Skin turgorSkin turgor is an abnormality in the skin's ability to change shape and return to normal (elasticity). Skin turgor is the skin's degree of resistance to deformation and is determined by various factors, such as the amount of fluids in the body (hydration) and age. A decrease in skin turgor is indicated when the skin (on the back of the hand for an adult or on the
abdomen for a child) is pulled up for a few seconds and does not return to its original state. A decrease in skin turgor is a late sign of dehydration.
Skin turgor is one way to estimate the state of hydration (fluids) and, to a lesser extent, nutrition. Skin turgor is a sign commonly used by health care workers to assess the degree of 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 accelerates this process. Poor skin turgor (elasticity) accompanies dehydration, but this can be a difficult sign to assess because most older residents have an age-related reduction in skin turgor under normal circumstances. If skin turgor is to be used in assessing for dehydration, the best areas to test are the skin over the sternum and forehead because these areas maintain better skin turgor than other areas. Generally, skin will feel warm and moist with dehydration.
The skin on the back of the hand, lower arm, or abdomen is grasped 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 is associated 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.
Connective tissue disorders, such as scleroderma and Ehler's-Danlos syndrome, can also affect the elasticity of the skin. This is not related to fluids, however, but to a change in the elastic properties of the skin tissue.