Treatment and Prevention of Skin Tears

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

elderly patient gauze wrap

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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.

What are Skin Tears

A skin tear is a form of avulsion that happens when 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.

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. There are subcategories that 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 protect it from further damage.

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 too much.

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

  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 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.

Dressings for Skin Tears

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 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.

If you used a dressing that hides the wound, change the dressing every three days and look for healing or signs of infection. Again, when removing the dressing be sure to peel it away gently in the direction of the skin flap.

Ways You Might Prevent Skin Tears

There are several steps you can take to try and prevent skin tears. Ask your doctor or health care 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 the most casual accidents like bumping into furniture or a scratch from a wedding ring. A paper in Wounds International recommends that 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 things like your bed sheets 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 longer 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.

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