Skin Maceration

Skin maceration is when your skin becomes soft, wrinkly and discolored after being in wet conditions for too long.

Mild cases of skin maceration (pronounced “mas-uh-REY-shuhn”) can happen if you spend too much time in a bath or pool. When this occurs, your skin will return to its normal appearance after you let it dry out.

But in severe cases, too much exposure to moisture can cause your skin to break down. This can cause itchy or painful sores. It also increases your risk of infection. Severe skin maceration can happen if you spend a lot of time walking in wet shoes. It can also affect babies who don't have their diapers changed regularly.

Mild cases of skin maceration don’t need treatment, just a little extra care. But if you have a sore, you may need special bandages and prescription creams to help keep your skin clean and dry.

Symptoms of skin maceration

Macerated skin:

• Appears lighter than your natural skin tone, usually white or gray (pallor)
• Looks wrinkly or like a prune
• Feels soggy or wet to the touch

Severe skin maceration may have symptoms like:

• Tenderness or pain
• A stinging or burning feeling
• Itching
• A bad smell

Maceration most commonly affects areas with skin folds, like between your fingers or toes or around your genitals. It’s also common to notice it on the tops of your fingers, in the palms of your hands and on the soles of your feet. But it can affect any area of your skin that has exposure to a moist or wet environment for a long time.

Causes

Too much moisture causes your skin to soften and eventually break down. Water and sweat are common sources. But others may include:

• Mucus
• Pee (urinary incontinence)
• Poop (fecal incontinence)
• Pus or fluid from a wound

Most people notice skin maceration after bathing or swimming for too long. But it can also develop when something wet stays on your skin, like:

• Bandages
• Gloves
• Socks
• Shoes
• Diapers
• Absorbent underwear
• Casts

Risk factors

Skin maceration is common. It can affect anyone at any age. You’ve probably experienced it after a long bath or a day in the swimming pool. But you may have an increased risk if you:

• Have a wound
• Work in or around water — for example, if you’re a lifeguard, plumber or construction worker
• Spend a lot of time outdoors, including camping or hiking
• Wear diapers or absorbent underwear
• Need long-term bed rest
• Sweat a lot (hyperhidrosis)

Complications

Bacterial infections can be a major complication. The top layer of your skin (epidermis) acts as a protective barrier. It helps keep germs that could cause infections out of your body. But macerated skin is weaker. It has a harder time keeping germs out. This increases your risk of infections. It’s also more likely to break down into an open sore due to friction — for example, if your skin rubs against clothing or your skin folds rub against each other.

How doctors diagnose macerated skin

Your healthcare provider can pretty easily diagnose it during a physical exam. They may also recommend a blood test or a culture test to rule out similar conditions, like an ulcer or infection.

How is macerated skin treated?

Mild cases usually go away on their own after letting the area dry out.

If you have maceration from a wound or sore, gently clean the affected area with soap and clean water and pat it dry. Your healthcare provider may recommend covering it in a waxy, watertight (occlusive) bandage or an absorbent (hydrofiber) bandage. These bandages help protect the affected area from moisture and bacteria.

Your provider may also recommend over-the-counter medicated powders or a barrier cream that contains zinc oxide. These are especially helpful in areas with skin folds. They help prevent moisture buildup and repair your skin barrier.

If you need prolonged bed rest, it’s a good idea to reposition yourself every few hours. This helps prevent moisture from getting trapped between your skin and the bed. Moisture-wicking or breathable clothing can also help. Clothes and underwear that consist of synthetic materials help pull moisture away from your body. Cotton clothes and underwear absorb moisture.

Recovery time

In mild cases, prune-like skin should go away within an hour of exposing it to air.

If maceration causes sores or wounds, these may take up to a few days or even weeks to heal completely. Keeping your skin clean and dry can speed up the healing time. It’s also a good idea to regularly change your bandages, especially if they get wet or dirty.

When should I see my healthcare provider?

Schedule an appointment with your provider if your skin doesn’t start to heal after a few days of airing out. You should also see your provider if you have signs of an infection, including pain, swelling or discoloration (meaning your skin looks red, purple, brown or black).

What can I expect if I have macerated skin?

The overall outlook is good. Most people get better after letting their skin dry out or treating wounds. Be sure to follow your provider’s instructions on how to care for a wound. This includes cleaning it and changing bandages.

If you get a bacterial infection, it may go away on its own. But your healthcare provider may recommend antibiotics. Antibiotics can treat most bacterial infections.