Moisture Associated Skin Damage

Moisture Associated Skin Damage (MASD)

Patient Information

Tissue Viability Service

• Author ID:           GR / KP
• Leaflet Ref:         TV 002
• Version:              1
• Leaflet title:         Moisture Associated Skin Damage (MASD)
• Date Produced:   September 2024
• Expiry Date:        September 2026

Introduction

Moisture associated skin damage (MASD) is a broad term for inflammation and skin damage as a result of prolonged or continuous exposure to moisture on the skin.

The moisture can be from urine, faeces, perspiration (sweat) or fluid from a wound or stoma. If this excess moisture is not controlled it may lead to open wounds (moisture lesions), sore, itchy, irritated or infected skin and it can also increase the risk of developing pressure ulcers.

This leaflet will guide you and offer some tips and advice on how to keep your skin healthy and reduce the risk of skin problems related to excess moisture. 

You may have been given this leaflet by your health care professional if you already have moisture associated skin damage or if your health care professional feels you are at risk of developing moisture associated skin damage.

A plan of care will be implemented by your health care professional to prevent or manage the moisture to your skin. Support from yourself or carers may be required if specific creams are prescribed.

Prevention and management

• Skin inspection - Check skin daily; consider using a mirror to help check skin. Look out for redness, inflammation, small breaks to the skin/skin loss. The skin may feel irritated or itchy. Any changes in the skin should be reported to your health care professional. If you are unble to check you own skin, your carer or heath professional will do this for you. 
• Manage excess mositure - Wash skin with a pH balanced cleanser, as soap can irritate the skin. Do not use perfumed products as these can cause irritation. Your health care professional can advise you on appropriate cleansers if needed. Gently pat skin dry after washing. Apply a small amount of barrier product, (this is prescribed by your health care professional).  The correct amount will be advised by your health care professional or further information is within the product information leaflet. Complete this regime daily or after all episodes of moisture on the skin, such as incontinence. 
• Diet and Fluids - Eating a healthy balanced nutritious diet and drinking good amounts of fluid can help to prevent skin damage and speed up the healing process. Your health care professional can provide you with further advice on dietary intake and provide information leaflets if necessary.
• Change position  - Changing position regularly will help with blood circulation and reduce a build up of heat. It also allows air to circulate and evaporate.  When seated, aim to change your position every 15 minutes, this can be standing up, walking or moving your body weight from one side to the other. When in bed, aim to change your position every 2 hours, this can be full turns from one side to other or gentle tilts at 30 degrees. Your health care professional can advise you on an indiviualised plan of care and provide you with further leaflets on reducing your risk of pressure ulcers.

Factors that increase risk of MASD

• Obesity increases skin folds, heat, sweat,and friction
• Urinary & Faecal incontinence
• Reduced mobility
• Poor skin hygiene
• Profuse sweating
• High levels of leaking from a wound
• Certain soaps/skin cleansers
• Incorrect use of barrier creams can reduce the effectiveness of incontinence pads
• Vigorous, rough drying of the skin
• Poor nutrition and dehydration
• Early formation of stoma
• Medications

Key points to remember

• Check skin daily - if you are unable to do this yourself, ask your carer or health care professional to do this for you, this will ensure any changes are noted early to prevent skin problems becoming worse.
• Always use a pH balanced non-scented wash/cleanser to clean your skin, always wash your skin throughly after moisture build up, such as following an episode of incontinece or sweating induced activity
• Pat skin dry – don’t rub as this will cause friction.
• If you are prescribed cream, apply a small amount as often as advised by your health care professional or in the product information leaflet supplied with the product.
• Enjoy a healthy diet and drink plenty fluids to keep skin in good condition.
• Change position regularly to allow the skin to breathe, sweat to evaporate and to reduce the build up of pressure.