Why is my wound warm to the touch?

Increased warmth is a sign of infection across several wound types, and warm skin in the area of redness is a symptom of cellulitis. But the skin around a venous ulcer may also be warm or hot in the ordinary course.

Warmth around a wound can mean two quite different things, and which one applies depends on whether it is new.

As a sign to report. Redness, increased warmth, or swelling around the wound are signs of infection for venous ulcers, ischemic ulcers and diabetic foot ulcers alike. For a pressure sore, the sign is skin close to the sore that is warm or swollen. With cellulitis, warm skin in the area of redness is one of the symptoms.

Increased, in three of those. The point is not a temperature but a change.

As an ordinary feature. With venous ulcers, the surrounding skin may be shiny, tight, warm, or hot, and discolored. That is one of the signs and symptoms of the ulcer itself, not one of the reasons to call. So on a leg with a venous ulcer, warmth may already be part of the picture.

There is a third case worth knowing, from the opposite direction. With ischemic ulcers, when you raise the leg, it turns pale and cool to touch. For a leg short of arterial blood, coolness rather than warmth is the finding.

There’s no set threshold for this, and no way to measure it precisely at home. Hands are not thermometers, and comparing one limb against the other is the closest most people can get.

That is why the useful report is comparative and specific: warmer than it was yesterday, or warmer than the other leg, rather than simply warm.

What to watch for

Contact your provider about redness, increased warmth, or swelling around the wound. Other signs of infection to report are more drainage than before or drainage that is yellowish or cloudy, bleeding, odor, fever or chills, and increased pain.

Contact your provider right away if you have symptoms of cellulitis, which include warm skin in the area of redness together with redness that gets bigger as the infection spreads.

Warmth that is new, or greater than the other limb, is the kind worth reporting. Warmth that has been there as long as a venous ulcer may be part of that ulcer’s usual picture.

A limb that has become cool and pale rather than warm is a different finding, linked to ischemic ulcers, and is also worth reporting.

Wound Wizard is general education and can’t assess your wound. Your own clinician is the right person to ask.

What we look at

  • Examining the wound and the skin around it
  • Comparing temperature against the other limb and previous visits
  • Checking for infection
  • Checking the blood flow in the area

Sources

  1. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm
  2. Cellulitis — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/article/000855.htm
  3. Ischemic ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000742.htm
  4. How to care for pressure sores — MedlinePlus, U.S. National Library of Medicine https://www.medlineplus.gov/ency/patientinstructions/000740.htm