Doughy skin; Poor skin turgor; Good skin turgor; Decreased skin turgor
Skin turgor is the skin's ability to change shape and return to normal (elasticity).
Skin turgor is a sign commonly used by health care workers to assess the degree of fluid loss or dehydration. Fluid loss can occur from common conditions, such as diarrhea or vomiting. Infants and young children with vomiting, diarrhea, and decreased or no fluid intake can rapidly lose a significant amount of fluid. Fever speeds up this process.
To determine skin turgor, the health care provider grasps the skin on the back of the hand, lower arm, or abdomen between two fingers so that it is tented up. The skin is held for a few seconds then released.
Skin with normal turgor snaps rapidly back to its normal position. Skin with decreased turgor remains elevated and returns slowly to its normal position.
Decreased skin turgor is a late sign in dehydration. It occurs with moderate to severe dehydration. Fluid loss of 5% of the body weight is considered mild dehydration, 10% is moderate, and 15% or more is severe dehydration.
Note: Edema (a buildup of fluid in the tissues that causes swelling) causes the skin to be extremely difficult to pinch up.
Connective tissue disorders, such as scleroderma and Ehlers-Danlos syndrome, can also affect the elasticity of the skin. This does not have to do with fluids, but is a change in the elastic properties of the skin tissue.
Greenbaum L. Deficit therapy. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 54.
Gorgas DL, Barry JD. Vital signs measurement. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 1.
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