Macerated skin; when skin feels whiter than normal, looks soggy, and feels extremely soft then it means your skin is macerated and is caused by the exposure of skin to excessive levels of moisture content which is obviously not healthy for the skin. Once your skin is macerated then it becomes vulnerable to other skin issues too more often.
What is skin maceration?
When skin is exposed to moisture for an extended period of time, maceration occurs. Skin that has been macerated appears lighter in color and wrinkled. To the touch, it may feel soft, damp, or sloppy. Skin maceration is frequently linked to poor wound care. Maceration can impede wound healing and render the skin more susceptible to infection, in addition to the pain and discomfort it produces.
Have you ever observed your fingertips were white and shriveled after getting out of the pool or bath? This is a less severe form of skin maceration. When the skin is exposed to moisture for an extended amount of time, skin maceration occurs, and it can be harmful to your health.
Things that cause skin maceration
Showering and keeping ourselves clean with water is a common occurrence in our daily lives. What if you were exposed to dampness 24 hours a day, seven days a week? Excessive moisture exposure can lead to maceration, a significant skin issue.
Moisture breaks down your skin on a cellular level, resulting in skin maceration. Once your skin has been damaged, it is much more susceptible to other forms of diseases and difficulties.
Moisture-associated skin damage (MASD) is a catch-all name for four different types of skin issues produced by extended moisture exposure:
-
Dermatitis caused by incontinence (IAD)
-
Intertriginous dermatitis is a type of dermatitis that affects both men and women (ITD)
-
Skin deterioration around the wound
-
MASD in the peristomal region
Different sources of moisture come into contact with the skin on a regular basis. Water and sweat, for example, are prominent sources of moisture that can wreak havoc on the skin’s appearance. Pus and other released fluids collect in the skin surrounding the wound during the healing process. Urine and waste may come into touch with skin in those who have incontinence.
You’ve most likely had skin maceration before. Mild maceration can be caused by soaking in a bath, wearing a bandage, or getting your feet wet when strolling in the rain. When your skin has had a chance to dry out, it usually goes gone quickly.
Long-term moisture exposure, on the other hand, can make it more difficult for macerated skin to heal. People who sweat excessively or come into prolonged contact with urine or wastes owing to incontinence are more likely to develop MASD. It can also happen to persons who have larger wounds that exude fluid if they aren’t kept clean and dry.
Symptoms of skin maceration
Skin maceration is becoming more widespread in the medical field, owing to an older population. The following symptoms can be experienced by those who have moisture-related skin damage:
-
Pain
-
Tenderness in the vicinity
-
A sweltering sensation
-
Pruritus is a term for extremely itching skin.
People who have skin maceration are more likely to develop various issues in the surrounding area. Because these germs thrive in a dark, damp environment, bacterial or fungal diseases can develop in macerated skin.
On macerated skin, painful pressure ulcers, often known as bedsores, can develop. Macerated skin can also develop or promote dermatitis, which is a painful, itchy skin condition.
Other factors that may contribute to or exacerbate MASD include:
-
Incontinence
-
A lack of hygiene
-
Friction or pressure on the skin that causes excessive stress
-
Yeast or fungi is present.
-
Humidity
-
Skin irritants, either chemical or biological
Summary
The softening and breaking down of skin as a result of prolonged moisture exposure is known as maceration. Jean-Martin Charcot was the first to describe it in 1877. Excessive volumes of fluid remaining in contact with the skin or the surface of a wound for an extended period of time causes maceration.
Other complications because of skin maceration
Other than the listed symptoms it can cause other complications too which are not good for anyone’s health. These are explained below:
Wound healing and dressing
An immunological response is triggered by injuries that result in open wounds. A molecule called histamine plays a role in this response. It causes the blood arteries to dilate, allowing plasma to flow freely.
Plasma and other fluids cause the skin around the incision to expand as they accumulate. To avoid maceration and associated complications, wounds must be cleaned, dried, and treated.
Fluid production might arise when a wound becomes infected. When a wound is slow to heal or doesn’t heal at all, maceration is more prone to occur. The following are some examples of chronic wounds that are susceptible to maceration:
-
Sores on the bed, Pressure ulcers are another name for this condition.
-
Ulcers in the veins. Legs are frequently affected.
-
Ulcers caused by diabetes. The feet and legs are frequently affected.
-
Burns of the third degree.
Hyperhidrosis
Excessive sweating is caused by hyperhidrosis, a common disorder. Sweating is required to keep the body cool. However, excessive sweating can result in minor maceration. Hyperhidrosis is a condition that affects the underarms, palms, and soles of the feet.
The most vulnerable parts of the body to maceration are the feet. This is due to the fact that wearing socks and shoes makes it more difficult for them to dry. Severe maceration of the feet can develop to trench foot, a similar condition.
Effects on hygiene
Skin maceration is more likely in those who have incontinence or who are confined to bed for lengthy periods of time owing to a medical condition. Contact with urine-soaked clothing, incontinence pads, or bedsheets over an extended period of time can cause:
-
Maceration
-
Adult diaper rash, or incontinence dermatitis
-
Infections caused by bacteria or fungi
-
Maceration can also be caused by wet regions between the skin’s folds.
