Skin Abrasion and Road Rash Treatment

Caring for Cuts and Scrapes

Great Victorian Bike Ride - Australia
Bicycle Network

Abrasions and road rash are very common sports injuries that are usually caused by a fall on a hard surface. As the athlete falls or slides on the ground, friction causes layers of skin to rub off. The skin is composed of an outer layer (the epidermis) which provides protection, and a deep inner layer (the dermis), which provides the firmness and flexibility of the skin.

Abrasions typically refer to an injury that removes these layers of skin.

Cyclists often refer to abrasions from crashes as "road rash." While a bike crash has the potential to cause a painful and severe abrasion, most abrasions are shallow scrapes that do not extend into the dermis and don't cause a great deal of bleeding. There is often little or no blood loss from an abrasion, but there can be a great deal of pain because of the many nerve endings that are exposed.​

Treatment for Abrasions and Road Rash

Conventional treatment of abrasions and road rash includes treating the area by cleaning the wound with mild soap and water or a mild antiseptic wash and then covering the area with an antibiotic ointment and a dry dressing. 

While a severe abrasion should be seen and cleaned by a physician, you can do some things to promote healing. First, because abrasions can easily become infected, you should clean the area thoroughly and remove any dirt and debris.

Ideally, you want to irrigate the area with a nontoxic surfactant such as 0.9 sodium chloride or Shur-Clens with a bit of pressure (use a syringe if possible). The area must be completely clean. If necessary, use a clean gauze to gently scrub the area. Do not scrub vigorously, as this can cause more tissue damage.

After the area is cleaned, use a semipermeable dressing such as Tegaderm, Bioclusive, or Second Skin to cover the wound, and attach the dressing to dry, healthy skin with adhesive tape. The dressing should be changed every few days. Keep the wound moist until it has healed. A moist environment promotes healing, improves tissue formation and protects the area from infection and scarring.

Products for Treating Abrasions and Road Rash

You may want to keep these with your first aid supplies if you enjoy an activity such as cycling or skateboarding where you may get abrasions:

Brave Soldier Antiseptic Healing Ointment is a unique blend of natural botanicals (tea tree oil, aloe, jojoba oil, vitamin E, and comfrey) that helps wounds heal quickly and reduces the likelihood of scarring. It includes 4 percent Lidocaine, which reduces the pain—road rash certainly is painful. This ointment is becoming a favorite healing ointment of triathletes and cyclists and works well on road rash, minor cuts, burns, blisters, and even saddle sores.

Deep Lacerations

While cleaning the skin abrasion, you should look for any deep cuts that may require stitches to heal properly.

Cuts that continue to bleed after 15 minutes of direct pressure, or cuts that extend deep into the skin and have edges that pull apart, may require stitches. If you are unsure if you need stitches, you should see a physician immediately.

Tetanus Shot

After an abrasion, you should get a tetanus shot it you are uncertain when you had your last one or if your last booster was more than 10 years ago. Tetanus is an acute infectious disease in which the voluntary muscles go into spasm. Spores of the bacteria that produce tetanus toxin are naturally present in the environment, so any dirt or debris in torn flesh like an abrasion carries the risk of developing tetanus.

Healing

After an abrasion, the layers of damaged skin will heal from the deeper layers to the surface layers and from the outer edges to the center. As healing begins, the area of the abrasion may look pink and raw, but in time, the wound will form new skin that is pink and smooth. Once it is healed, stop using any antibiotic applications and instead use regular moisturizing cream to keep the skin soft.

When to See the Doctor

See your doctor if the you note signs of an infection during the healing process, such as increasing redness, swelling, discharge of pus, or fever. This can indicate a wound infection that may need oral antibiotics.

Prevention

Prevention of abrasions is possible by wearing protective pads and covering any exposed skin with a layer of clothing. You can't always predict when you will suffer an abrasion, but sports like cycling and skateboarding make it much more likely. If you play sports where road rash is a possibility, it's wise to have the necessary first aid supplies available in an emergency.

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