Skin Ulcers: A Comprehensive Guide to Types, Causes, Treatment, and Prevention

• Written by Mudit Handa

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The prevalence of skin-related diseases has increased significantly in recent decades. This increase in skin issues has become a global concern, significantly burdening healthcare systems, including those in India. Skin ulcers are among the most common dermatologic problems in India.

According to the Department of Dermatology, PGIMER & SSKM Hospital, Kolkata, skin ulcers are common in 4.5 out of 1,000 people. This points to people’s knowledge gap of the early stages of skin ulcers that become severe enough to be treated by surgery.

Hypertension, arterial insufficiency, neuropathy in the diabetics, acute pressure, and vasculitis are some key factors contributing to the rapid rise of this skin disease.

This article will detail the types, causes, and treatment procedures to cure skin ulcers.

What is a Skin Ulcer? 

Skin ulcers are open sores that form on the surface of the skin. They can be painful, slow to heal, and may lead to complications if left untreated. Understanding the different types of skin ulcers, their causes, and available treatment options is essential for effective management and prevention.

What are the Different Types of Skin Ulcers?

Given below are the different types of skin ulcers:

• Bedsores: Bedsores develop from prolonged pressure on the skin, often affecting people with limited mobility.
• Venous Ulcers: These ulcers develop due to poor blood circulation in the veins, usually in the legs.
• Arterial Ulcers: Arterial ulcers occur when there is insufficient blood flow to the arteries, typically affecting the feet and toes..
• Diabetic Ulcers: Diabetic ulcers, a common complication of diabetes, often develop on the feet.
• Deep Tissue Injury (DTI): In addition to the above four skin ulcers, this is another type of skin injury that may not be immediately visible but can develop rapidly to become a severe ulcer. It often appears as a deep bruise or blood-filled blister and is not considered an ulcer. It has been mentioned here to inform you that you should treat it before it becomes an ulcer.

What Causes Skin Ulcers?

A variety of factors are responsible for the development of skin ulcers. These include the following:

• Pressure: Constant pressure on the skin restricts blood flow, leading to tissue damage and ulcer formation.
• Poor Blood Circulation: Inadequate blood flow, whether due to venous or arterial insufficiency, can deprive the skin of oxygen and nutrients, making it prone to ulcers.
• Diabetes: High blood sugar levels can damage nerves and blood vessels, increasing the risk of foot ulcers.
• Injury: Trauma, burns, or cuts can create open wounds that may develop into ulcers.
• Infection: Bacteria or other microorganisms can infect wounds, hindering healing and causing ulcers.

What are the Different Skin Ulcer Stages?

Skin ulcers are typically classified into stages based on their severity and depth of tissue damage. The most commonly used system is the National Pressure Ulcer Advisory Panel (NPUAP) staging system, which includes the following stages:

• Stage 1: The skin is intact but discoloured (it may appear red, blue, purple, or dark in people with darker skin tones). Compared to the surrounding tissue, the area may feel warm, firm, soft, or painful.
• Stage 2: The skin is broken, forming a shallow open sore. It may appear as a blister or abrasion. The surrounding skin may be red and irritated.
• Stage 3: The ulcer extends deeper into the skin, reaching the subcutaneous fat layer. The wound may have a crater-like appearance.
• Stage 4: The ulcer is deep and extensive, reaching muscle, bone, or tendons. There may be visible damage to these underlying structures.
• Unstageable: After the above four stages, the last stage of the ulcer occurs, where the depth of the ulcer cannot be determined due to dead tissue (slough or eschar) covering the wound bed.

Medical professionals use these stages to assess the severity of an ulcer and guide treatment decisions. Early detection and intervention are crucial for preventing ulcers from progressing to more severe stages and improving healing outcomes.

What are the Possible Treatment Methods for Skin Ulcers?

A step-by-step procedure is followed for skin ulcer treatment​. 

• First Aid: Cleaning the wound, removing dead tissue (debridement), and applying appropriate dressings are essential for promoting healing.
• Pressure Relief: Redistributing pressure and offloading the affected area are crucial for pressure ulcers.
• Compression Therapy: Compression stockings or bandages can improve blood flow in venous ulcers.
• Medications: Antibiotics may be necessary to treat infections, while pain relievers can manage discomfort.
• Surgery: In certain severe cases, surgical intervention may be required to remove a blockage in the blood flow or remove the malignant tissue.

These treatment approaches for skin ulcers are tailored to the specific type and severity of the ulcer. However, for quick recovery, you must adhere to the treatment plan prescribed by your dermatologist throughout the treatment process.

How to Heal Skin Ulcers Naturally?

Here are some natural remedies that may aid in healing skin ulcers:

• Honey: Honey has antibacterial and anti-inflammatory properties. Medical-grade honey can be applied to the wound to promote healing and prevent infection.
• Aloe Vera: Aloe vera gel has soothing and moisturising properties that can help heal wounds.
• Turmeric: Turmeric contains curcumin, a compound with anti-inflammatory and antioxidant effects. It may help reduce inflammation and promote healing.
• Garlic: Garlic has antibacterial properties and may help fight infection.
• Proper Nutrition: A balanced diet rich in vitamins and minerals is essential for wound healing. Focus on foods high in protein, vitamin C, and zinc.

However, it's crucial to remember that skin ulcers require proper medical attention. Natural remedies can be used as a complementary approach alongside conventional treatment but should not be considered a replacement for professional medical advice. 

Note: Natural remedies can be a helpful addition to conventional treatment for skin ulcers, but they should be used only under the guidance of a healthcare professional or a dermatologist.

How to Prevent Skin Ulcers?

Here are some practical ways to avoid skin ulcers:

• Regular Skin Checks: Inspecting the skin for signs of pressure or injury is crucial, especially in people with limited mobility or diabetes.
• Proper Positioning: Repositioning and using pressure-reducing devices can prevent pressure ulcers.
• Control Blood Pressure and Sugar: Controlling blood sugar levels in diabetes and managing circulatory problems can reduce the risk of ulcers.
• Protecting the Skin: Keeping the skin clean and dry, avoiding injury, and wearing appropriate footwear can help prevent ulcers.
• Maintain Skin Hygiene: Keep the ulcer clean and dry to prevent infection.
• Avoid Irritants: Avoid harsh soaps, chemicals, and scrubbing the ulcer.

These are some effective healthy habits that can prevent the occurrence of skin ulcers. 

Skin ulcers are a common but often preventable and treatable condition. Early detection, proper wound care, and addressing underlying causes are essential for effective management. By understanding the types, causes, and treatment options for skin ulcers, individuals can take proactive steps to maintain healthy skin and prevent complications.

However, in addition to learning the essential health and hygiene tips mentioned above, you must also be financially prepared for medical treatment like surgery if it is inevitable. The only way to be financially ready is to buy appropriate health coverage in advance.

Rea More: Everything you need to know about Anemia and its Symptoms

Have Advance Health Coverage Against Surgical Costs 

Although most skin ulcers can be easily treated by various medical approaches followed by a dermatologist, specific severe types of ulcers require surgery. Surgical costs can be unexpectedly high, and additional expenses such as ICU charges, medications, and consumables can further increase the financial burden. Hence, you must get a comprehensive health insurance plan such as Care Advantage by Care Health Insurance. This plan covers all your treatment costs and advanced technology methods up to the sum insured.

So, it's time to plan your health coverage today and live stress-free.

Disclaimer: Verifying the policy details and coverage with the official policy documents is essential. Also, kindly consult a professional medical expert to confirm the details of your health concerns.