How to Treat and Prevent Skin Tears

Thin, Delicate Skin Can Tear Even While You Try to Treat It

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Skin tears become more common as we age because the skin becomes drier and more delicate. Unlike healthier skin that stretches when stressed, delicate skin can come apart with relatively little pressure. Even adhesive bandages can stick hard enough to rip the delicate skin of some people.

A skin tear is a form of avulsion that happens when the skin has become very thin and delicate. It is common as we age because the blood vessels that perfuse skin get more sclerotic and feed less moisture and nutrients to the skin tissue.

Medical professional wrapping an injured arm with gauze
PIXOLOGICSTUDIO/SCIENCE PHOTO LIBRARY / Getty Images

Skin Tear Categories

There are three categories of skin tears. The difference between them is whether or not the skin flap is still viable.

Category 1

The skin flap is complete enough for all the edges to close. This kind of skin tear might heal if you replace the skin flap where it belongs and wrap the wound with a light dressing.

Some subcategories have to do with whether or not the skin flap is viable. Category 1a means the skin flap is pink and healthy. In Category 1b the skin flap is pale, blue, or purple, which means it probably won't heal.

Category 2

The skin flap is damaged and won't close properly. In this case, the tear will not heal correctly because the flap won't reach the edges of the wound. Like above, Category 2a means the flap is pink. Category 2b means the flap is pale or blue.

Category 3

The skin flap is completely gone. This will take the longest to heal.

More important than treatment is to prevent skin tears. Very little can be done to close skin tears, especially when the skin flap is missing. If the skin is torn, treatment will center around keeping the wound clean and protecting it from further damage.

Risk Factors

Though skin tears can happen to anyone of any age, some people are more at risk than others. They include:

  • Elderly people, particularly those who are frail and require assistance moving around
  • Infants, as they are at a higher risk of falling or bumping into objects
  • People with impaired mobility, who may be more prone to falls and accidental injuries
  • People with a previous history of skin tears
  • Those who have a cognitive impairment or dementia, or who may be more likely to become agitated and injure themselves
  • Those who have chronically dry, dehydrated skin
  • People who have thin skin due to long-term use of certain medications, such as topical cortisone creams
  • Post-menopausal women, as decreased estrogen levels cause the skin to become more fragile

If you fall into one or more of these categories, you may want to consider developing strategies to help prevent skin tears from occurring.

How to Treat a Skin Tear

The overall goals of treatment are to keep the wound free of infection and protect the surrounding skin and tissues while keeping it moist to promote healing. If the skin flap is still attached (categories 1 and 2), you want to try and preserve it and get it close to its original position without stretching it too much.

Before you begin, wash your hands thoroughly with soap and put on gloves if they're available. Steps to take:

  1. If the wound is bleeding, apply pressure and elevate it as much as possible.
  2. Rinse the skin tear with tap water or a saline solution. Be careful not to tear the skin worse and do not use hydrogen peroxide or other products—water or saline is just fine.
  3. Either let the skin tear air dry or pat it dry very carefully. Do not rub it.
  4. If there is a flap of skin, gently lay it back in place or as close as possible. Do not stretch it too far or force it in any way.
  5. Cover the skin tear with a dressing that is appropriate for skin tears.

Some skin tears can be quite severe and may require the attention of a doctor. If you are uncomfortable with treating any severity of skin tear yourself or notice signs of infection, seek medical attention. If your doctor's not available, try an urgent care clinic.

The length of time that it takes for a skin tear to heal depends on the type of skin tear and your overall health. Most skin tears can resolve in four weeks, but after four weeks they are considered chronic.

Complications

Skin tears should be treated as soon as possible to prevent complications from occurring. If left untreated, skin tears can lead to infection, which may progress to cellulitis, or sepsis—a condition that is life-threatening. Additionally, skin tears that are improperly dressed may not heal as they should. As a result, they may easily re-tear or become chronic.

Dressings

Several types of dressings work well for skin tears. These include film dressings such as Tegaderm and petroleum jelly gauze. If you have delicate skin or have experienced skin tears in the past, it might be a good idea to have one of these available just in case.

Film dressings are transparent and allow you to watch for healing and infection without removing it. This is particularly helpful with skin tears. If the dressing becomes soiled, remove it, clean the skin tear, and dress the wound again. If the skin tear develops signs of infection, contact your doctor.

When using film dressing, you need to be very careful when removing it. Make sure to pull it off in the same direction as the skin flap. If you pull it in the reverse direction, you could re-open the tear.

Prevention

There are several steps you can take to try and prevent skin tears. Ask your doctor or healthcare provider for advice specific to you and consider employing some of these strategies.

Keep Your Skin Moist

Dry skin can lead to skin tears, and this is the most important point of prevention. Try to avoid soaps that can dry out your skin and apply a quality moisturizer at least twice a day. You can also cover particularly fragile skin with barrier films or creams or wrap it in bandages.

Create a Safe Environment

Skin tears are most common in the elderly population and are often caused by casual accidents like bumping into furniture or a scratch from a wedding ring. Simple changes around the home can be of great help.

Keep walkways clear of clutter and remove rugs or other obstacles so you don't trip or bump into things. Place pads on sharp edges around the house, and remain mindful of any abrasive fabrics on furniture that can scrape the skin.

Wear Protective Clothing

By covering the majority of your delicate skin with clothing, you can prevent many skin tear injuries. This can be as simple as a single layer of your normal clothes, but consider wearing long sleeve shirts and long socks.

Just be sure to take care when changing your clothes and be mindful of zippers, buttons, and other things that can grab your skin.

Eat a Balanced Diet

Poor nutrition and chronic dehydration can cause your skin to be fragile and increase the risk of tearing. To keep your skin strong and promote healing if a skin tear occurs, drink plenty of water and optimize your diet with fruits and vegetables that are rich in vitamin C. You can also help support collagen production in your skin by adding more high-protein foods to your diet, such as fish, eggs, and beans.

Avoid Adhesives

Try to avoid using adhesive bandages or medical tape unless absolutely necessary, as these can cause delicate skin to tear. If you must dress a skin tear, consider wrapping the wound in a petroleum-based gauze wrap that is non-adhesive, then securing the wrap with medical tape.

A Word From Verywell

Skin tears can be very painful and some take more time to heal than others. The best way to protect against skin tears is to prevent them from occurring. If you know you are at risk, create a safer environment where you will be less likely to fall or bump into a hazardous object, and take steps to strengthen and protect your skin. If an accident happens, try not to panic—with proper wound care, most skin tears can heal without infection or chronic re-tearing.

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