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Skin turgor

Skin turgor is the skin's ability to change shape and return to normal (elasticity).

Alternative Names

Doughy skin; Poor skin turgor; Good skin turgor; Decreased skin turgor

Considerations

Skin turgor is a sign used by health care workers to assess fluid loss or dehydration . Fluid loss can occur from common conditions, such as diarrhea or vomiting. Infants and young children with vomiting, diarrhea, and decreased or no fluid intake can rapidly lose a significant amount of fluid. Fever speeds up this process.

To determine skin turgor, the health care provider grasps the skin on the back of the hand, lower arm, or abdomen between two fingers so that it is tented up. The skin is held for a few seconds then released.

Skin with normal turgor snaps rapidly back to its normal position. Skin with decreased turgor remains elevated and returns slowly to its normal position.

Decreased skin turgor is a late sign in dehydration. It occurs with moderate to severe dehydration. Fluid loss of 5% of the body weight is considered mild dehydration, 10% is moderate, and 15% or more is severe dehydration.

Edema (a buildup of fluid in the tissues that causes swelling) causes the skin to be extremely difficult to pinch up.

Causes


  • Decreased fluid intake
  • Dehydration
  • Diarrhea
  • Diabetes
  • Extreme weight loss
  • Heat stroke (excessive sweating without enough fluid intake)
  • Vomiting

Connective tissue disorders, such as scleroderma and Ehlers-Danlos syndrome, can also affect the elasticity of the skin. This does not have to do with fluids.

Home Care

You can quickly check for dehydration at home by pinching the skin over the back of the hand, on the abdomen, or over the front of the chest under the collarbone. This will show skin turgor.

Mild dehydration will cause the skin to be slightly slow in its return to normal. To rehydrate, drink more fluids -- particularly water.

If turgor is severe, indicating moderate or severe dehydration, see your health care provider right away.

When to Contact a Medical Professional

Call your health care provider if:

  • Poor skin turgor occurs with vomiting, diarrhea, or fever.
  • The skin is very slow to return to normal, or the skin "tents" up during a check. This can indicate severe dehydration that needs quick treatment.
  • You have reduced skin turgor and are unable to increase your intake of fluids (for example, because of vomiting).

What to Expect at Your Office Visit

The health care provider will perform a physical exam and ask questions about your medical history, including:

  • How long have you had symptoms?
  • What other symptoms came before the change in skin turgor (vomiting, diarrhea, others)?
  • What have you done to try to treat the condition?
  • Are there things that make the condition better or worse?
  • What other symptoms do you have (such as dry lips, decreased urine output , and decreased tearing )?

Tests that may be performed:

Intravenous fluids may be needed for severe dehydration. You may need medicines to treat other conditions that affect skin turgor and elasticity.

References

Greenbaum L. Deficit therapy. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 54.

Gorgas DL, McGrath JL. Vital signs measurement. In: Roberts JR, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Saunders Elsevier; 2014:chap 1.

Updated: 5/11/2014

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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