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Painful red skin
Category: Skin, Hair & Nails · All skin symptoms
What it can feel like
Painful red skin means an area of skin that is red, warm, swollen and tender, often spreading — the classic picture of cellulitis, a bacterial infection of the skin and the tissue just beneath it. It usually enters through a break in the skin, which may be as small as athlete's-foot cracking between the toes.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Painful red skin can be associated with cellulitis after cuts, bites, ulcers or fungal skin breaks; with an abscess forming (a localised, fluctuant collection); and with inflammation that mimics infection, such as gout over a joint or a flare of eczema.
Other possible causes
Spreading skin infection can enter the bloodstream and cause sepsis; infection on the face, around the eye, or in the tissues of the neck or perineum is especially dangerous. A severe, rapidly progressive deep infection (necrotising fasciitis) presents with pain out of proportion to the appearance.
Red flags — when to seek help promptly
- Red, painful skin with fever, shivering or feeling unwell — urgent
- Redness spreading rapidly, or a red streak travelling up a limb
- Red skin on the face or around the eye, or with eye symptoms
- Pain that seems far worse than the skin looks, or skin turning dusky, blistered or numb — emergency
- Skin infection in someone with diabetes, poor circulation or a weakened immune system
What a clinician may do
A clinician will assess the spread (often marking the edge), temperature and circulation, and start antibiotics scaled to severity — tablets for early cases, intravenous for spreading or systemic ones. Blood tests and cultures follow severe cases; abscesses need drainage, not antibiotics alone.
Watch: related videos
Examination and clinical videos from the MedicalVideos.com library relevant to this symptom. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Why mark the edge of the redness?
Because spread is the best early measure of whether treatment is winning. A dated pen line turns tomorrow's judgement from memory ('is it bigger?') into fact. Photographs with the line included are a good modern addition.
How do I know if it is an abscess instead?
An abscess is a contained collection — a tender, fluctuant (boggy) swelling, sometimes pointing with a pale centre — rather than spreading sheet-like redness. Antibiotics penetrate collections poorly, so the treatment is drainage; cellulitis without a collection is treated with antibiotics alone.
Related symptoms — Skin, Hair & Nails
Browse the P section of the A–Z list or return to the Symptoms A–Z hub.