Maceration of the skin: treatment, patches, types of maceration, concept

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Maceration is a process of wet loosening and swelling of the skin under the influence of a liquid. We will talk about this symptom more in detail today.

What is maceration of the skin

Maceration is a physiological or pathological process of wet loosening, impregnation and swelling of the epidermis, caused by prolonged or periodic exposure to liquids. In normal life, such a reaction is the norm when wrinkling of the skin on the pads of the fingers and toes is observed with long-term exposure to water during manual washing, bathing, long bathing.

Classification

A complete classification of such a phenomenon as maceration is not developed. But experts consider the skin maceration in two versions:

• as a non-dangerous physiological manifestation;
• as a pathological phenomenon, when maceration acts as one of the signs of dermatological diseases.

Isolate the localization of the process in abnormal conditions and diseases:

• any skin areas with dermatoses;
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• buttocks, skin folds in infants;
• perianal region( around the anus);
• skin around the stoma in patients after surgery in the area of ​​the gastrointestinal tract, bladder.
• area between the fingers and under them;Axillary region
• ;
• brushes and feet( usually with professional activities related to working in wet conditions).

Reasons for the appearance of

The leading cause of physiological and pathological maceration is the long-term contact of the epidermis with the liquid. The degree of expression is directly related to the duration of the action of the liquid medium, its composition and temperature.

For example:

• on contact with water for about 40 minutes, maceration will manifest itself on the fingertips, more than 10 hours on the feet and palms;
• The higher the liquid temperature, the stronger the reaction;
• salt water is faster than fresh water, will cause maceration.

There are additional reasons that reinforce the abnormal process:

1. Mechanical : permanent or periodic rubbing of the skin in areas with high humidity.
2. Chemical : bile salts, irritants in urine, fecal enzymes, intermediate products of their interaction, chemical detergents, alkaline medium.
3. Biological : the aggression of infectious microorganisms, aggravating manifestations of maceration.

Detection of a symptom in yourself

To reveal natural maceration is easy when bathing in a bath. Symptom - wrinkling and whitish coloration of the pads on the fingers, not related to sex or age.

Signs and processes in the epidermis at different stages of maceration:

1. Swelling of the upper layer of the dermis due to impregnation of tissue with liquid. The skin becomes wrinkled, flabby.
2. The formation of small lesions on the surface of the skin due to the rejection of cells of the stratum corneum. Possible itching, soreness, burning. Formation of cavities in the thickness of the epidermis due to the separation of cells by liquid.
3. Continuation of loosening of skin tissue with the formation of internal cracks and cavities.
4. The superficial layer of the skin bursts( tearing away), opening the subcutaneous layer of the dermis.

The first stage of maceration is not dangerous. The phenomenon is eliminated after 2 to 3 hours after stopping contact with the liquid. If the effect of water lasted longer than 20 hours, signs of maceration disappear after 24 to 48 hours. A threatening situation arises if the rejection of the superficial layer of the dermis begins, with further deep damage to the layers of the skin.

What diseases and disorders can indicate the sign

Unlike physiological maceration, swelling of the epidermis with subsequent stages of damage and rejection of the upper layer of the skin is observed in many diseases in dermatology.

Maceration with skin diseases in adults, children, babies is almost always accompanied by other abnormal changes: hyperemia( redness), swelling, erosion, scratching, itching, burning and pain, development of blisters with watery or bloody contents. Since the permeability of the skin in infants is significantly higher than in adults, maceration in skin pathologies in children occurs very often.

Pathological conditions in which the most likely skin maceration:

• Contact, atopic, diaper dermatitis.
• Perianal dermatitis( inflammatory phenomena with maceration around the anus).It develops against the background of bacteriological and fungal infection, hemorrhoids, enterobiasis, dysbacteriosis, intestinal inflammations( colitis, proctitis), anal fissure.
• Intertrigo is a common form of contact dermatitis in infants in skin folds.
• Wet eczema.
• Bedsores in severe patients, forced for a long time lying down.
• Hyperhidrosis( abnormally high sweating), as well as maceration of interdigital spaces with sweating.
• Intertriginozny fungus( dermatophytosis) between the fingers of the feet and hands.
• Cold neurosculitis.
• Frostbite, frostbite( thawing stage).

