Foot ulcers Kōmaoa waewae

A foot ulcer is a wound or sore on your foot that is slow to heal. They can be in the top layer of your skin or deep in the tissue of your foot. People with diabetes are at higher risk of getting foot ulcers.


What causes foot ulcers

You can get foot ulcers for many reasons, but they are often caused by serious conditions such as:

  • diabetes
  • peripheral vascular disease
  • rheumatoid arthritis.

Anything that can result in your skin breaking open can cause ulcers such as:

  • stubbing your toe
  • burning your skin on a hot surface
  • poorly fitted shoes.

Symptoms of a foot ulcer

The most common symptom of of a foot ulcer is an open sore that does not heal. There may be some redness, swelling and pain or tenderness. 

A foot ulcer can be hidden under a thick layer of discoloured skin (callus). 


Diagnosing a foot ulcer

Your healthcare provider can diagnose an ulcer, but they might send you to a specialist for treatment. 


Treating foot ulcers

Talk to your healthcare provider about assessing your feet and developing a plan for treating your ulcer.

In most cases your podiatrist, practice nurse or other healthcare provider will remove any hard, dead or infected skin that is stopping the ulcer from healing. They will apply dressings and if needed, a temporary pad to help keep pressure off your wound while it heals. They will give you advice about footwear and ways to keep pressure off your ulcer.

They will also tell you how to keep the dressings clean and dry and arrange follow-up appointments. They may arrange for a nurse to change your dressings or show you how to change them yourself.

If there is any infection, you may need a course of antibiotics.

Your healthcare provider may refer you to a specialist to speed up the healing process. This could be a:

  • vascular surgeon
  • orthopaedic surgeon
  • orthotist (someone who can make special devices for your feet and shoes)
  • infection expert
  • diabetes specialist nurse or
  • dietitian.

When to get help

If you have diabetes and think you could have a foot ulcer, contact your healthcare provider immediately.

Also see your healthcare provider or after-hours medical service as soon as possible if your ulcer has a patch of skin around it that is red, warm and seems to be getting bigger. These could be signs of an infection (cellulitis). 


Diabetes and foot ulcers

Diabetes can cause muscle and nerve damage in your feet, which can change the shape of your feet. This can cause foot deformities, such as bunions or hammertoes. Your footwear can rub the skin on these deformities, making it break open.

Also, if you have diabetes, you may have little or no feeling in your feet. This loss of sensation, caused by the nerve damage from diabetes, means it may be harder for you to tell when your footwear is rubbing.

With diabetes, you may have a reduced blood supply (peripheral vascular disease) going to your feet and the site of the ulcer. This means the wounds will take longer to heal.

Your risk of developing ulcers is even higher if you have previously had a foot ulcer, or if you also have other diabetes complications, such as eye problems or kidney problems.


Self care for foot ulcers

You can help your ulcer heal and reduce your chance of getting another by:

  • not smoking
  • checking your feet every day for any new sores or signs of infection (redness, heat or swelling)
  • washing your feet every day and drying carefully especially between your toes
  • wearing well-fitting shoes
  • keeping good control of your blood sugar levels (if you have diabetes) and blood pressure
  • eating well and aiming for a healthy weight
  • keeping as active as possible

Staying active and eating well