute to ulcers?

How can I tell the difference between arterial and venous ulcers?

While the ulcers appear different to a trained physician, Dr. Bulger doubts that a layperson can tell the difference.

In this section, you will hear:

  • How do arterial and venous ulcers differ in appearance? Is the pain level different?
  • Which ulcer type appears wet, and which appears dry?
  • Skin discoloration is a sign of which type of ulcer?

Can ulcers heal on their own?

According to Dr. Bulger, “theoretically yes, but it’s unlikely. The real question is over what period of time.”

In this section, you will find out:

  • What happens if an ulcer is present over a long time?
  • How long should someone with an ulcer wait before seeking treatment?
  • Will a wound get better by itself?
  • Are ulcers prone to secondary infection?

How does CVR treat venous ulcers?

“There are multiple steps in treating an ulcer. CVR has significant expertise in wound care due to the background of the physicians and the (advanced) equipment available in the office.”

– Dr. Christopher Bulger, CVR, South Windsor, CT

In this section, you will come to understand:

  • What is the first step in successfully treating an ulcer?
  • Are venous and arterial ulcers mutually exclusive, or are there overlapping features?
  • What component of an ulcer gets treated first?
  • How an artery is like a kitchen faucet.
  • What is the first step in treating a venous ulcer? How has this standard of care changed over the past few years based on definitive data? How has this standard reduced the healing time?
  • Using this data, how does CVR treat a venous ulcer?

I have a venous ulcer. What should I do?

Dr. Bulger emphasizes that “any wound that doesn’t heal within four weeks using routine care (keeping it clean and covered) must be seen by a physician.”

In this section, you will establish:

  • Do all physicians have expertise in wound care?
  • What is a wound center?
  • Do CVR physicians have the skill and experience to diagnose and treat arterial ulcers as well as venous ulcers?

Make an appointment to diagnose and treat your wound today!

Don’t ignore a wound that won’t heal! Non-healing wounds can lead to increased pain, infection, pus or odorous drainage, scarring, and even amputation. CVR has 100+ locations across the United States with lead physicians who have deep knowledge and experience in diagnosing the cause of your ulcer and treating it successfully.

To schedule with Dr. Bulger or another highly=qualified CVR physician near you, call 1-800-FIX-LEGS (1-800-349-5347) to speak to a Patient Services Representative, or schedule online, 24 hours a day, seven days a week.


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