Macerated skin can happen to everyone, regardless of their hygiene. Mild maceration can also be caused by simple things like not drying your feet or hydrating them too much before putting on socks.
Treatments for skin maceration
Keeping skin clean and dry can assist speed up the recovery process because skin maceration is caused by persistent moisture. The first step in treating skin maceration is to carefully clean the skin to eradicate microorganisms. Consider using a no-rinse, pH-balanced cleanser in cases of incontinence.
Then, as a protective barrier, an ointment should be put to the skin. Keep skin clean and dry, and if maceration is caused by incontinence, change soiled clothes as soon as possible. Reduce friction and pressure to aid in the healing of skin maceration.
To relieve pressure on the region, you or your loved one may need to shift yourself or your loved one every 1-2 hours. To help ease painful regions, consider using supportive padding. Changing bandages correctly isn’t the only approach to encourage recovery. Proper nutrition, particularly protein, will provide your body with the nutrients it requires to begin the process of self-repair.
Drinking the correct amount of water will also speed up the healing process. To fully heal, you’ll need normal blood circulation. Tobacco use should be avoided. Smoking slows the healing process by obstructing blood circulation. If you suspect that you have skin maceration, see your doctor right away. If left untreated, it might become infected and worsen.
Specific types of bandages
Specific types of bandages and dressings are used to treat macerated skin caused by wounds, including:
Occlusive dressings
These are wax-coated and nonabsorbent, making them airtight and impermeable. They’re made to reduce wound pain and speed up healing by offering maximum moisture and microbial prevention.
Hydro fiber dressings
These are sterile gauze pads and bandages that absorb excess moisture as the body heals. Iodine is present in several Hydro fiber dressings, which minimizes the risk of maceration. Inquire with your doctor about which bandage kind is appropriate for your wound.
They can also show you how to put it on properly and recommend how often you should change it. Additionally, your healthcare professional may prescribe topical treatments to help prevent excess moisture from forming around the area.
Prevention
When the wound environment is kept wet, the patient has a better outcome than when the wound environment is dry. According to studies, moist wound conditions promote faster healing, stronger wound contraction, less scarring, and lower infection rates, among other advantages.
Patients frequently remark that keeping their wound moist makes it easier to remove wound coverings. However, if a wound becomes excessively damp, maceration can occur, preventing healing. Clinicians are thus faced with the dilemma of keeping the wound environment moist enough to promote healing while remaining dry enough to avoid maceration.
The most effective strategy to prevent wound maceration is to address the underlying issue that is causing the exudate to flow. Venous leg ulcers, for example, frequently have moderate to heavy drainage or high-flow exudate. To regulate the drainage and treat the underlying cause of venous leg ulcers, compression therapy or elevating the leg may be used.
After you’ve exhausted all of your treatment options, it’s time to think about the best wound dressing for preventing maceration and promoting healing. The dressing chosen should be based on the amount of exudate the wound is producing. Choose a highly absorbent dressing, such as a hydro fiber, for a wound with a lot of exudates.
A less absorbent dressing may be acceptable for a wound with a lesser volume of exudate. The goal is for the dressing to absorb the exudate and prevent it from being absorbed by the skin around the wound, without drying up the wound.
Summary
It is critical to change dressings often to avoid maceration. Maceration can occur if dressings are left on for too long, especially if the wound is producing a lot of exudates.
Frequently asked questions:
Following are some of the frequently asked questions about skin maceration:
1. How long does it take for skin to macerate?
Urine and wastes are irritating to the skin, but wastes, in particular, can include bacteria that aggravate skin maceration. Maceration caused by incontinence might develop in as little as four days. It commonly appears in the creases of the skin, the inner thighs, and the buttocks.
2. How long does it take for maceration to go away?
I would recommend a minimum of 24 hours for considerable resolution or getting the skin’s shear strength back to somewhere near full strength. Remember that maceration can cause damage all the way through the epidermis.
3. How can you prevent maceration?
It is critical to change dressings often to avoid maceration. Maceration can occur if dressings are left on for too long, especially if the wound is producing a lot of exudates. Dressings should not be left on heavily exudative wounds for more than one day.
4. What are the primary causes of maceration?
Excessive volumes of fluid remaining in contact with the skin or the surface of a wound for an extended period of time causes maceration. The wound itself may produce this fluid, or it may be the result of urine incontinence or excessive perspiration.
5. How do you dry macerated wounds?
To help dry the skin, most cases of skin maceration only require a little fresh air. Allowing free circulation of air around the wound, even if the skin is broken, is usually preferable to firmly bandaging it until a scab has formed.
Conclusion
To simply put about the macerated skin, before applying dressings, take into account the patient’s medical history, the etiology of the wound, the amount of wound exudate, and the wound’s location on the body. Hydrofibre or alginate dressings can be used to cover the peri-ulcer region generously to avoid or decrease maceration, and absorbent pads can be used as a secondary dressing to offer further absorption.