What Is an Ulcer?

Medically reviewed by Robert Burakoff, MD

An ulcer is an open sore that can show up on the skin, in the lining of an organ, or on the surface of any body tissue. Ulcers can occur on many parts of the body including the stomach, intestines, mouth, and eyes.

The main symptom of an ulcer is pain or discomfort around the area where the ulcer has developed. The cause of an ulcer will depend on what type of ulcer a person has.

Types of Ulcers

All types of ulcers are similar in that they are lesions or sores that occur somewhere in your body that cause pain. Another similarity among ulcer types is that a lot of them are caused by bacterial infection.

What differentiates these types of ulcers is where they occur in your body and how they are treated. Some common type of ulcers are:

Stomach Ulcers

A stomach ulcer, also known as a peptic ulcer, is a sore on the lining of your stomach or lower intestine. These lesions are caused when stomach acids, which help digest food, damage the walls of the stomach or lower intestine. Approximately 1 to 6% of people in the United States have peptic ulcers.

The stomach is usually protected by a mucus layer that prevents stomach acids from damaging its walls. When this mucus layer breaks down, stomach acids can reach the stomach walls and lead to the damage that causes ulcers. There are two main causes for stomach ulcers:

  • Infection with a bacteria called helicobacter pylori

  • Long-term use of nonsteroidal anti-inflammatory medicine (NSAIDs) like aspirin and ibuprofen

Both of these contribute to the breakdown of the protective coating that prevents stomach acids from reaching the walls of the stomach.

According to the NIH, 30 to 40% of people in the United States get a helicobacter pylori infection during their lifetime.

People who take NSAIDs for a long time and/or at high doses have a high risk of developing ulcers. Additionally, the prevalence of ulcers caused by NSAID use is higher in older people versus younger adults.

Other less common causes for stomach ulcers include:

  • Infections caused by certain viruses, fungi, or bacteria (apart from helicobacter pylori)

  • Medicines that increase the risk of developing ulcers, like corticosteroids, medicines used to treat low bone mass, and some antidepressants (particularly when taken alongside NSAIDs)

  • Surgery or medical procedures that affect the stomach or lower intestine

  • Chronic diseases like cirrhosis or chronic obstructive pulmonary disease

Related:How Do You Know if You Have a Stomach Ulcer?

Skin Ulcer

A skin ulcer is a round, open sore or wound on your skin. It could be due to a minor skin injury that isn't healing properly because of infection, inflammatory conditions, or blood circulation issues.

A small or mild skin ulcer isn’t necessarily dangerous on its own, but it could become severe if not treated properly.

Some types of skin ulcers include:

  • Pressure ulcer: Also called bedsores or decubitus ulcers, a pressure ulcer develops when there’s continued pressure on a certain area of your body, which compresses the blood vessels underneath your skin and disrupt blood circulation.

  • Venous ulcer: These types of ulcers can occur on your skin, specially the legs, when your blood circulation isn't flowing as usual, causing pressure, excess fluid and open sores to form. These ulcers typically has an uneven border around a shallow sore with a red base, sometimes covered by yellowish tissue.

  • Ischemic ulcer: Also known as an arterial ulcers, these develop when there's reduced blood flow to the feet or legs. You may develop a sore that is dark red, yellow, gray, or black, with a raised edge around the wound.

  • Neuropathic skin ulcer: Sometimes called diabetic ulcers, these kinds of ulcers typically develop due to nerve damage in people with uncontrolled diabetes. Because they don't know they are injured, it's more common for the injury to go untreated and lead to ulcers. In diabetics, this most commonly happens in the pad of the feet.

Related:Types of Skin Lesions and Their Causes

Mouth Ulcer

Mouth ulcers are sores of lesions found in or around the mouth. There are many disorders that cause mouth ulcers.

Some of the main causes are:

  • Canker sores: Canker sores can occur as a result of some viral infections, a injury from dental work, or biting the tongue or cheek

  • Gingivostomatitis: This is an infection of the mouth and gums that causes swelling and sores as a result of poor mouth hygiene. It is a common infection in children.

  • Oral herpes: Herpes is a viral infection caused by the herpes simplex virus type 1. This infection causes cold sores on the mouth, lips or gums.

  • Oral cancer: Some oral cancers begin as mouth ulcers. Ulcers that are indicative of mouth cancer can occur on the inside your cheek, floor and roof of the mouth, or on the gums

  • Lichen planus: This is a condition of the skin, hair, nails, mouth and genitals is a condition that causes an itchy rash in your mouth that can appear purple. This rash can sometimes develop into a mouth ulcer.

Corneal Ulcer

A corneal ulcer, also known as keratitis, is an open sore in the outer layer of the cornea. It is usually caused by bacterial infection, specially in people who wear contact lenses and don't clean them properly. This is especially common in people who wear extended-wear contact lenses.

According to the American Academy of Ophthalmology, other common causes for corneal ulcers are dry eye syndrome, infections caused by viruses, fungi, and amoebae, cuts or scrapes of the eye, Bell’s palsy and other eyelid disorders.

Related:Experts Recommend the Best Eye Drops for Dry Eyes

Ulcer Symptoms

Ulcer symptoms depend on what type of ulcer you have. All ulcers cause pain and discomfort in the area of the body where they appear.

Here are some specific symptoms people with ulcers can experience:

Stomach Ulcer Symptoms

  • Dull and/or burning pain that comes and goes, in the upper part of your abdomen

  • Feeling full soon after eating a meal

  • Nausea, vomiting, bloating, and belching

  • Very black stool or stool with blood

Skin Ulcer Symptoms

  • The sores typically look circular, crater-like, open and raw.

