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An ischemic foot is a foot which is not receiving an adequate blood supply, possibly resulting in the foot becoming cold and hairless, with a weak pulse and poorly growing toenails. Ischemic feet commonly occur in people with atherosclerosis or diabetes, and the feet are then more prone to developing ulcers and infections. Once ischemia has been diagnosed, it is important to take extra care to avoid injury or infection to the foot, as an inadequate blood supply can make it difficult to heal. Ultimately, an insufficient blood supply could lead to gangrene, where tissues die off, and this could lead to amputation of the foot and sometimes part of the limb.
The causes of an ischemic foot include atherosclerosis, where arteries are narrowed by fatty deposits, and diabetes. Atherosclerosis is more likely to occur in people who smoke, eat unhealthily, take little exercise and drink too much alcohol. As well as diabetes, conditions associated with high blood pressure or high cholesterol can predispose a person to developing atherosclerosis. Having close relatives with the condition also increases the risk.
Often, the symptoms of ischemic foot problems are associated with other symptoms of atherosclerosis. Pain may be experienced in the calves while walking, due to narrowing of the arteries in the leg. The pain usually goes away while resting.
There may be a loss of leg hair below the knees and a doctor may be able to detect that the pulses in the arteries of the feet feel weaker than normal. Typically, an ischemic foot will feel abnormally cool to the touch. As the ischemia progresses, the feet and toes may become painful at rest, especially when raised up, as in bed at night.
Finally, ulcers may begin to develop on the feet, appearing as if punched out of the surrounding skin. They often occur where the toes rub against one another or where any part of the foot rubs on shoes, socks or bed covers. These ulcers do not usually bleed and may be painful.
Preventing an ischemic foot from progressing and leading to complications may involve changing a person's lifestyle, so that smoking is abandoned, weight is lost, a healthy diet and exercise are taken up and alcohol intake is reduced. Drugs may be used to lower blood pressure and cholesterol, control diabetes and prevent blood clotting. Occasionally, treating an ischemic foot may involve surgery to open up or bypass blocked arteries. Ulcers may require cleaning and dressing, and possibly antibiotics if infected.