What Causes Induration?

Induration refers to the hardening and thickening of the skin, making it firmer than normal. It may occur due to conditions that trigger inflammatory processes or infiltration of cancer cells.

Scleroderma is a condition that closely represents and causes skin induration. Although other conditions also cause induration, most of them are quite uncommon.

Healthcare providers conduct a thorough physical examination followed by a skin biopsy to determine the underlying cause of induration. Treatment varies depending on the underlying cause. If left untreated, induration of the skin can lead to serious complications such as joint pain, muscle weakness, excessive weight loss, and shortness of breath.

What Does Induration Look Like?

Induration is when an area of skin feels thicker or firmer than normal. The texture of the affected part of the skin appears different from the surrounding area. Here are some possible skin symptoms:  

• Slight discoloration, such as red, purple, white, or yellow
• Smooth, shiny, and slightly wrinkled skin
• Raised or bumpy skin
  

Some people develop only one or two indurated skin patches, but it can also spread across the body. The exact appearance of the skin varies depending on the specific condition causing the induration and its severity.

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Causes of Induration

Skin induration often develops due to conditions triggering inflammatory processes and infiltration of cancer cells into body tissues. Some common causes of induration are listed below.

Skin Infections

Various types of skin infections can lead to induration of the skin. These include:

• Infections leading to abscesses (pus-filled bumps or pockets under the skin)
• Bacterial infections of the soft tissues
• Wound infections
• Insect bite infections

Chronic Conditions

Certain conditions that trigger inflammatory processes can cause induration of the skin. A few common conditions are:

• Scleroderma: This autoimmune condition causes skin inflammation and thickening. Improper immune system functioning leads to excessive collagen production, which ultimately causes skin hardening. Collagen is a naturally occurring protein in your body found in connective tissues, including skin and muscles.
• Diabetes mellitus: Diabetes can cause skin hardening, especially in the peripheral parts of the body like arms, feet, nails, hands, or legs.
• Panniculitis: This is a group of conditions characterized by inflammation of the body's subcutaneous fat tissue (fat tissue located right under your skin). It can cause induration of skin along with formation of nodules and plaques.
• Lichen sclerosus: This chronic (long-term) inflammatory condition forms white patchy areas that often become indurated.
• Venous stasis dermatitis: This condition causes poor lower leg circulation. It's also called stasis dermatitis, venous eczema, and gravitational dermatitis.

Cancer Cell Infiltration

The migration of cancer cells, also called cutaneous metastatic disease, from the primary tumor to other body tissues can cause skin induration. This most often occurs in cases of lung or breast cancer. Skin cancer can also cause skin induration.

When To See a Healthcare Provider

You may want to see a healthcare provider if your skin starts turning thick or bumpy for no known reason. Early diagnosis can help identify the underlying condition and prevent the induration from worsening.

Healthcare providers will ask about your symptoms and medical history. They'll often recommend a skin biopsy to confirm the diagnosis of the underlying cause. A biopsy is a procedure that removes a sample of your cells or tissue from your body so it can be examined under a microscope and tested.

Reach out to a healthcare provider immediately if induration leads to symptoms like:

• Shortness of breath
• Joint pain
• Muscle weakness
• Difficulty swallowing
• Unexplained weight loss

Treatment for Induration

Induration treatment depends on the underlying cause. Common treatment options include:

• Topical or oral steroids for conditions such as scleroderma
• Antibiotic therapy or incision and drainage for abscesses
• Medications such as metformin to help manage diabetes
• Immunosuppressive medications such as methotrexate
• Oral or topical antibiotics for bacterial infections
• Phototherapy using a medication called psoralen plus ultraviolet A radiation (PUVA) for conditions such as scleroderma or granuloma annulare (a chronic skin condition that often has no symptoms other than a round rash with a red ring around the border, often on the hands and feet)

Your healthcare provider can recommend the treatment approach for your particular condition.

How To Prevent Induration

Strategies to help prevent the onset and worsening of induration of the skin include the following:

• Use warm compresses when you notice early signs of skin hardening
• Moisturize your skin daily
• Use mild, fragrance-free soaps and cleansers
• Protect the skin from getting injured
• Use a humidifier when the air is dry
• Keep insect repellents accessible if you are prone to insect bites
• Regularly monitor underlying conditions that can cause induration

A Quick Review

Induration is the thickening and hardening of skin that may occur due to various underlying causes. The indurated skin often feels different and may become discolored, wrinkly, smooth, or shiny.

Diagnosis of the underlying cause is important for improving skin induration. A healthcare provider can help identify the underlying cause and recommend appropriate treatment. You can also follow certain prevention tips to improve skin induration and prevent possible complications.