Causes and types of scrapes
Scrapes (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 Symptoms
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.
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.
Seek Care Now
Based 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
- 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.
Seek Care Today
Based 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.
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.
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.
- 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.
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.
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.
Try Home Treatment
You 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.
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.
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.
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.
Minor 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.
Stop 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 wound
Clean 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 and soap. Mild dishwashing soap, such as Ivory, works well. 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 bandage
Most 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.
- An antibiotic ointment, such as polymyxin B sulfate (for example, Polysporin) or bacitracin, will keep the bandage from sticking to the wound. Apply the ointment lightly to the wound. Antibiotic ointments have not been shown to improve healing. Be sure to read the product label about skin sensitivity. If you have a skin rash or itching under the bandage, stop using the ointment. The rash may be caused by an allergic reaction to the ointment.
- 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, bruising, and pain relief
An ice or cold pack may help reduce swelling and bruising. Never apply ice directly to a wound or the skin. This could cause tissue damage.
Elevate the injured area on pillows while applying ice and anytime you are sitting or lying down. Try to keep the area at or above the level of your heart to reduce swelling.
|Try a nonprescription medicine to help treat your fever or pain:|
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.
|Be sure to follow these safety tips when you use a nonprescription medicine:|
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Signs of infection develop.
- Symptoms become more severe or more frequent.
Since 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 Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Questions to prepare for your appointment
You 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?
|William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|H. Michael O'Connor, MD - Emergency Medicine|
|Last Revised||November 7, 2013|
Last Revised: November 7, 2013
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