What periwound skin is and why it matters

“Periwound” means the skin right around a wound, roughly the area under and beside the dressing. Periwound skin care is everything done to keep that skin intact: controlling drainage, choosing dressings and tapes with care and catching irritation early.

A wound closes from its edges inward. When the surrounding skin is soggy, raw or cracked, new skin has a harder time growing across, the wound can get larger, dressings stop sticking and changes hurt more. Your treating clinician checks this skin at each visit and decides which products to use. Your part is to follow the plan and notice changes between visits.

Common problems with the skin around a wound

  • Too much moisture (maceration). Skin soaked by drainage looks pale or white, soft and wrinkled, like fingers after a long bath.
  • Dryness. Flaky, scaly or cracked skin, common on the lower legs and in older adults.
  • Tape and adhesive injury. Redness in the shape of the dressing border, blisters, or skin that lifts off with the tape.
  • Irritation or allergy. An itchy, red or bumpy rash where a product touched the skin.
  • Callus. Thick, hard skin around a wound on the foot, usually from pressure.
  • Possible infection. Redness or discoloration that spreads, with warmth, swelling or growing pain.

On darker skin, an inflamed area may look darker, purple or gray instead of red, so go by warmth, swelling, firmness and tenderness as well.

How drainage damages healthy skin

A wound heals best with a moist surface, but the skin around it needs to stay dry. When a dressing cannot hold the fluid a wound produces, the fluid spreads onto healthy skin and sits there, softening and irritating the outer layer.

The usual reasons are a dressing that is not absorbent enough, a dressing left on past its change time, or a wound that has started to drain more. Heavier drainage can itself point to swelling or infection, so it is always worth reporting. Our guides to what wound drainage means and types of wound dressings give more background.

Sweat, urine and stool can harm skin in the same way, as our page on moisture-associated skin damage explains.

What the treating clinician may change

The clinician matches the plan to the problem. They may:

  • Switch to a dressing that absorbs more, or less
  • Adjust how often the dressing is changed
  • Add a barrier product that shields skin from drainage
  • Use a gentler adhesive, or secure the dressing without tape
  • Recommend a moisturizer for dry skin away from the wound
  • Address the cause, such as leg swelling or pressure

Gateway arranges the supplies the clinician orders and passes updated instructions to the others involved in your care. Our page on dressing selection and changes explains how dressings are matched to a wound.

What you can do between visits

  1. Keep to the schedule. Have the dressing changed as often as ordered. Do not stretch the time to save supplies.
  2. Report leaks early. Tell the clinician about a dressing that soaks through, lifts or leaks before the next change.
  3. Go slowly with tape. Remove adhesive gently, the way you were shown, and say so if removal hurts or leaves marks.
  4. Ask before adding products. Keep lotions, creams, powders, oils and home remedies away from the wound unless the clinician approved them.
  5. Do not scratch or pick. Leave flaking skin and scabs at the edge alone.

Skin on swollen legs is fragile, so with a venous leg ulcer, wearing compression as ordered protects skin along with the wound. Regular skin checks by a primary care clinician can catch dry, thin or damaged skin elsewhere on the body.

Changes to report to your clinician

Call the treating clinician’s office if you see:

  • White, soggy or wrinkled skin at the wound edge
  • New open spots, blisters or skin that peels away with the tape
  • A rash, bumps or strong itching under the dressing
  • Redness or discoloration that is spreading, or skin that feels hot
  • More drainage, a new odor, more pain, fever or chills

Our guide to the signs of wound infection explains more. Call 911 for trouble breathing, sudden confusion or bleeding that does not stop with firm pressure.

If you live in Greater St. Louis or the Metro East and do not have a wound care clinician, send the request care form or call 314-325-0126.

Common questions

What does macerated skin look like?

Macerated skin has taken in too much moisture. It looks lighter than the skin around it, often white or gray, and feels soft, swollen and wrinkled. It may be sore, and it breaks down easily when rubbed or when tape is pulled off. It usually means the dressing is not keeping up with the drainage.

Can I put lotion on the skin near my wound?

Ask your clinician first. Moisturizer often helps dry skin on the rest of the leg or arm, but it should stay out of the wound and usually away from the area where the dressing has to stick. The clinician can tell you which product to use and how close to the wound it can go.

Should I let the wound air out to dry the skin around it?

Not unless your clinician tells you to. Leaving a wound uncovered dries out the wound bed, which generally works against healing, and exposes it to germs and bumps. Soggy skin at the edge is usually handled with a more absorbent dressing, more frequent changes or a skin barrier, and those choices belong to the clinician.

Does thick, hard skin around a foot wound need attention?

Yes, mention it. Callus around a foot wound usually signals ongoing pressure or rubbing at that spot, and it can hide what is happening underneath. Do not trim, file or soak it yourself, and avoid store-bought callus removers. The treating clinician or a podiatrist decides how to manage it.

Related pages

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Updated October 2026