  • The ulcers might ooze clear fluid, blood, or pus (when infected)

  • The wound may be raised, inflamed, or have a discolored border

  • The ulcer is itchy, painful, or feel like it's burning.

Mouth Ulcer Symptoms

  • Pain in the mouth

  • Red bumps that develop into an ulcer in the mouth

  • Lesions with a white or yellow center

  • Mouth soreness that removes your desire to eat

Corneal Ulcer Symptoms

  • Severe pain and eye soreness

  • Redness of the eye

  • Feeling like you have something in your eye

  • Tearing of the cornea

  • Pus or discharge

  • Blurred Vision

  • Light sensitivity

  • Swelling of the eyelids

Treatment for Ulcers

The treatment plan to help your sore heal will depend on the type of ulcer you have and its severity. Because many ulcer types are caused by infections, treatment options will include some type of antibiotics to get rid of the bacteria that is causing the sore.

Treatment for Stomach Ulcers

Stomach ulcers are treated with medicines that help manage the effects of stomach acid damage and/or get rid of an helicobacter pylori infection. The following are the common treatments used for stomach ulcers

  • Proton pump inhibitors: This medication reduces the amount of stomach acid you produce. Commonly prescribed proton pump inhibitors are omeprazole (Prilosec), esomeprazole (Nexium), and lansoprazole (Prevacid)

  • Bismuth subsalicylate: This medication help reduce the flow of liquids in your stomach, reducing inflammation. It can be prescribed as a liquid or tablet. Pepto-Bismol is a common brand-name of this type of medication.

  • Antibiotics: These are used to fight a helicobacter pylori infection.

Treatment for Skin Ulcers

Treating a skin ulcer depends on the type of ulcer you have, how severe it is, and your overall health. There are certain kinds of treatment options:

  • Medication: Your healthcare provider may suggest an OTC or prescription drug like antiobiotics to help you manage the pain and prevent further infection. In the case of ischemic ulcers, they may also prescribe medications to help get your blood flowing.

  • Dressings: Keeping an ulcer covered may help keep an ulcer moist, clean, and infection-free to help support the healing process. Your healthcare provider can show you how to best apply and change your dressing.

  • Medical procedures: Depending on the severity of an ulcer, a medical procedure like a skin graft, or amputation (in extremely severe ulcer cases), may be recommended.

  • Blood circulation treatments: Wearing compression socks, propping up your feet when lying down, exercising, and getting massages may help the blood circulation in your legs improve.

Treatment for Mouth Ulcers

Treating mouth ulcers depends on the type of mouth ulcer you have. If a mouth ulcer is caused by a specific underlying disease, like oral cancer, your doctor will establish a treatment plan for that condition.

For other common types of mouth ulcers, the typical treatments are:

  • Gently cleaning your mouth and teeth regularly

  • Using medicines to rub on your ulcer like antihistamines, antacids, and corticosteroids

  • Non-alcohol based over-the-counter (OTC) mouthwashes

  • Medically prescribed mouthwashes like chlorhexidine mouthwash

If a mouth ulcer is caused by oral herpes, topical antiviral creams and oral antiviral tablets like acyclovir, famciclovir, and valacyclovir are prescribed.

Treatment for Corneal Ulcers

Treatment for eye ulcers depends on the cause and severity of the ulcer. Common types of corneal ulcer treatment are:

  • Antibiotic, antifungal, and/or antiviral eye drops

  • Steroid or anti-inflammatory eye drops

In severe cases, an ophthalmologist might suggest a corneal transplant to replace a damaged cornea with a healthy one in order to restore vision.

Preventing Ulcers

In many cases, ulcers are not life-threatening, but they can significantly affect someone's quality of life. There are many ways to prevent developing stomach, mouth, or corneal ulcers.

Stomach ulcers caused by NSAIDs like ibuprofen and aspirin can be prevented by lowering the dosage you take and/or reducing how often you use these OTC medications.

If taking NSAIDs for pain management is necessary, taking these medications along with a proton pump inhibitor tablet can reduce the risk of developing a stomach ulcer. Additionally, quitting smoking has also shown to lower the risk of developing stomach ulcers.

If you have a condition that makes skin ulcers more likely or know that you're prone to developing them, it’s a good idea to schedule a visit with a healthcare provider to discuss this. You should also check your feet and legs every day for signs of an injury.

Otherwise, experts generally recommend implementing certain healthy lifestyle changes, such as keeping chronic diseases like diabetes, high blood pressure, or high cholesterol under control. You should also exercise to maintain healthy blood flow, and eat a healthy diet that supports healing.

Preventing mouth ulcers depends on the cause, and your hygiene. According to the NIH, the best way to prevent mouth ulcers that are not related to cancer or herpes is to brush your teeth twice a day and scheduled dental check ups regularly. In general, regular brushing after meals and flossing once a day can keep your mouth clean and free of foods that might trigger a canker sore.

Finally, corneal ulcers can be prevented by using protective eyewear when doing activities that can lead to an eye injury and properly cleaning your contact lenses prior to wearing them.

A Quick Review

Ulcers are lesions on the surface of your skin or organs that cause pain and discomfort on the affected area. Stomach, mouth and corneal ulcers are often caused by bacterial or viral infection, medication overuse and/or some sort of physical injury.

While painful, ulcers are not usually life threatening and can be managed by a variety of OTC medications that can help manage symptoms and help your ulcer heal.

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