Why is the skin around my wound getting harder?

Increased firmness around a wound is a sign of infection for a diabetic foot ulcer, and a tight, glossy, stretched look is a symptom of cellulitis. Hardened, discolored skin on a lower leg can also be a sign that blood is pooling.

Hardening skin around a wound can mean three different things, and they point in different directions.

As a sign of infection. Increased firmness around the wound is one of the signs of infection for a diabetic foot ulcer, along with redness, increased warmth or swelling, extra drainage, pus, odor, fever or chills, and increased pain.

As a sign of cellulitis. A tight, glossy, stretched appearance of the skin is one of the symptoms of this skin infection, together with warm skin in the area of redness and redness that gets bigger as the infection spreads.

As a sign of blood pooling. With venous insufficiency, dark red, purple, brown, hardened skin is a sign that blood is pooling. That is one of the early signs that appear before an ulcer forms, and it tends to develop over months rather than days.

So the timescale is what separates them. Skin that has hardened gradually on a lower leg, with discoloration, points to venous insufficiency. Skin that has become firm, tight or glossy around a wound over days points to infection.

One more thing can harden skin in a way nobody wants. Pressure sores can be covered in dead skin that is yellow, tan, green, or brown. And eschar — a dry, hard covering — is in some circumstances deliberately left in place.

This page cannot tell you which of these your skin is doing. What it can do is give you the words, and the one question worth answering before you call: has this come on over days, or over months?

What to watch for

Increased firmness around the wound is a sign of infection for a diabetic foot ulcer. Contact your provider if any signs of infection appear.

Contact your provider right away if you have symptoms of cellulitis, which include a tight, glossy, stretched appearance of the skin.

Hardened, discolored skin on a lower leg that has developed gradually is an early sign of venous insufficiency rather than of infection — but it is still a reason to have the leg looked at.

Whether the change came on over days or over months is the most useful thing you can say when you report it.

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

What we look at

  • Examining the skin around the wound
  • Judging whether the change is recent or longstanding
  • Checking for infection
  • Checking the blood flow in the leg

Sources

  1. Diabetes - foot ulcers — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000077.htm
  2. Cellulitis — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/article/000855.htm
  3. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm
  4. Wound Debridement — StatPearls, National Library of Medicine https://www.ncbi.nlm.nih.gov/books/NBK507882/