Skin damage from moisture
Skin damage from moisture
What is moisture-associated skin damage?
If skin is exposed to moisture and remains damp or wet for long periods of time, it becomes soft, fragile, more easily damaged and more likely to develop pressure ulcers. The skin’s natural protective barrier breaks down, leading to soreness, irritation and sometimes skin loss. This is known as Moisture-Associated Skin Damage (MASD). It can be caused by:
- urine
- faeces (stool)
- sweat
- wound fluid (exudate)
- saliva
- leakage from a stoma.
Moisture associated skin damage is common, preventable and treatable. It is not caused by poor hygiene. Early recognition, gentle skin care, moisture control and skin protection are the best ways to keep skin healthy and comfortable.
Types of moisture associated skin damage
- Incontinence-associated dermatitis
This occurs when skin comes into contact with urine or faeces. It commonly affects the bottom, perineal area, groin, inner thighs - Skin fold dermatitis (Intertrigo)
This occurs where skin rubs together and traps moisture. It commonly affects the groin, armpits, underneath breasts, abdominal folds and between toes. - Peristomal Skin Damage
This occurs around a stoma when skin is exposed to leaks from stoma output. - Periwound Skin Damage (skin around a wound)
This occurs around wounds when wound fluid leaks onto surrounding skin.
What does moisture associated skin damage look like?
Skin that has become overly wet from prolonged contact with moisture appears soft, wrinkled, and fragile, and may be sore or uncomfortable. You may notice:
• red, pink or darker patches of skin
• sore or tender skin
• burning or stinging sensations
• itching
• wet, weeping skin
• cracked skin
• an unpleasant odour
• areas where the top layer of skin has worn away.
If left untreated, damaged skin has an increased risk of infection and pressure ulcers.
Who is at risk?
You may be more likely to develop moisture associated skin damage if you:
• have urinary or faecal incontinence
• sweat heavily
• have skin folds
• are overweight
• have diabetes
• have limited mobility
• use pads or continence products
• have a stoma
• have a wound that produces a lot of fluid
• need help with personal care
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Good skin care can often prevent moisture associated skin damage. It’s important to keep skin clean, dry and protected, and to check it daily.
Keep skin clean by washing with warm (rather than hot) water and a gentle, pH balanced cleanser, then gently pat dry. Avoid harsh soaps and vigorous rubbing or scrubbing.
Keep skin dry by changing wet clothing, pads or continence products promptly. Make sure to dry skin folds carefully. Wear breathable clothing and manage sweating where possible.
Protect skin from moisture by using barrier products such as creams, films or sprays – your healthcare professional will be able to advise which product is suitable.
Check skin daily, looking out for redness, soreness, darkening, weeping, cracks or itching. A mirror can be helpful or ask a family member or carer for assistance if required.
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Your healthcare professional will assess the cause and severity of symptoms and recommend appropriate treatment. This could include:
• Regular gentle cleansing to remove urine, stool, sweat or wound fluid.
• Reducing contact between skin and moisture by changing pads regularly, improving continence care, managing wound fluid or improving the fit of a stoma.
• Applying barrier creams or barrier films to protect damaged skin and support healing.Please remember moisturising treatments applied directly to the skin to soothe and hydrate it can be a fire risk. Read about the safe use of emollient products.
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Sometimes a fungal infection (such as thrush) develops in moist areas. Signs of this may include increased redness, itching, satellite spots – small, separate red spots, bumps, or pus-filled pimples scattered just outside the edges of a main, larger rash. If soreness persists an antifungal treatment may be prescribed. To reduce discomfort, keep the skin cool and dry, avoid tight clothing, use prescribed creams as directed and avoid scratching
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Contact your nurse, GP or healthcare professional if:
- skin becomes very sore
- the area is becoming larger
- the skin starts to break down
- there is bleeding
- there is an unpleasant smell
- you think there may be an infection
- treatment is not helping.
Early treatment can prevent complications and help the skin heal more quickly.