How to tell if a wound isn't healing properly?

September 28, 2025 •

4 min read

An estimated 1 to 2 percent of the US population experiences a chronic wound in their lifetime. Recognizing the difference between normal inflammation and a healing problem is crucial to prevent serious complications, so knowing how to tell if a wound isn't healing properly can be lifesaving.

Quick Summary

A wound that isn’t healing properly may show persistent or worsening pain, spreading redness, increased swelling, foul-smelling drainage, or a lack of improvement over several weeks. These symptoms often signal an underlying issue like infection or a chronic condition interfering with the natural healing process.

Key Points

Spreading Redness: If redness expands beyond the wound edges, especially with dark discoloration, it may indicate infection.
Worsening Pain: Pain that increases over time, instead of subsiding, is a key sign that something is wrong.
Unusual Discharge: Thick, cloudy, or green/yellow pus, especially with a foul odor, is a definitive symptom of an infected wound.
Lack of Improvement: A wound that doesn't decrease in size or show new tissue growth after several weeks is considered chronic and needs medical attention.
Systemic Symptoms: Watch for systemic signs like fever or chills, which can indicate the infection is spreading beyond the wound.

Recognizing the Red Flags of Improper Healing

When a wound occurs, the body immediately begins a complex healing process involving four overlapping phases: hemostasis, inflammation, proliferation, and remodeling. While some redness, swelling, and pain are normal during the initial inflammatory stage, certain signs indicate the process has been stalled or complicated, most often by an infection. Learning to differentiate between a healthy response and a problem is the first step toward proper care.

Signs of a Localized Wound Infection

Infection is one of the most common reasons a wound fails to heal correctly. A localized infection occurs when harmful bacteria contaminate the wound bed and overwhelm the body's immune response. Look for the following symptoms that suggest a bacterial infection:

Increasing or spreading redness: While initial redness around the wound is normal, an infection causes redness that expands outward from the wound's edges over time. In darker skin tones, this may appear as darker, purplish, or reddish-brown coloration.
Worsening pain: Pain should gradually decrease as a wound heals. If the pain intensifies, becomes throbbing, or spreads beyond the wound site, it is a significant warning sign.
Increased swelling and warmth: A wound will feel warm and appear slightly swollen in the first few days, but these symptoms should subside. If swelling increases or the area remains excessively hot to the touch, it points to a problem.
Foul odor and unusual drainage: A foul-smelling odor is a strong indicator of bacterial overgrowth. Likewise, changes in drainage color and thickness—from clear or light yellow to thick, cloudy, or green/yellow pus—are key signs of infection.
Absence of new tissue formation: In the proliferation phase (after 5-7 days), new, healthy granulation tissue should begin to form, appearing pink or beefy red. A non-healing wound may show little to no new tissue growth.

Indications of Chronic or Delayed Healing

Beyond immediate infection, other factors can cause delayed healing, turning an acute wound into a chronic one that can last for weeks or months.

No change in wound size: A healthy wound should get smaller over time as the edges contract. If the wound remains the same size or gets larger after several weeks, its healing is impaired.
The wound stays in the inflammatory phase: If a wound remains red, swollen, and tender for more than a few weeks without progressing to the next healing stage, it's likely stuck in chronic inflammation.
Appearance of necrotic tissue: Dead tissue, known as necrotic tissue, can prevent a wound from healing. It often appears as dark, leathery, or sloughy material in the wound bed.
Changes in skin at the edges: The skin surrounding the wound may become dark, discolored, or fragile, potentially signaling poor blood flow or other complications.

How to Tell: Infected vs. Healthy Wound

To help visualize the differences, this table compares the key characteristics of a healthy wound to an infected one.


