Ulcers on Legs From Diabetes: Recognising and Managing Skin Wounds

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Ulcers on legs from diabetes can develop when poor circulation, nerve damage, and impaired healing affect the skin. These wounds may appear on the feet, ankles, heels, or lower legs. Because diabetes can make injuries harder to detect and slower to heal, early medical assessment is essential.

A leg ulcer is an open area of skin that may persist rather than healing normally. Its cause can vary, and not every ulcer in a person with diabetes is directly caused by diabetes. Venous disease, arterial disease, pressure, infection, and injury may also contribute.

Why Leg Ulcers Develop

High blood glucose over time can damage nerves and blood vessels. Nerve damage may reduce the ability to feel pain, heat, pressure, or minor injuries. A person might therefore continue walking on an injured foot without realising that the skin has broken.

Circulation problems can limit the delivery of oxygen and nutrients to damaged tissue. This can slow healing and increase the risk of tissue breakdown. Swelling caused by venous circulation problems may also contribute to ulcers around the lower legs and ankles.

Pressure, poorly fitting shoes, minor cuts, and repeated friction can further damage vulnerable skin. When several risk factors occur together, a small wound may become increasingly difficult to manage.

Symptoms to Watch For

Ulcers may appear as open sores, shallow craters, or areas of damaged skin. The surrounding area may become red, swollen, warm, discoloured, or painful. Some wounds release fluid or develop an unpleasant smell.

However, diabetic neuropathy can reduce pain, meaning a serious wound may not hurt much. A lack of pain does not mean the ulcer is harmless.

Seek prompt medical assessment for any new ulcer if you have diabetes. Urgent evaluation is especially important if the wound is worsening, there is spreading redness or pus, the skin becomes black, or the foot is unusually cold or discoloured. Fever or feeling very unwell may indicate a serious infection.

Diagnosis and Treatment

A clinician will examine the wound and assess its depth, location, and signs of infection. They may check blood circulation, sensation, blood glucose, and other factors that affect healing. Further tests can be required when an arterial problem or deeper infection is suspected.

Treatment may involve appropriate wound dressings, pressure relief, removal of damaged tissue by a trained professional, and management of infection when present. If circulation is poor, specialist assessment may be needed to determine whether vascular treatment could help.

The treatment plan should address the underlying cause, not just the visible wound. Do not apply unprescribed creams, strong antiseptics, or home remedies to an ulcer without clinical guidance.

Prevention and Daily Care

Check your feet and lower legs every day for blisters, cracks, swelling, colour changes, and skin breakdown. Use suitable footwear, avoid walking barefoot, and seek professional help with corns or thickened nails if you have reduced sensation.

Follow your diabetes care plan and attend routine foot assessments. Ask your clinician how to manage swelling, protect vulnerable skin, and reduce pressure safely.

Get Help Early

Ulcers on legs from diabetes can lead to serious infection and tissue damage when treatment is delayed. Early assessment, correct wound care, and attention to circulation and blood glucose can improve the chance of healing. If a new wound appears, contact your healthcare professional promptly rather than waiting for symptoms to become severe.

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