Elimination of the

problem Physiological maceration does not require treatment, but only prevention of prolonged contact with water, observance of necessary measures preventing its development during professional activity with prolonged exposure to moisture on the epidermis.

Permanent or frequently occurring maceration can be not only a sign of abnormal conditions, but also a factor leading to the development of diseases. Accompanied by cold, friction, rapid temperature changes, wind loads, maceration contributes to the development of pathologies such as contact dermatitis, cold neuroasculitis, fever, trench stop( frostbite at a temperature above zero with long-term humidity).

With hyperhidrosis

• When sweat is exaggerated, spacious shoes are picked up, cotton socks are washed as often as possible using antibacterial soap, with obligatory thorough drying of the interdigital spaces.
• From pharmaceuticals apply: ointments, creams and gels containing formaldehyde, which has a tannic effect and helps to narrow the pores( Formagel, Formidron, an old but effective means - Teimurov paste).Recommended lotions, solutions, baths with broth of a tea fungus, bark of an oak, a thyme).
• For elimination of maceration with a strong sweating in the underarm zone, beta-blockers, tablets containing oxybutin, benzotropin, and Bellaspan, Belloid are used according to the doctor's prescription. It should be remembered that these drugs have contraindications and significant adverse reactions. Need sedatives, including plant( valerian, motherwort), if the hyperhidrosis is caused by a neurosis.
• Laser therapy to reduce sweat secretion and prevent maceration is considered to be an effective and safe method. The sweat glands are treated with a laser beam and their function is suppressed.

Means for different diseases

With the pathological development of maceration, to eliminate the problem means, first of all, to identify the causative disease that provokes this painful condition.

Requires:

• consultation of a dermatologist;
• conducting a checkup with a gastroenterologist, proctologist;
• tests for the presence of microorganisms in infectious diseases, if bacterial skin infection has joined;
• call for a surgeon in case of deep lesion of the dermis.

It should also be understood that when choosing a local remedy for maceration, you need to consider how this or that ointment or cream will affect other skin defects that are present in dermatology( ulceration, flaking, erosion, swelling, wetness or excessive dryness of the skin, the introduction of fungior microbes).

Local remedies often prescribed for dermatological diseases with manifestations of maceration of stages 1 - 2:

1. Atopic, contact, diaper dermatitis: Bepanten, Drapolen, Dexpanthenol, Desitin, Baneocin( powder), Zinc ointment, Protopic, Skin Cap, Psilo-balm, La Cree, Gystan.
2. Perianal dermatitis: Posterizan, Aurobin, Dexpanthenol, ointments with zinc and antiseptics, suppositories with methyluracil, baths with oak bark, chamomile, chistotel, sequin, Sinaflan ointment.
3. Interdigital fungus: Exodermil, Mycospores, Nystatin ointment, Lamisil, Ecosax, Mifungar, Nizoral, Travogen.
4. Bedsores: Sulfargin, Oflomelid, Eplan, Stellanin.
5. Elimination of maceration on the skin around the stoma in post-operative patients: protective cream Proctive to the Danish company Coloplast Conveen, an absorbent powder Coloplast Powder, forming a protective film in contact with exudate, Cream Critical barrier with pronounced skin maceration, provoked by prolonged irritation of the skin with urine and feces.

In severe cases of maceration, with exfoliation of the epidermis, when treatment with ointments does not give positive changes, surgical excision of the upper layer of skin is performed, after which the healing process lasts from 2 to 4 weeks. Necessarily antibacterial, immunostimulating agents, vitamins and a diet with inclusion of products containing large amounts of minerals are prescribed.

Maceration of skin( photo)