What Skin Turgor Means
Skin turgor refers to the skin's elasticity and ability to return to its original position after being pinched and lifted, serving as a clinical assessment tool primarily for evaluating hydration status. 1
Definition and Assessment Technique
Skin turgor is assessed through the "skin turgor test" or "tenting test," performed by pinching and gently lifting the skin over the shoulder blades (or forehead in some protocols). 1 The test measures how quickly the skin returns to its normal anatomical position after being released. 1
Normal vs. Abnormal Findings
- Normal skin turgor: The skin quickly returns to its original shape immediately after release 1
- Decreased turgor (prolonged tenting): The tent remains elevated or is slow to resolve, indicating dehydration 1
- Severe dehydration: The skin tent persists, and patients may exhibit additional signs including weakness, immobility, and sunken eyes 1
Clinical Significance and Limitations
Primary Application: Dehydration Assessment
Skin turgor is most commonly used to assess hydration status, particularly in clinical settings where rapid bedside evaluation is needed. 1 The test can detect mild dehydration, with studies showing that even a 0.83% body weight loss during exercise produces visually detectable changes in skin turgor. 2
However, skin turgor has significant limitations as a dehydration assessment tool in adults and may not be the best choice for some clinical situations, potentially leading to medical emergencies if relied upon exclusively. 3
Age-Related Considerations
The reliability of skin turgor decreases with age due to changes in the elastic fiber network of the skin. 4 Older adults naturally experience decreased skin elasticity independent of hydration status, making the test less specific in geriatric populations. 4
Underlying Physiology
Skin turgor reflects the viscoelastic properties of the dermis, which contains a network of elastin and collagen proteins with elastic properties. 1 The dermis stores much of the body's water supply, and reduction in total body water directly affects these elastic properties. 1
Factors Affecting Skin Turgor
- Hydration status: Decreased total body water reduces skin elasticity 1
- Age: Progressive loss of elastic fiber integrity decreases the ability of skin to return to its original position 4
- Anatomical location: Skin elasticity varies significantly by body region 4
- Skin thickness: The dermis thickness (1.5-4 mm) varies by anatomical site, affecting measurement reliability 1
Clinical Context
While the pinch test remains the most commonly used measure of skin turgor in clinical practice 3, it should be interpreted alongside other clinical signs and not used as a standalone diagnostic tool, particularly in adult populations where its predictive value for dehydration is questionable. 3