Diabetic Wounds on Legs: Why They Form and How to Treat Them

Wound care is an intricate process—one that is significantly affected by underlying conditions, such as diabetes. This condition impacts nearly every system in the body, including the skin, nerves, and blood vessels. However, while an estimated 38 million Americans live with diabetes, many are unaware of how it impacts wound healing.

As we discussed previously, diabetic foot ulcers are among the most frequently treated complications in wound management. However, while less common, leg ulcers are equally challenging. Poor circulation and reduced blood flow can delay healing and contribute to chronic wound development, increasing the risk of life-threatening complications.

At Royal Wound Care, we believe treatment begins with proper education. To help, today’s post serves as a comprehensive, patient-focused guide to diabetic wounds on legs. We will discuss how diabetes impacts wounds, what leg sores look like, and how to effectively treat them. Expert insights are the first step to safer, more efficient healing.

Diabetic Wounds on Legs: Why They Form and How to Treat Them

Many patients often assume that uncontrolled blood sugar is the leading cause of non-healing open wounds. However, this isn’t always the case. While managed sugar can significantly reduce risk, it doesn’t eliminate it completely.

From high blood pressure and poor circulation to nerve damage and a weakened immune system, there are many reasons why people with diabetes experience both foot and leg ulcers. And today, we’re here to discuss it.

Whether you’re facing a leg ulcer for the first time or dealing with a chronic ulcer that keeps returning, proper care is essential to quality of life and long-term healing.

Related: Managing Chronic Wounds: A Comprehensive Guide

Does Diabetes Cause Sores on Legs?

Yes, diabetes can cause sores on legs. In fact, studies show that people with diabetes have a 15-25% chance of developing an ulcer at some point. Additionally, research states that ulcers above the malleoli (the bumps on the inner and outer sides of the ankle) are almost as common as foot ulcers.

Ultimately, ulcers develop due to a combination of symptoms. Some of these include diabetic neuropathy (nerve damage), reduced blood flow from peripheral arterial disease (PAD), and narrowed vessels. At the heart of it all, however, lie high blood sugar levels.

High blood sugar can damage nerves and weaken the blood vessels that supply the legs. As a result, patients begin to experience a lack of sensation in the lower extremities. As opposed to feeling a minor scrape or consistent pressure, diabetics may not notice or realize skin irritation until the wound has progressed.

Additionally, elevated glucose levels can slow the immune response. A combination of impaired white blood cell function and reduced oxygen and nutrient delivery to the affected area makes it even more difficult for the body to recover and for wounds to heal.

Without proper care, these wounds can lead to amputation, severe infections, worsening pain, and tissue death. Most importantly, however, they can significantly decrease a patient’s quality of life. Following expert-led advice is essential for helping wounds heal faster, safer, and more effectively.

Related: Diabetic Wound Care: Specialized Treatment for Optimal Healing

What Do Diabetic Leg Sores Look Like?

Diabetic leg sores can appear differently based on several factors, including severity, circulation, and infection risk. However, here are general guidelines to look for based on the University of Texas (UT) Classification wound stages:

Grades (Wound Depth):

• Grade 0: Ulcerative site that has completely healed

• Grade 1: Superficial wound that does not involve exposure of the tendon, joint capsule, or bone

• Grade 2: Wound that has penetrated beyond superficial layers; is reaching tendon or joint capsule, but not yet bone

• Grade 3: A deep diabetic ulcer that has fully penetrated the bone or joint

Classification Stages:

• Stage A: Pre-ulcerative lesions; there is no skin break, no restriction of blood supply, and no infection

• Stage B: Infected wounds that still have adequate blood flow

• Stage C: Slow-healing wounds with lack of blood flow; doesn’t show signs of infection, but are more prone to it

• Stage D: Wounds with both a lack of blood flow and a current infection

What to look for:

• Redness, discoloration, or shiny patches of skin

• Dry, fragile skin that cracks easily

• Areas that are warm, swollen, or tender

• A small open wound that slowly grows larger

• Yellow, white, or brown tissue inside the ulcer

• Drainage, older, or increasing pain

• Increased firmness (callus) surrounding the wound

Wounds caused by peripheral artery disease (PAD) often look “punched out.” They will have well-defined edges, appear discolored, and can sometimes ooze or bleed. Early identification makes all the difference in how a wound heals.

