Skin Health More Skin Conditions Induration Skin Hardening Signs and Causes By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Sherry Christiansen Medically reviewed by Medically reviewed by Leah Ansell, MD on February 20, 2021 linkedin Leah Ansell, MD, is board-certified in cosmetic and medical dermatology. She is an assistant professor at Columbia University and works in private practice in New York City. Learn about our Medical Review Board Leah Ansell, MD Published on February 22, 2021 Print Skin induration is a deep thickening of the skin that can result from edema, inflammation, or infiltration, including by cancer. Diagnosis of skin induration is made by palpation (feeling) the area and assessing whether the raised area has a hard, resistant feeling. Because there are many different underlying causes of induration of skin, the treatment varies widely. Kunnapat Jitjumsri / EyeEm / Getty Images Signs of Induration Indurated skin generally has the following signs: Hardened skinFeels firmer to the touch than surrounding skinAppears thickLooks smooth and shiny The indurated areas commonly appear on the hands and face but can also be found on the chest, back, abdomen, breasts, or buttocks. Causes of Induration The primary underlying causes of skin induration include: Specific types of skin infectionCutaneous metastatic cancersPanniculitis The precise physiological process that results in many conditions that cause skin induration includes the inflammatory process and infiltration of the skin by certain types of cancer cells. Skin Infections There are several types of skin infections that can manifest with symptoms of skin induration, examples include: An abscessAn inflamed cystInsect bites that become infected Not only is there an underlying skin condition that can cause infections that exhibit skin induration, but there is also a causative microorganism. According to a Baylor University Medical Center study, staphylococcus aureus is responsible for the majority of skin and soft tissue infections. Cutaneous Metastatic Cancers Cutaneous metastasis occurs when cells from a cancer in the body spread to the skin. Metastatic skin lesions may originate from various other types of cancer. Another source of cutaneous metastasis is skin cancer. In this instance, the primary melanoma spreads/infiltrates to distant areas of the skin, where secondary growths begin to surround the primary melanoma site. Scleroderma Scleroderma (systemic sclerosis) is a rare condition involving inflammation and fibrosis of the skin and internal organs. There are three phases of the disease, and the second phase involves skin induration. The condition is linked with significant illness and mortality rates. Diabetes Diabetes can cause a condition called recurrent plantar ulcers, which are ulcers or sores on the bottom of the feet (due to poor circulation to the lower extremities). Studies have shown that induration on the soft tissue of the feet may cause an increased risk of recurrent foot ulcers in diabetics because it results in a decrease in the foot’s ability to absorb shock when a person is bearing weight. Panniculitis Panniculitis is an inflammation within the fat tissue of the body and has many underlying causes, including: InfectionsInflammatory disorders (such as lipodermatosclerosis)Trauma or exposure to the coldConnective tissue disordersPancreatic disorders Symptoms of panniculitis may include reddened, tender nodules (indurated areas of the skin) over the chest, abdomen, breasts, face, and buttocks. Diagnosis of panniculitis is most often made by visual examination in combination with doing a biopsy for confirmation. Treatment Treatment of induration of skin varies greatly depending on the underlying cause. Example treatment options may include: For an abscess, the treatment of choice may be antibiotics, incision, or drainage.For inflammatory disorders, like scleroderma or lichen sclerosus, immunosuppressants or steroid creams can be used. Supportive care Supportive care for conditions involving skin induration can vary greatly, depending on the underlying cause. Examples of supportive care for skin conditions may include: Warm compressesAnalgesiaElevation of the affected extremity (to help reduce any swelling) A Word From Verywell Many skin conditions require close follow-up care, particularly if symptoms begin to worsen and/or if treatment (such as antibiotics) is ineffective. Skin infections are commonly resistant to certain types of antibiotics; therefore, if a fever develops, the induration gets larger, or the area becomes reddened and hot to touch, it is vital to consult with the health care provider as soon as possible. Your antibiotic may need to be changed to a different type of medication. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Race E, Berthelot C, Cather JC. Painful nodule with induration and spreading erythema. Baylor University Medical Center Proceedings. 2005;18(4):401-404. doi:10.1080/08998280.2005.11928101 Race E, Berthelot C, Cather JC. Painful nodule with induration and spreading erythema. Baylor University Medical Center Proceedings. 2005;18(4):401-404. doi:10.1080/08998280.2005.11928101 DermNet NZ. What is cutaneous metastasis? Rheumatology Network. Skin hardening, but is it systemic sclerosis? Updated March 31, 2009. Brink T. Induration of the diabetic footpad: another risk factor for recurrent neuropathic plantar ulcers - verhärtung der diabetischen fußsohle - eine prädisposition für rezidivierende neuropathische fußgeschwüre. Biomedizinische Technik/Biomedical Engineering. 1995;40(7-8):205-209. doi:10.1515/bmte.1995.40.7-8.205