Feature	Healthy Wound	Infected Wound
Redness	Mild, localized, and fades over time	Spreading, dark, or has red streaks
Swelling	Mild, decreases over a few days	Increasing or painful swelling
Pain	Gradually subsides	Worsening, persistent, or throbbing
Discharge	Clear or light yellow fluid in minimal amounts	Thick, cloudy, yellow, or green pus
Odor	Absent or neutral	Often foul or unpleasant
Temperature	Mild warmth, decreases with time	Excessive warmth or heat
Healing time	Shows signs of progress within weeks	Delayed or shows no improvement after several weeks

When to Seek Medical Attention

It is essential to know when to escalate a wound from home care to professional medical attention. Consult a doctor or wound care specialist immediately if you notice any of the following:

Signs of infection worsen or appear, including fever, chills, or red streaks extending from the wound.
The wound fails to show signs of improvement after several weeks of proper care.
The wound is deep, large, or caused by a puncture from a dirty object.
You have a chronic condition like diabetes or poor circulation that puts you at higher risk for complications.
You cannot stop excessive bleeding with continuous, firm pressure after 5 to 10 minutes.

For more detailed information on proper wound care, a valuable resource is the MedlinePlus Medical Encyclopedia, specifically their article on how wounds heal. This resource offers comprehensive guidance on the stages of healing and proper treatment.

Factors that Impair Wound Healing

Certain underlying conditions and lifestyle choices can compromise the body's ability to heal effectively. Addressing these factors is often critical to resolving a non-healing wound:

Diabetes: Poorly controlled blood sugar can damage blood vessels and nerves, impairing circulation and nerve function, which are both essential for proper healing.
Poor Circulation: Conditions like peripheral artery disease or chronic venous insufficiency can limit blood flow to the wound, depriving it of the oxygen and nutrients needed for repair.
Malnutrition: The body requires adequate protein, vitamins (especially A, C, and E), and minerals (like zinc) to repair tissue effectively. Nutritional deficiencies can significantly delay healing.
Smoking: Nicotine constricts blood vessels, reducing oxygen delivery to the wound site and significantly delaying recovery.
Age: Older adults often have slower healing times due to reduced collagen synthesis and decreased immune response.
Medications: Certain drugs, like corticosteroids, can suppress the immune response and slow down the healing process.
Obesity: Excess weight can place tension on surgical wounds and compromise blood flow to tissues, increasing the risk of infection and complications.

Conclusion

Observing a wound's progress is crucial for proper care. By understanding the normal stages of healing and recognizing the key warning signs of a problem—such as worsening pain, spreading redness, foul odor, or persistent swelling—you can take appropriate action. Never underestimate the importance of monitoring a wound, especially if underlying health issues are a concern. Prompt recognition and medical attention are vital for preventing minor issues from escalating into serious complications and ensuring a healthy recovery.

Frequently Asked Questions

Normal inflammation occurs right after injury, causing mild, localized redness, swelling, and warmth that improve over a few days. Infection, however, causes these symptoms to worsen or spread over time, often accompanied by pus, a foul odor, and persistent pain.

Healthy healing tissue, known as granulation tissue, is typically a light pink or beefy red color and has a bumpy or granular texture. As the wound closes, new skin forms over this tissue.

No, it's best to avoid using hydrogen peroxide or alcohol. They can be too harsh and may damage the new, healthy tissue needed for healing. Use gentle soap and water or a saline solution to clean the wound instead.

Diabetes and poor circulation can impair wound healing by reducing blood flow, which limits the oxygen and nutrients that can reach the wound. This can lead to slower healing and a higher risk of infection.

The formation of a scab is part of the healing process, protecting the wound from germs. However, a wound that won't form a scab, or a scab that keeps reopening, can signal a healing problem. A proper moist wound environment is often preferred for healing, but constant reopening is a concern.

Most minor wounds begin to show signs of significant healing within a week or two and are fully healed within six weeks. If your wound has not improved or shows no signs of healing within a month, it is considered chronic and requires medical evaluation.

If your stitches come undone, this is known as wound dehiscence. You should contact your healthcare provider immediately for guidance. It may be necessary to have the wound re-evaluated and potentially re-sutured to prevent complications.