Maceration occurs when skin is in contact with moisture for too long. Macerated skin looks lighter in color and wrinkly. It may feel soft, wet, or soggy to the touch.
Skin maceration is often associated with improper wound care. In addition to the pain and discomfort it causes, maceration can also slow wound healing and make skin more vulnerable to infection.
Keep reading to learn more about the causes of macerated skin and how to treat it.
Skin regularly comes into contact with different sources of moisture. Water and sweat, for example, are common sources of moisture that can affect the appearance of skin. During the process of wound healing, pus and other discharged fluids accumulate in the skin surrounding the wound. In people with incontinence, urine and feces may also come into contact with skin.
You’ve probably experienced skin maceration before. For example, soaking in a bath, wearing a bandage, or getting your feet wet while walking in the rain can all cause mild maceration. Most of the time, it goes away quickly once your skin has a chance to dry out.
However, prolonged exposure to moisture can make it more difficult for macerated skin to return to normal.
Wound healing and dressing
Injuries that result in open wounds activate an immune response from the body. Part of this response involves a chemical called histamine. It widens the blood vessels to allow the release of a fluid called plasma.
As plasma and other fluids accumulate, they cause the skin around the wound to swell. Wounds need to be cleaned, dried, and dressed to prevent maceration and its complications.
When a wound is infected, fluid production can increase. That makes maceration more likely to occur when a wound is slow to heal or isn’t healing.
Some common chronic wounds that are vulnerable to maceration include:
- Bed sores. These are also known as pressure ulcers.
- Venous ulcers. These often affect the legs.
- Diabetic ulcers. These often affect the feet and legs.
- Third-degree burns.
Hyperhidrosis is a common condition that causes excessive sweating. Sweating is necessary to help cool the body. However, too much sweat can cause mild maceration.
Hyperhidrosis usually affects the underarms, palms of the hands, or soles of the feet. The feet are the most susceptible to maceration. This is because wearing socks and shoes make it harder for them to dry. Severe maceration in the feet can lead to a related condition called trench foot.
Poor hygiene can increase the risk of skin maceration, especially for people with incontinence or who stay in bed for long periods of time due to a condition.
Prolonged contact with urine-soaked clothing, incontinence pads, or bedsheets can lead to:
- incontinence dermatitis, or adult diaper rash
- bacterial or fungal infections
Wet areas between the folds of the skin can also contribute to maceration.
You don’t have to have poor hygiene to experience macerated skin. Simple things, such as not drying your feet or moisturizing too much before putting on socks, can also cause mild maceration.
Treatment for macerated skin depends on the cause and how serious it is. In mild cases, exposing the affected area to air is usually enough to reverse it. However, treatment is usually necessary for more severe cases.
Treatments for macerated skin caused by wounds include specific types of bandages and dressings, including:
- Occlusive dressings. These are nonabsorbent and wax-coated, making them both airtight and watertight. They’re designed to decrease wound pain and healing time by providing maximum protection against moisture and bacteria.
- Hydrofiber dressings. These are sterile gauze pads and bandages that absorb extra moisture during the healing process. Some Hydrofiber dressings include iodine, which reduces the risk of maceration.
Ask your healthcare provider about which bandage type would work best for your wound. They can also show you the best way to put it on and advise you on how often to change it. In addition, your healthcare provider might prescribe topical creams to prevent extra moisture around the wound.
Healthy skin acts as a barrier to protect the internal organs and tissues from outside threats. Macerated skin is a weak barrier. It’s more susceptible to bacterial and fungal infections than healthy skin is. It also breaks down easily. Macerated skin around a wound can also increase healing time.
In addition to increasing your risk of infection, macerated skin can also lead to pain and discomfort. Rubbing macerated skin against clothing or footwear can create a new wound, or even expose tissues beneath the skin.
Most of the time, mild skin maceration resolves on its own once the affected area dries out. However, people with incontinence or who stay in bed for long periods due to a condition have an increased risk of complications, such as infection.
If you have a wound that doesn’t seem to be healing, contact your healthcare provider. You may need additional treatment to prevent maceration or infection.