They get just as nasty and achey as the knuckles. They start getting pulled in and trying to heal together and it hurts. Sometimes they hurt so bad, it's hard to bend or straighten the elbow. Sometimes, they make the muscles around the area sore.
Sometimes, they start pulling SO bad, the only release, is to pull the scab off, just to release the pressure. That's why the one on the right, in the picture, doesn't look as bad. Because it's minus the big nasty scab. I had to pull it off this morning at 0330, just so I could bend my arm to get comfortable to sleep.
What the hell kind of plan is that? Who knows, but it works.