Skin Tears

What is a skin tear?

A skin tear is a traumatic wound that is caused by direct contact between the skin and another object, such as removing an adhesive (sticky) dressing from the skin or falling against furniture.

The skin tear may vary in depth, but does not extend to the deepest layer of skin.¹

What causes a skin tear?

A skin tear may happen from:

• a fall

• being repositioned or assisted to move

• injury caused by equipment

• removal of adherent (sticky) dressings

• trauma from jewellery or nails tearing the skin during day-to-day activities such as washing and dressing.

Skin tears can happen to any part of your body, but they are most common on the legs, arms and the back of your hands.

Who is most at risk of skin tears?

Those who already have fragile or vulnerable skin (old or very young skin) are most at risk of skin tears. This is because less force is required to cause a traumatic injury to fragile skin.

Those who need help to be washed, dressed and need help to move around are also at risk of a skin tear. 

Some medications, such as corticosteroids, can cause ‘thinning’ of the skin, which makes skin tear injuries more likely.

How will I know if I have a skin tear?

A skin tear can be something as simple as a small, shallow wound or as complicated as a large tear in the skin.

The surrounding skin may appear purple and discoloured, similar to a bruise.

Your Doctor or Nurse will be able to diagnose a skin tear from when you tell them about your medical history and by examining your wound.

What will the Doctor or Nurse do?

Your Doctor or Nurse will clean the skin tear. If it is bleeding, gentle pressure will be applied until the bleeding stops.

Your Doctor or Nurse may try to reposition the skin flap. This is done using a sterile/clean technique. The flap is usually held in place using skin glue or dressings. A dressing may be applied to cover the wound and protect the area.

If the skin flap cannot be repositioned, a dressing will be applied to cover the skin tear and to protect the area.

The dressing will usually remain in place for 5 to 7 days to prevent disturbing the skin tear as it heals.

Your Doctor or Nurse will carefully remove your dressing after 5 to 7 days to avoid damaging the healing wound.

Will I need any further treatment?

If you have a skin tear on your lower leg that does not show signs of healing after 2 weeks, you may need further treatment to stop the skin tear turning into an ulcer.

What can I do if I am in pain?

Skin tears can be very painful. Your pain can be managed by taking your usual painkillers, if you already have some. Ask your Doctor or Nurse if you need any further advice.

What other things can I do to help heal my skin tear?

If you have a skin tear to your lower leg, you can help reduce any swelling by keeping your affected leg elevated whenever possible. Ideally, you should try to keep your heels above your hips while you are in a sitting or lying position.

It is important that you avoid sleeping in an armchair at night and that you sleep in bed whenever possible.

Keep as active as possible and continue with your normal activities.

Ask your Doctor or Nurse to show you some foot and ankle exercises. You must be careful not to cause further injuries to your affected leg while performing these exercises.

People with vulnerable skin often suffer from dry itchy skin. Washing and moisturising your skin regularly can help maintain healthy skin.

Applying an over-the-counter moisturiser or a cream or ointment prescribed by your Doctor or Nurse will help to moisturise your skin.

If your itching is severe, speak to your Doctor or Nurse.

Itchy skin can also be caused by an allergic reaction to the dressings or creams applied. If your Doctor or Nurse thinks this is the case, they may change the dressings or creams.

It is important to avoid scratching your skin if it feels itchy. Scratching could cause more damage to your skin. Keeping your fingernails short will help to avoid further wounds.

What are the signs that my skin tear is infected?

Skin tears can become infected. Your skin tear may be infected if you have some or all of the following:

• A high temperature and you feel feverish.

• Increasing pain to the wound or surrounding area.

• Unpleasant discharge or smell coming from the skin tear.

• Redness and swelling of your skin around the skin tear.

If you think your skin tear is infected, you should contact your Doctor or Nurse and they will advise you what to do. They may need to change your treatment plan. If you feel unwell, you must seek urgent medical attention.

How can I prevent more skin tears?

You and your carer/family can help reduce your risk of skin tears in several ways:

• You and the people helping to care for you should avoid wearing jewellery, such as wrist watches or jewelled rings.

• You and the people caring for you should keep fingernails short.

• You should maintain a balanced diet.

• You should drink plenty of fluids.

• You should mobilise safely – use equipment to support mobility in the correct way to reduce the risk of falls and trauma.

• You should wear long sleeves and trousers to protect your skin.

• You should stop smoking / drug misuse.

• You should elevate your legs when resting.

• You should sleep in bed at night time, whenever possible.

• You should take care of your skin. Avoid using soap to wash and use a moisturising soap substitute instead.

• You should apply moisturiser twice a day.

• You should speak to your Doctor or Nurse if you need support with any lifestyle changes.

References

International Skin Tear Advisory Panel, 2018, website:

Comments, concerns, compliments or complaints

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