Moisture-Associated Skin Damage (MASD): Definition & Treatment

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Moisture-associated skin damage, caused by skin exposure to sweat, urine, and other forms of moisture, can cause harmful effects to the skin. Read this lesson to learn more about what causes MASD, along with potential treatment options to alleviate the symptoms of this condition.

What is MASD?

MASD, or moisture-associated skin damage, is a skin condition causing irritation and redness of the skin due to constant contact with a source of moisture. In severe cases, MASD can lead to skin breakdown and erosion, causing especially sore and open areas.

MASD can occur on the skin anywhere on the body. However, high risk locations for MASD are characterized by areas that may be difficult to dry, get minimal exposure to air, or folds of skin that rub or rest on each other.

Marilyn, a 72-year-old resident in a local assisted care facility, has been working hard to manage her MASD. Typically caused by a prolonged exposure to moisture, Marilyn has MASD related to incontinence, or inability to hold her urine. Because Marilyn has limited mobility and difficulty moving around, she is unable to change her briefs as often as she should. This means that urine stays in contact with her skin and becomes the irritant that causes MASD.

Causes of MASD

Unfortunately, Marilyn's skin is sometimes exposed to urine for long periods of time while she waits for assistance to change her briefs. Other moisture-related factors may cause MASD, and include:

  • Liquid stool: Similarly to urine, incontinent episodes of stool that are not cleansed immediately from the skin, keep moisture and bacteria in close contact.
  • Drainage: Drainage may contribute to the development of MASD and can come from wounds, tubes, or intentional open areas on the skin (i.e. an ostomy, or a surgical-made drainage site for stool).
  • Sweat: Extreme sweating, also known as diaphoresis, may be the cause of metabolic or hormonal conditions. Excess amounts of sweat that remain in contact with the skin may contribute to the development of MASD.
  • Other bodily fluids: Fluids like saliva or mucus can cause MASD. For example, an individual on a chronic ventilator (breathing machine), may be at high risk for MASD due to oral drainage coming into constant contact with the skin.

Treating MASD

Not only does moisture alone irritate the skin, but other irritants carried by moisture can create problems. Moisture caused by exposure to urine, for example, can change the chemical balance of the skin. This chemical change can make the skin fragile, and prone to irritate, inflammation, and breakdown. Fortunately for Marilyn, topical (skin) treatments exist that can act as a barrier between the irritated skin and harmful moisture. Even though she is unable to control her incontinence, she can help protect her skin from MASD by applying protective topical creams after thorough cleansing.

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