What is it?
An ulcer is a break in the skin that does not heal normally. In diabetes, ulcers usually form at pressure points on the sole or toes, often beneath a callus, and are frequently painless because of neuropathy.
What causes it?
- Pressure on a numb foot
- Poorly fitting shoes
- Foot deformities
- Reduced circulation
- Minor injuries that go unnoticed
What does it feel like?
- Drainage on a sock
- A callus with dark discoloration
- Redness, swelling, or odor
- Often no pain at all
How is it diagnosed?
Assessment of wound depth and size, testing for infection (including X-rays for bone involvement), circulation studies, and review of blood-sugar control.
When should you see a podiatrist?
- Right away — any open wound on the foot with diabetes should be seen promptly
- Urgently for spreading redness, fever, or foul odor
Nonsurgical treatment
- Offloading
- Special boots, casts, or footwear to take pressure off the wound — the most important part of healing.
- Debridement
- Removing unhealthy tissue so the wound can heal.
- Infection management
- Cultures and antibiotics when needed.
- Advanced wound therapies
- Dressings and biologic therapies selected for the wound.
- Circulation evaluation
- Coordinated with vascular specialists when needed.
When is surgery considered?
Surgery may be needed to treat bone infection, drain an abscess, or correct a deformity that keeps causing ulcers.
Procedures range from removing infected bone to correcting deformities that create pressure, with the goal of healing the wound and preventing recurrence.
Related procedures
What is recovery like?
Healing time depends on wound size, circulation, and how consistently pressure is kept off the wound. Preventing recurrence with protective footwear and regular visits is essential.
Frequently asked questions
Why won't my foot wound heal?
The usual reasons are ongoing pressure, infection, poor circulation, or high blood sugar. Effective wound care addresses each of these.
Do I need to stay off my foot?
Pressure must be removed from the wound. How that is done — boot, cast, or modified footwear — depends on the wound's location and your situation.