Scrapes
Topic OverviewCauses and types of scrapesScrapes (abrasions) are skin wounds
that rub or tear off skin. Most scrapes are shallow and do not extend far into
the skin, but some may remove several layers of skin. Usually there is little
bleeding from a scrape, but it may ooze pinkish fluid. Most scrapes are minor,
so home treatment is usually all that is needed to care for the wound. Scrapes occur most often in warm weather or warm climates when the skin
on the arms and legs is more exposed. They are most commonly caused by
accidents or falls but can occur anytime the skin is rubbed against a hard
surface, such as the ground, a sidewalk, a carpet, an artificial playing
surface, or a road (road rash). School-age children ages 5 to 9 are most
affected. Scrapes can occur on any part of the body but usually
affect bony areas, such as the hands, forearms, elbows, knees, or shins.
Scrapes on the head or face may appear worse than they are and bleed a lot
because of the good blood supply to this area. Controlling the bleeding will
allow you to determine the seriousness of the injury. Scrapes are usually more
painful than cuts because scrapes tear a larger area of skin and expose more
nerve endings. How a scrape heals
depends on the depth, size, and location of the scrape. Occasionally the injury
that caused the scrape will also have caused a cut or several cuts that may
need to be treated by a doctor. For more information, see the topic
Cuts. What to do if you get a scrape?When you have a scrape: - Stop the bleeding with direct pressure to
the wound.
- Determine if other tissues, such as
blood vessels, nerves, tendons, ligaments, joints, bones, or internal organs,
have been injured.
- Determine if you need to be evaluated and treated by a
doctor.
- Clean the wound and remove any dirt or debris to
prevent infections (both bacterial skin infections and
tetanus, or lockjaw), decrease scarring, and prevent
"tattooing" of the skin. (If dirt or other debris is not removed from a scrape,
the new skin heals over it. The dirt can then be seen through the skin and
often looks like a tattoo.)
- Determine if you need a
tetanus shot.
Check your symptoms to decide if and when you
should see a doctor. Check Your SymptomsDo you have a scrape? Scrapes are wounds that rub or tear off the skin. How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Do you have a cut that is more than 1 in. (2.5 cm) across? Yes Cut larger than 1 in. (2.5 cm) across No Cut larger than 1 in. (2.5 cm) across Do you have a puncture wound? This is a wound caused by a sharp, pointed object going through the skin. Puncture wounds are deeper and narrower than cuts. How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Has the pain lasted for more than 8 hours? Yes Pain for more than 8 hours No Pain for more than 8 hours Is the pain getting worse? Do you think you may have a fever? Are there red streaks leading away from the area or pus draining from it? Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area? "Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps. Yes Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area No Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area Were you able to clean the wound well? You may not be able to clean the wound if it is deep, hurts too much, or has an object stuck in it. Yes Able to adequately clean wound No Unable to adequately clean wound Is there an object stuck in the wound, and you can't get it out? You may not be able to remove it because of where or how deep the wound is or because it causes severe pain. Is the object large or small? Large means things like a nail or piece of wood that is at least 2 in. (5.1 cm) long and anything bigger than that. Small means things like a pencil tip or a small splinter or sliver. Large Large embedded object Small Small embedded object A deep scrape may need stitches. If you need stitches, it's best to get them within 8 hours of the injury. Superficial Superficial wound Is the wound deep enough that you can see the bone, muscle, or tendon? Muscle looks dark and thick, and tendon and bone looks white and shiny. Yes Muscle, tendon, or bone is visible No Muscle, tendon, or bone is visible Is the wound on the face? Are you worried about scarring? Yes Worried about scarring How large is the scrape? Larger scrapes may need more care, like cleaning and bandaging. Larger than the palm of your hand Scrape is larger than palm At least 1 in. (2.5 cm) across but no larger than your palm Scrape is at least 1 in. (2.5 cm) across but no bigger than palm Less than 1 in. (2.5 cm) across Scrape is less than 1 in. (2.5 cm) across Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Some types of facial wounds are more likely to leave a scar than others. These include: - Jagged wounds on the face.
- Cuts on the eyelids.
- Cuts to the lips, especially if they cut through the edge of the lip.
Stitches or other treatment may help prevent scarring. It's best to get treated within 8 hours of the injury. With severe bleeding, any of these may
be true: - Blood is pumping from the wound.
- The
bleeding does not stop or slow down with pressure.
- Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may
be true: - The bleeding slows or stops with pressure but
starts again if you remove the pressure.
- The blood may soak through
a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be
true: - The bleeding stops on its own or with
pressure.
- The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
- A superficial scrape affects
just the top layer of skin.
- A deep scrape
goes below the top layer of skin.
- The wound may gape open.
- There may
be a cut in the scrape.
- The flesh may look very raw and ground up,
or there may be a chunk of tissue missing.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot. - For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:
- You haven't had a tetanus shot in the past 5
years.
- You don't know when your last shot was.
- For a clean wound, you may
need a shot if:
- You have not had a tetanus shot in the past 10
years.
- You don't know when your last shot was.
Symptoms of infection may
include: - Increased pain, swelling, warmth, or redness in or
around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
To clean a wound well: - Wash your hands first.
- Remove large
pieces of dirt or debris from the wound with cleaned tweezers. Do not push the
tweezers deeply into the wound.
- Hold the wound under cool running
water. If you have a sprayer in your sink, you can use it to help remove dirt
and other debris from the wound.
- Scrub gently with water, a mild
soap, and a washcloth.
