What are skin tears? Understanding a common yet overlooked wound

Skin tears are a common but often unrecognised type of wound, especially among older adults and people with fragile skin. Skin tears can be quite painful and distressful and despite their frequency, they are often misdiagnosed or ignored. This can lead to complications that could have been avoided with early recognition and care.¹

In this article, we’ll explore what skin tears are, how they happen, and why they matter, for both individuals and healthcare systems.

A skin tear is a traumatic wound caused by mechanical forces, including removal of adhesives and patient handling, the depth of which may vary (not extending through the subcutaneous layer)¹. Skin tears are specific injuries not to mix up with lacerations or cutaneous laceration. They are initially acute wounds¹ and usually heal within 14–21 days, depending on the size and depth². In cases of delayed wound healing, a skin tear can develop into a complex chronic wound³.

Skin tears typically result from¹:

• Mechanical forces (e.g. shear and friction)
• Trauma (e.g. dressing/adhesive removal or bumping into objects)
• Improper patient handling

While normal skin can withstand most impacts, less force is required to cause a skin tear in individuals with fragile skin¹. Depending on the circumstance, the skin may separate partially or fully:

In a partial thickness wound, the epidermis is separated from the dermis.

In a full thickness wound, both the epidermis and dermis are separated from underlying structures.

Skin tears can occur anywhere on the body¹,³ but the areas most prone to skin tears are the outer forearms, elbows, and hand dorsum. They are also often seen on lower limbs, like the calves and shins.⁶

The International Skin Tear Advisory Panel (ISTAP) classifies skin tears into three types¹:

Skin tears can happen to anyone, but certain groups are especially vulnerable due to age, skin condition, or medical factors.

Those more vulnerable include:

• Newborns, whose skin is still developing:
  A newborn's dermis is not fully developed and has approximately 60% of the thickness of adult skin. The skin is less elastic and more prone to damage by shear forces⁴.
• Older adults, whose skin becomes more fragile with age:
  Due to skin changes in older adults, their skin is more vulnerable to skin tears. They are also at the highest risk of developing infections and comorbidities, which can cause skin tears to be a complicated wound or may develop into a chronic wound¹. This risk is especially high in care settings, where frequent handling, dressing changes, and medical interventions can increase the likelihood of skin trauma.

Skin tears aren’t just a medical concern. They can have a negative impact on the health care system by causing high material and labor costs, an increased workload for caregivers as well as prolonged hospital stays. The full extent of the practical and financial burden to healthcare systems is not fully known, as skin tears are frequently underreported or misdiagnosed¹. But when left unaddressed, these wounds can escalate, leading to longer recovery times, more complex care needs, and increased pressure on staff and budgets.

That’s why education and a strong multidisciplinary team matter. Giving clinicians the right skills to spot risks and protect skin integrity–supported by nurses, aides, and allied health professionals–helps prevent complications and improve outcomes¹.

Build your own individual solution using silicone adhesives – with the following products.