The smoker's leg - the peripheral arterial disease

Definition - What is a smoker's leg?

Vascular damage occurs in the smoker's leg due to smoking or due to the substances that the body absorbs over the years. These lead to circulatory disorders, which are also called peripheral arterial occlusive disease (PAD). A smoker's leg typically has exposed skin that heals poorly and sometimes becomes infected. It can also happen that the tissue dies in the open areas.

Peripheral arterial occlusive disease (paVk)

PAD (peripheral arterial occlusive disease) is a vascular disease that usually affects the legs. This results in calcifications in the blood vessels, so that initially only a little blood can be pumped through, and later sometimes no blood at all. The body parts behind the constriction are no longer adequately supplied with blood. Smoking is one of the greatest risk factors for the development of the disease. If there is a PAD due to smoking, one speaks of a smoker's leg.

For more information, see: Peripheral arterial disease

Causes of a smoker's leg

The causes of the smoker's leg lie in the ingredients of the cigarettes. These include many substances that the body cannot break down, so that they accumulate in the body over several years and thus lead to tissue damage. Smoking not only damages the lungs, it also has a major impact on many other organs. This influence is noticeable in the cardiovascular system, among other things. Those who are addicted to nicotine and often take up a cigarette expose their bodies to repeated stressful situations. This increases the level of stress hormones in the body, which increases blood pressure. This increased blood pressure, in turn, affects the vessel walls and causes them to age faster and thus break earlier. The lack of oxygen that results from smoking also stimulates the bone marrow to produce more red blood cells. The blood becomes thicker because of the many cells, which is why clots occur more quickly at narrow points in the vessel. Tobacco smoke also contains many aggressive substances that get into the bloodstream when smoking and damage the blood vessels themselves. The vascular damage leads to circulatory disorders, which cause the typical smoker's leg.

For more information, see: Causes of a circulatory disorder in the leg

At what age do you get a smoker's leg?

When a smoker's leg develops is less dependent on the age of the person concerned and more on the duration and the amount of cigarette consumption. Age as well as blood pressure, eating habits, stress, etc. play a role in the development of the smoker's leg, but smoking contributes the largest part of the development. Usually, the peak of incidence for PAD that is not caused by smoking is around 70 years of age. However, smokers can develop PAOD at the age of 30 or 40.

These can be early signs of a smoker's leg

There are many early warning signs for the smoker's leg that already indicate a disturbed blood flow. This includes, for example, strong callus formation and particularly dry skin on the lower legs and feet. The circulatory disorder can also show up in the form of cold feet and a rather pale / bluish skin color. This is a warning sign at the latest when the muscles (e.g. the calves) hurt during exercise.

You can recognize a smoker's leg by these symptoms

The smoker's leg is particularly noticeable through its load-dependent pain, which is due to the fact that the muscles are not adequately supplied with blood or oxygen during exercise. In addition, the lack of blood circulation can also damage the tissue, so that open areas of the skin can easily occur. These typically heal very slowly and can become infected easily. In the advanced stage, the tissue dies and turns black.

Symptoms on the toes of a smoker's leg

The toes are more or less the end of the legs, so the blood has to travel the furthest way to get there. With circulatory disorders, the symptoms often become noticeable on the toes particularly early. They quickly become cold and pale, and sensory disturbances and open skin areas can also appear on the toes. In addition, the growth of the toenails can be disturbed by the low blood flow.

Pain in a smoker's leg

The pain in a smoker's leg at the beginning of the disease is due to the poor blood supply to the muscles. Therefore, pain occurs primarily during physical exertion. They can later make themselves felt in peace. The open areas of skin on the legs can also cause pain, especially if they become infected. In the course of time, however, the nerve fibers that conduct pain are also damaged, so that the legs become less sensitive to pain.

Also read: Pain in the leg

These symptoms make a smoker's leg in terminal stages

The end stage of the smoker's leg is characterized by gangrene and necrosis. Necrosis means that the tissue dies. In the smoker's leg, this happens because of the deposited toxins and poor blood circulation. Usually the spots turn dark to black. Gangrene also describes such tissue necrosis, a distinction is made between moist (infected with bacteria) and dry (leather-like) gangrene.

For more information, see: Open leg

Ulcers on the leg

The open leg is caused by the fact that the skin and the underlying tissue of the smoker's leg cannot be adequately supplied with nutrients. In addition, the waste products of the metabolism are not transported away from there, so that they are deposited and additionally damage the tissue. The resulting open areas often develop into ulcers because the body cannot close them again quickly.

For more information, see: Open leg

Treatment of the smoker's leg with maggots

Maggots are ideal for treating open areas on smokers' legs. They can be placed directly on the skin defect. The maggots eat away the dead tissue and leave the cells that are still alive, thereby cleaning the wound. At the same time, they prevent bacterial colonization and thereby reduce dangerous infections. After treatment with maggots, the wound should be professionally bandaged.

For more information, see: Therapy for circulatory disorders in the leg

Prognosis for a smoker's leg

The prognosis for the smoker's leg is usually poor. Especially if the triggering factors such as smoking, high blood pressure, stress, unhealthy lifestyle, etc. are not addressed. As a result, the vascular situation usually worsens and the disease progresses. In addition, it is usually not only the vascular status of the legs that is bad. The coronary arteries and other important arteries can also clog and cause life-threatening organ damage.

When is an amputation of the leg necessary?

Amputation of the smoker's leg may be necessary if the infection is too severe.A bacterial colonization that cannot be adequately treated with antibiotics can spread to the entire body and develop into blood poisoning with life-threatening organ damage. To protect against this, an overly infected smoker's leg must be amputated. Even if the tissue on the leg has died, this can be dangerous for the body, as the dead cells still secrete substances that are toxic to the body. In consultation with the person concerned, an amputation of, for example, toes or feet can also be carried out in this case.

You might also be interested in: Causes of an amputation

Can a smoker's leg get better?

A smoker's leg can improve if you quit smoking. This removes the major trigger from the disease. Within a few years the body can rid itself of some of the stored toxins and thus improve the vascular status again. Anyone who achieves an overall healthier lifestyle and eliminates other risk factors through exercise and a healthy diet will also advance the improvement of the disease.

You might also be interested in: How to quit smoking

Diagnosis of the smoker's leg

The smoker's leg is first diagnosed on the basis of the symptoms. In this way, the smoking status can already be determined in an anamnesis (questioning the person concerned), and complaints such as a shortened walking distance and pain in the legs during exercise are inquired about. To assess the blood flow, the pulse is measured on both legs and feet. In addition, the flow rate of the blood can be measured with an ultrasound device.

For more information, see: Diagnosis of peripheral arterial disease

Stages of the smoker's leg

The smoker's leg is divided into four stages. Stage I describes a condition in which the vessels have already suffered damage, but there are still no symptoms. In stage II there is a greatly reduced walking distance to a few 100 meters due to the circulatory disorders. If pain also occurs at rest, you are in stage III. In stage IV tissue destruction (necrosis) occurs, and bacterial infections of the leg are also possible.

Smoker's lung

The smoker's lung develops over years of smoking. Tobacco smoke contains many substances that the body cannot break down. These settle in the lungs and damage the tissue. This leads to a chronic inflammatory process in the lungs. A smoker's lung is characterized by the fact that those affected often have to cough as the body tries to get rid of the harmful substances. An increased susceptibility to respiratory infections is also typical. Later, there is a shortage of breath, which can occur even with low stress.