Skin indentation refers to a temporary depression or mark left on the skin’s surface. While often harmless and quickly reversible, persistent indentations can sometimes raise questions or concern about why skin might stay indented.
Everyday Reasons for Indentations
Mechanical pressure is a common cause of temporary skin indentations. External forces, such as clothing seams, prolonged sleeping positions, or leaning against hard surfaces, compress the skin. The pressure temporarily deforms the skin, creating a visible mark that typically resolves quickly once removed, often within minutes to an hour.
Mild dehydration can also contribute to the skin’s susceptibility to indentations. When the body is slightly dehydrated, skin turgor, its elasticity and ability to return to its original shape, is reduced. This makes the skin less resilient and more prone to holding impressions from external pressure. These instances are not a cause for concern and resolve as normal hydration is restored.
When Fluid Buildup is the Cause
Persistent skin indentations can signal fluid accumulation in tissues, known as pitting edema. This occurs when excess fluid builds up in the interstitial spaces (between cells), causing the skin to retain an indentation after pressure is applied. This swelling can be a symptom of medical conditions affecting the body’s fluid balance.
Heart failure, where the heart struggles to pump blood, can increase pressure in blood vessels, causing fluid to leak into surrounding tissues, often in the legs and ankles. Kidney disease also causes pitting edema as impaired kidney function prevents efficient excretion of excess fluid and sodium. Similarly, liver disease, especially cirrhosis, can cause fluid retention due to reduced albumin production (a protein that helps keep fluid in blood vessels) and increased pressure in the portal vein system.
Venous insufficiency is another common cause, where damaged valves in leg veins struggle to return blood to the heart, leading to blood pooling and fluid leakage into the lower extremities. Certain medications, including some blood pressure drugs, NSAIDs, and corticosteroids, can cause fluid retention as a side effect. Lymphedema, a type of swelling from impaired lymphatic drainage, can also result in skin indentations, though it may appear less “pitting” and more doughy than other edema, involving protein-rich fluid buildup.
How Skin Structure Affects Indentations
The skin’s intrinsic properties play a significant role in its ability to resist and recover from indentations. Collagen and elastin are essential proteins providing the skin with structural integrity, elasticity, and firmness. Collagen contributes tensile strength, allowing the skin to withstand stretching, while elastin provides the ability to recoil after compression.
Natural aging leads to a decrease in collagen and elastin production, and existing fibers can become fragmented or disorganized. This reduction diminishes the skin’s resilience, making it less capable of bouncing back quickly from pressure and more prone to retaining indentations. As a result, older skin may show temporary marks from clothing or bedding for longer periods.
While mild dehydration temporarily affects skin turgor, severe or chronic dehydration can significantly impair overall skin elasticity. When the body lacks sufficient fluid, skin tissues become less plump and pliable, making indentations more pronounced and slower to resolve. Certain connective tissue disorders, such as localized scleroderma, can also alter skin texture by causing thickening and hardening. This change makes skin less flexible and more susceptible to persistent indentations.
When to Talk to a Doctor
While many skin indentations are harmless, consult a healthcare provider if certain signs or symptoms are present. Seek medical advice if indentations are persistent, worsening, or widespread rather than isolated. Concerning signs also include indentations accompanied by pain, redness, warmth, or noticeable skin discoloration.
It is important to see a doctor if other symptoms accompany the indentations, such as shortness of breath, unexplained weight gain, fatigue, or changes in urination. If skin indentations appear suddenly or without a clear cause like prolonged pressure, medical evaluation is warranted. This article provides general information and is not a substitute for professional medical diagnosis or advice.