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Skin Maceration: Definition & Process

Instructor: Ian Lord

Ian is a real estate investor, MBA, former health professions educator, and Air Force veteran.

Anytime the skin gets wet and stays wet there is a risk of the skin breaking down in a process known as maceration. In this lesson we will define skin maceration, identify its causes, and go over some prevention methods.

Hiking Danger

Joel gets home from a backpacking trip and notices that a patch of skin on his foot feels wrinkly and soft when he takes off his boots. Some of that area has also turned white compared to his normal skin tone. What is going on?

Joel is experiencing a minor case of skin maceration. Let's take a look at what skin maceration is and how it occurs, along with some general guidance to avoid it.

Definition

Skin maceration is the softening and breakdown of the skin due to prolonged contact with moisture. Any source of moisture can cause this; water, sweat, urine, or the fluids seeping from a wound can cause skin tissue breakdown if in contact for long enough.

During the process, skin softens, wrinkles, and begins to turn white as it breaks down and separates. You might think you'd notice all this skin alteration right away, but it may not be painful in the earliest stages.

Damp skin is more prone to breakdown, especially when bearing weight or experiencing the movement of body motion. This is why Joel's foot was susceptible to maceration. His feet were wet with sweat, and subject to weight and movement forces during his hike.

Causes

Maceration can happen without an underlying injury, such as in the case of Joel's foot. His sock couldn't absorb all the sweat coming from his foot, which led to the breakdown of that area of skin.

Maceration can also occur in the folds of an obese person's skin or on the back and buttocks of a person on bed rest.

Any open wound can have a complicated healing process if skin maceration also occurs. Fluid seepage can break down the skin surrounding the wound as the body's healing process is trying to close and repair it. This produces risk of the skin breaking down, as well as creating a high moisture environment suitable for Staph or other bacterial infections.

Prevention

How is Joel going to take care of his problem and make sure it doesn't happen again? For now, he needs to let the skin air out as much as possible, and, if he must wear them, regularly change his socks to keep his feet dry. To prevent skin maceration in the future he will want to wear good quality, moisture wicking socks, and change them often. Washing and drying his feet regularly will also prevent excess exposure to sweat.

Regular bathing and careful attention to drying off before putting on clothes can help prevent skin maceration. If moisture gets trapped under clothing or jewelry there is an opportunity for prolonged exposure.

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