Additionally, although commonly confused, the appearance of diabetic leg ulcers is significantly different from that of venous ulcers. To learn more, visit: “How to Treat Venous Ulcers and Leg Swelling Effectively.”

How to Treat Diabetic Leg Wounds

Maintain Blood Sugar Levels

In terms of healing diabetic leg ulcers, maintaining blood sugar levels is the first and most crucial step. When doing so, patients can experience improved circulation, stronger immunity, enhanced cell function, and increased levels of growth factors.

As a result, cells can successfully repair and build new tissue, encouraging the wound to heal and close faster. Additionally, growth factors support the body’s natural healing signals, such as epithelial cells, connective tissue, blood vessels, and white blood cells. When these systems work together, the body is more equipped to prevent complications and heal successfully.

Related: How Long Does It Take for a Wound to Heal: What Every Nurse and Patient Should Know

Clean and Dress the Wound Properly

Whether patients opt for self-care, home health care, or in-clinic wound care, cleaning and dressing wounds is essential for healing. To start, cleaning the ulcer effectively removes pathogens, debris, bacteria, and dead tissue.

However, it’s important to avoid harsh antiseptics—like hydrogen peroxide or alcohol—and instead use antimicrobial ointments, hydrating gels, or prescribed topical treatments.

Moreover, wound dressings further protect the injured area from harmful external factors. Just like with cleansers, the type of dressing can significantly influence the healing timeline. Opt for moisture-retentive, antimicrobial, or collagen-infused dressings.

Related: Caring for Your Wound

Don’t Ignore Infection Warning Signs

As we discussed before, many individuals with diabetes experience reduced sensation. Because of this, even if they’re aware of a wound, they may not be able to feel pain, pressure, or worsening symptoms that signal the injury is becoming more severe.

To catch things before they progress, it’s essential to continue monitoring the area for any warning signs. This includes redness, increased warmth, swelling, pus or drainage, a foul odor, increased pain, firmness, or non-healing wounds. If caught early, patients can visit a specialist before severe complications arise.

Implement Diet and Lifestyle Changes

When managing diabetic wounds, every seemingly minor thing matters. Lifestyle factors, health history, and comorbidities can delay healing or lead to chronic ulcers. To start, we recommend re-evaluating lifestyle changes where possible.

For example, high blood pressure, smoking, and consuming alcohol can impair immune response, increase infection risk, and hinder healing. When addressed and managed early, patients can actively work with physicians to improve the body’s ability to heal.

Additionally, nutrition and diet have a key role in healing timelines. Wound healing is complex, and the proper vitamins, minerals, and nutrients can provide the body with fuel it needs to heal.

Related: Nutrition and Wound Healing: What to Eat for Faster Wound Healing

Know When to Visit a Wound Care Specialist

When managing diabetes, both leg and foot care can often feel challenging and isolating. However, reaching out to specialized wound care specialists can make a significant difference throughout the process.

At Royal Wound Care, we pride ourselves on accessible, exceptional care tailored to each individual. We don’t just aim to treat the wound—we care for each person as a whole. Along with expert-led advice and unique care plans, we also offer advanced wound treatments that accelerate healing and improve lives.

From debridement and UltraMIST® Therapy to wound VAC therapy and skin substitutes, healing isn’t only possible—it’s within reach.

Related: When to See a Wound Care Specialist: Signs It’s Time to Get Expert Help

With intentional lifestyle changes and wound care specialists, diabetic wounds on legs don’t have to determine long-term health outcomes.

It’s not uncommon for individuals with diabetes to experience foot ulcers, leg ulcers, and non-healing wounds. However, commonality doesn’t make them any less challenging. With the right approach, intentional lifestyle changes, and intervention from a specialized wound care clinic, healing is just around the corner.

At Royal Wound Care, we understand the importance of bridging the gap between accessibility and recovery. This is why we offer in-clinic services and mobile wound care. Patients don’t have to live with chronic pain or risky complications. We’re here to heal, help, and protect you—no matter what your wound looks like.

Additionally, we offer advanced education opportunities and professional partnerships for both SNFs and independent nurses. With reduced re-hospitalizations, lower infection rates, and improved patient outcomes, healing has never felt more promising.