Clinical reference tool
Skin Turgor Assessment
Grade a turgor finding, get the charting phrase, and see where the assessment is and isn’t reliable.
- 1
Who are you assessing?
- 2
Which site are you using?
Choose a patient group first.
- 3
What did you observe on release?
Choose an assessment site first.
Skin turgor grading scale
Recoil time is measured from the moment the pinched skin fold is released.
| Grade | Recoil time | What you see |
|---|---|---|
| Elastic (normal) | Immediate, under 2 seconds | Skin springs back the instant it is released. |
| Slightly decreased | About 2 to 3 seconds | A brief delay before the skin settles back. |
| Decreased (slow recoil) | Roughly 3 to 4 seconds | Skin returns visibly slowly after release. |
| Tenting (poor) | Over 4 seconds, or remains elevated | The pinched skin stays peaked or 'tented' and settles back very slowly, or not at all. |
Where to check skin turgor
Over the sternum
PreferredGenerally the most reliable site in adults. Skin here is less affected by age-related elastic loss than the back of the hand.
Inner forearm
Common alternative in adults and older children. Easy to access and reasonably reliable.
Forehead
Sometimes used in older adults, where limb skin has lost elasticity.
Abdomen
PreferredPreferred in infants and young children.
Inner thigh
Alternative paediatric site when the abdomen is unsuitable.
Back of the hand
Widely taught, but the least reliable site — skin here loses elasticity with age independently of hydration. Prefer the sternum or forearm in adults.
How to document skin turgor
Record the finding, the recoil time and the site. Naming the site matters, because interpretation depends on it.
Elastic (normal)
Skin turgor elastic; immediate recoil (<2 seconds) at the sternum.
Slightly decreased
Skin turgor slightly decreased; recoil approximately 2-3 seconds at the sternum.
Decreased (slow recoil)
Skin turgor decreased; delayed recoil approximately 3-4 seconds at the sternum.
Tenting (poor)
Skin turgor poor; tenting noted at the sternum with recoil >4 seconds.
When skin turgor is unreliable
Turgor is neither sensitive nor specific for dehydration on its own. These factors change how it should be read.
| Factor | Effect |
|---|---|
| Older age | Elastic recoil declines naturally, so turgor often appears reduced regardless of hydration. The single most common reason turgor misleads. |
| Obesity | Subcutaneous tissue makes the skin fold difficult to raise and interpret. |
| Oedema | Excess interstitial fluid can mask reduced turgor entirely. |
| Connective tissue disorders | Conditions such as Ehlers-Danlos increase skin extensibility; scleroderma reduces it. Both invalidate the usual interpretation. |
| Recent significant weight loss | Loose skin can mimic poor turgor without volume depletion. |
Common questions
- How many seconds is normal skin turgor?
- Normal skin turgor recoils immediately, in under 2 seconds. A recoil of roughly 2-3 seconds is borderline, 3-4 seconds is considered decreased, and skin that stays tented for more than 4 seconds is recorded as poor turgor.
- Where should you check skin turgor?
- Over the sternum or the inner forearm in adults, and over the abdomen or inner thigh in infants and young children. The back of the hand is widely taught but is the least reliable site, because skin there loses elasticity with age independently of hydration.
- What does skin tenting mean?
- Tenting describes skin that stays peaked after being pinched and released, rather than settling back. It indicates poor skin turgor and is classically associated with significant volume depletion, though it becomes less reliable in older adults.
- How do you document skin turgor?
- Record the finding, the recoil time and the site — for example: “Skin turgor elastic; immediate recoil (<2 seconds) at the sternum.” For an abnormal finding: “Skin turgor poor; tenting noted at the sternum with recoil >4 seconds.” Naming the site matters, because interpretation depends on it.
- Why is skin turgor unreliable in older adults?
- Skin loses elastic recoil as part of normal ageing, so an older adult can show reduced turgor while being adequately hydrated. In this group, turgor should never stand alone — assess mucous membranes, orthostatic vital signs, urine output and weight change alongside it.
- Is decreased skin turgor the same as dehydration?
- No. Decreased turgor is a sign that can accompany volume depletion, but it is neither sensitive nor specific on its own. Obesity, oedema, connective tissue disorders and age all affect it. Treat it as one input to a fuller assessment.