Subcutaneous Emphysema: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Subcutaneous Emphysema?
Emergency room doctors often care for subcutaneous emphysema first, because it is often found after an injury. The cause decides which other doctors help, such as a lung doctor or a surgeon. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is subcutaneous emphysema?
Subcutaneous means under the skin. Subcutaneous emphysema happens when air gets into the tissues under the skin. It most often happens in the skin of the chest or neck. It can also happen in other parts of the body.
It is a rare condition. Other names for it include crepitus, subcutaneous air, tissue emphysema, and surgical emphysema. When surgery causes it, it is sometimes called surgical emphysema.
Air under the skin may also mean that air has collected in a deeper part of the body that cannot be seen with the naked eye.
Symptoms
The skin can often look smoothly bulging. A doctor who presses on the skin may feel a crackling feeling. That feeling is called crepitus. It happens as the gas is pushed through the tissue.
Causes and who gets it
Air can leak into the tissues under the skin in several ways. Possible causes include:
- A collapsed lung, often with a broken rib.
- A broken bone in the face.
- A tear in the airway, which is the windpipe or voice box area.
- A tear in the esophagus (the tube from the mouth to the stomach) or the gut.
This condition can happen due to blunt trauma, blast injuries, gunshot or stab wounds, forceful vomiting, whooping cough, or diving injuries.
Some medical procedures that place a tube in the body can also cause it. Examples are endoscopy, a central venous line, a breathing tube placed in the throat, and bronchoscopy, which looks into the airways.
Air can also collect under the skin of the arms, legs, or torso after certain infections, such as gas gangrene, or after scuba diving. Scuba divers with asthma are more likely to have this problem than other divers.
How doctors diagnose it
A doctor can often see the bulging skin and feel the crackling when touching it. The care team measures and watches vital signs, such as oxygen level, temperature, pulse, breathing rate, and blood pressure.
Tests may include chest and belly x-rays, a CT scan (a detailed scan made with x-rays) of the chest and belly or the area with the air, blood tests, and a heart tracing called an electrocardiogram.
Treatment
Symptoms are treated as needed. The person may get breathing support, such as oxygen through an outside device or a breathing tube connected to a ventilator, which is a life support breathing machine.
If a lung has collapsed, a doctor may place a chest tube. This is a tube through the skin and muscles between the ribs into the space around the lung. The person may also get fluids through a vein and medicines to treat symptoms.
When to see a doctor
Call 911 or the local emergency number right away if you feel air under the skin in any of the situations that can cause it, especially after an injury. Subcutaneous air after trauma can point to serious injuries that need urgent treatment. Do not give the person anything to drink. Do not move the person unless it is truly needed to get away from danger. Protect the neck and back if you have to move them.
Most of the conditions that cause it are severe, and you are likely already being treated by a provider.
Call 911 or go to the emergency room if you have trouble breathing, chest pain, fainting, a sudden change in mental state, or bleeding that will not stop.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Because this condition is often an emergency, an urgent evaluation usually happens in a hospital. After that, either type of doctor can help with follow-up, review the hospital records, and coordinate care with specialists.
Common questions
What causes subcutaneous emphysema?
Several problems can cause it, including a collapsed lung (often with a broken rib), a broken face bone, and a tear in the airway or esophagus. Injuries, forceful vomiting, diving injuries, and medical procedures with tubes can also lead to it.
Is subcutaneous emphysema serious?
It can be. After an injury it can point to serious injuries that need urgent treatment. The outcome depends on the cause. If major trauma, a procedure, or an infection is behind it, how serious that problem is will decide the outcome. Cases linked to scuba diving are most often less serious. If the air spreads widely, it can result in a collapse of breathing and of the heart and blood vessels.
What does subcutaneous emphysema feel like?
The skin may feel crackly when it is pressed. This crackling feeling is called crepitus. The skin often bulges smoothly where the air has collected.
When should I call 911 for subcutaneous emphysema?
Call 911 right away if you feel air under the skin in any of the situations that can cause it, especially after an injury. It can mean serious injuries that need urgent treatment.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
