Skin turgor is a measurement used in a physical assessment to evaluate the skin’s elasticity. This elasticity is the ability of the skin to change shape and quickly return to its original form. Assessing skin turgor offers insight into the body’s overall fluid balance and hydration status.
The Procedure for Assessing Turgor
The assessment begins by choosing the correct location on the body, which varies depending on the patient’s age. For adults, the preferred site is the skin over the sternum, such as the midclavicular region just under the collarbone, as it is less affected by age-related changes. Other common areas include the forearm or the abdomen, which is often used when assessing infants and young children.
To perform the check, a healthcare provider gently grasps a fold of skin between their thumb and forefinger. The skin is lifted slightly, held momentarily to form a peak, and then released. The focus is on observing the skin’s recoil mechanism after release.
Identifying Normal and Abnormal Findings
Once the skin is released, the observation of how quickly it flattens determines the turgor finding. A normal result is described as a “Brisk Return,” where the skin immediately snaps back to its original flat position within one to two seconds. This rapid return indicates appropriate water tension and elasticity.
An abnormal finding is documented as a “Sluggish Return” or “Tenting.” This occurs when the pinched skin fold remains elevated or peaked for a noticeable period after release, taking longer than a few seconds to flatten completely. The visual observation of the skin staying elevated, resembling a small tent, is the basis for the term “tenting.”
What Abnormal Turgor Indicates
A sluggish return or tenting result is a sign of fluid volume depletion, most commonly associated with dehydration. When the body loses substantial fluid, interstitial fluid shifts into the vascular compartment to maintain circulating blood volume. This process reduces the fluid content in the dermis, causing the skin to lose its normal tension and elasticity.
Poor skin turgor indicates moderate to severe fluid loss, although it is considered a relatively late sign of dehydration. Other factors can also contribute to decreased skin elasticity, including significant malnutrition, rapid weight loss, or certain connective tissue disorders like Ehlers-Danlos syndrome.
The skin naturally loses elasticity with age, meaning a sluggish return in an older adult may not solely be due to dehydration. However, when poor turgor is observed alongside symptoms such as vomiting, diarrhea, or fever, it suggests a significant fluid deficit. Reduced skin turgor in vulnerable populations, particularly infants and the elderly, warrants prompt medical evaluation.