Skin turgor is one way to estimate the state of hydration (fluids) and, to a lesser extent, nutrition.

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 accelerates this process.

The skin on the back of the hand, lower arm, or abdomen is grasped 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 is associated 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 (accumulation of fluid in the tissues that causes swelling) causes the skin to be extremely difficult to pinch up.

• dehydration
• extreme weight loss
• decreased fluid intake
• vomiting
• diarrhea
• diabetes
• heat stroke (excessive sweating without adequate fluid intake)

Connective tissue disorders, such as scleroderma and Ehler's-Danlos syndrome, can also affect the elasticity of the skin. This is not related to fluids, however, but to a change in the elastic properties of the skin tissue.

A quick check of skin turgor by pinching the skin over the back of the hand, on the abdomen, or over the front of the chest under the collarbone is a good way to check for dehydration at home.

Mild dehydration will cause the skin to be slightly slow in its return to normal. To rehydrate, drink more fluids -- particularly water.

If turgor is severe, indicating moderate or severe dehydration, see your health care provider immediately!

• poor skin turgor accompanies vomiting, diarrhea, or fever.
• a check of skin turgor results in very slow return to normal, or the skin "tents" up. This can indicate dehydration that is severe enough to require immediate treatment.
• a person with reduced skin turgor is unable to increase his or her intake of fluids (for example, because of vomiting).

A general physical examination and health history will be performed.

Medical history questions documenting skin turgor in detail may include:

• How long has this been present?
• What other symptoms preceded the change in skin turgor (vomiting, diarrhea, others)?
• What have you done to try to treat the condition?
  • Did it make it better?
  • Is it getting worse?
• What other symptoms are also present (such as dry lips, decreased urine output, and decreased tearing)?

Diagnostic tests that may be performed are:

• blood chemistry (such as a chem-20)
• urinalysis
• cbc

INTERVENTIONS:
Intravenous fluids may be necessary for severe dehydration. Medications may be necessary to treat other conditions that affect the skin turgor and elasticity.