- If some dirt or other debris is still in
the wound, clean it again.
- If the wound starts to bleed, put
direct, steady pressure on it.
If a chemical has caused a wound or burn, follow the instructions on the chemical's container or call Poison Control (1-800-222-1222) to find out what to do. Most chemicals should be rinsed off with lots of water, but with some chemicals, water may make the burn worse. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Puncture Wounds Cuts Home TreatmentMinor scrapes can be treated
effectively at home. Home treatment can prevent infection and promote healing.
If you do not have a high risk of infection, do not have other injuries, and
do not need a tetanus shot or an evaluation by a doctor, you can clean and bandage
a scrape at home. How a
scrape heals depends on the depth, size, and location
of the scrape. BleedingStop the bleeding with direct pressure to
the wound. Nonprescription products can be applied to the skin to help
stop mild bleeding of minor cuts, lacerations, or abrasions. Before you buy or
use a nonprescription product, be sure to read the label carefully and follow
the label's instructions when you apply the product. After you have
stopped the bleeding, check your symptoms to decide if and when
you should see a doctor. A scrape may continue to ooze small
amounts of blood for up to 24 hours and may ooze clear, yellowish, or
blood-tinged fluid for several days. Cleaning the woundClean the wound as soon as
possible to reduce the chance of infection, scarring, and "tattooing." (If dirt
or other debris is not removed from a scrape, the new skin will heal over it.
The dirt can then be seen through the skin and may look like a tattoo.) - Remove any splinters from the scrape
before you get the splinters wet.
- Use a large amount of water under moderate
pressure (faucet at least halfway open). Washing the wound will remove as much dirt, debris, and
bacteria as possible, which will reduce the risk of infection.
- If
you have a water sprayer in your kitchen sink, try using the sprayer to wash
the wound. This usually removes most of the dirt and other objects from the
wound. Avoid getting any spray from the wound into your eyes. It may be easier
to rinse a large, dirty scrape in the shower.
- Wash the wound for 5
minutes with large amounts of clean, running water. Some nonprescription products are available for wound
cleaning that numb the area so cleaning doesn't hurt as much. Be sure to read
the product label for correct use.
- Scrub gently with a washcloth.
Moderate scrubbing may be needed if the wound is very dirty. Scrubbing your
scrape will probably hurt and may increase bleeding, but it is necessary to
clean the wound thoroughly.
- Do not use rubbing alcohol, hydrogen
peroxide, iodine, or Mercurochrome, which can harm the tissue and slow
healing.
Stitches, staples, or skin adhesives (also called liquid stitches) Determine whether your wound needs to be treated by a
doctor. Scrapes usually do not need to be closed with stitches, staples, or skin adhesives, but sometimes you will have a deep cut along with a scrape. Consider applying a bandageMost scrapes heal well
and may not need a bandage. You may wish to protect the scrape from dirt or
irritation. It is important to clean the scrape thoroughly before bandaging it
to reduce the risk of infection occurring under the bandage.
Scrapes may heal with or without forming a
scab. - Select the bandage carefully. There are many
products available. Liquid skin bandages and moisture enhancing bandages are
available with other first aid products. Before you buy or use one, be sure to
read the label carefully and follow the label's instructions when you apply the
bandage.
- If you use a cloth-like bandage, apply a clean bandage
when your bandage gets wet or soiled to further help prevent infection. If a
bandage is stuck to a scab, soak it in warm water to soften the scab and make
the bandage easier to remove. If available, use a nonstick dressing. There are
many bandage products available. Be sure to read the product label for correct
use.
- Watch for
signs of infection. If you have an infection under a
bandage, a visit to your doctor may be needed.
- Apply a thin layer of petroleum jelly, such as Vaseline, lightly to the wound. It will keep the bandage from sticking to the wound.
Tetanus- Determine whether you need a
tetanus shot.
- You may have a localized
reaction to a tetanus shot. Symptoms include warmth, swelling, and redness at
the injection site. A mild fever may occur. Home
treatment can help reduce the discomfort.
Swelling and pain reliefElevate the injured area on pillows anytime you
are sitting or lying down. Try to keep the area at or above the level of your
heart to reduce swelling. Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
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Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow
these safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all
directions on the medicine bottle and box.
- Do not take more than
the recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: PreventionSince most scrapes are caused by accidents
or falls, it is hard to prevent them. Some general safety tips may reduce
your risk of injury. - Pay close attention to what you are
doing.
- Know how to use objects properly.
- Have good
lighting so you can see what you are doing.
- Prevent falls in your home by removing hazards that might cause a fall.
- Wear
gloves whenever possible to protect your hands.
- Wear other safety
gear, such as glasses or boots, as appropriate.
- Wear protective
gear, such as hand, wrist, elbow, or knee pads and helmets, during sports or
recreation activities.
- Store dangerous objects in secure places
away from children.
- Teach children about safety, and be a good role
model.
Be sure to have a tetanus shot every 10 years. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. Questions to prepare for your appointmentYou can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What are your main symptoms? How long have you
had your symptoms?
- How and when did the injury occur? Have you had
any injuries in the past to the same area? Do you have any continuing problems
because of the previous injury?
- Did other injuries occur at the
same time?
- What home treatment measures have you tried? Did they
help?
- What nonprescription medicines have you tried. Did they
help?
- What prescription and nonprescription medicine do you
take?
- Were drugs or alcohol involved in your
injury?
- When was your last
tetanus shot?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerH. Michael O'Connor, MD - Emergency Medicine Martin J. Gabica, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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