Decoding skin turgor, the simple test often used to spot dehydration

Changes in skin turgor due to dehydration

In dehydration, the body loses fluids and electrolytes, Dr Sridhar says, leading to a decrease in the skin’s elasticity. This occurs because water plays a crucial role in maintaining skin plumpness and elasticity; without adequate hydration, the skin becomes less supple. 

Physiologically, dehydration reduces the volume of interstitial fluid—the fluid that surrounds the cells, including skin cells—leading to a more “deflated” appearance of the skin and slower turgor.

Skin turgor is commonly assessed on the back of the hand, lower arm, or abdomen, according to Dr Swetha Sridhar (Source: Freepik)

Specific areas for skin turgor assessment

Skin turgor is commonly assessed on the back of the hand, lower arm, or abdomen, according to Dr Sridhar. However, these areas can be less reliable in older adults due to the natural loss of skin elasticity with aging. 

In such cases, she says, clinicians may assess skin turgor in areas less affected by aging, such as over the sternum or the forehead, to gauge hydration more accurately.

Clinical assessment and diagnostic tools

Dermatologists and healthcare practitioners evaluate skin turgor through a comprehensive examination of hydration levels. While observing skin turgor can serve as an initial indicator, it is commonly integrated with additional markers and diagnostic methods for a more thorough assessment.

“These may include patient history, physical examination for other signs of dehydration, and laboratory tests measuring electrolyte levels, kidney function, and urine concentration,” Dr Sridhar informs. It is essential to consider the overall health condition of the patient when diagnosing skin turgor accurately and assessing hydration levels.

Reliability of skin turgor as an indicator of dehydration

While changes in skin turgor can indicate dehydration, Dr Sridhar underscores the importance of recognising its limitations and encourages employing a comprehensive approach when diagnosing and managing dehydration because “it’s not always a reliable standalone measure”. 

Dehydration severity and its impact on skin turgor can vary widely among individuals, influenced by factors such as age, overall health, and the presence of certain conditions. 

For example, elderly individuals naturally have less elastic skin, she says, which may not reflect hydration status accurately. It’s important to consider other signs of dehydration, such as dry mouth, fatigue, decreased urine output, and dizziness, alongside skin turgor.

In the end, Dr Sridhar agrees that skin turgor is a useful, non-invasive tool for assessing hydration status, but highlights that it should be considered alongside other signs and symptoms of dehydration. Accurate assessment requires a holistic approach, taking into account the individual’s age, health status, and other diagnostic findings.