How to Treat Road Rash and Abrasions

Tips for Cyclists, Runners, and Other Road Athletes

Abrasions are common injuries among road athletes, typically caused by a fall or crash onto a hard surface. Cyclists will often refer to minor abrasions as "road rash," "friction burns," or "strawberries" in which only the outermost layer of skin, called the epidermis, is affected. While there may raw tissue and some minor bleeding, the injuries can often be treated sensibly with first aid.

By contrast, those that involve deeper layers of skin, called the dermis, are far more serious and may require medical treatment to stop the bleeding, suture the wound, and prevent infection.

When to Seek Treatment

There is often a fine line between an injury that you can treat on your own and those you should have tended to by a doctor. Oftentimes, in the midst of a race or training, we make the wrong judgment and try to "push through" the pain, only to find ourselves dealing with a serious infection later.

Generally speaking, you should seek medical attention if:

  • There is severe pain.
  • It hurts to move the affected body part.
  • There is a cut on the face large than a 1/4 inch.
  • There is a cut on the body larger than a 1/2 inch.
  • Bleeding is difficult to stop whatever the size of the wound.
  • A gaping wound remains open when relaxed.
  • You see fat globules in the exposed tissues.
  • You have a head injury, were unconscious, or are experiencing confusion, a lack of coordination, or memory loss.
  • There are other injuries, such as cracked ribs, which may be less apparent but more serious.

If in doubt, don't risk it. Stop what you are doing and either see a doctor or visit your nearest emergency care facility.

As a rule, any open wound should be treated within six hours of the injury.

Self-Treatment

Many road injuries are treatable at the site of the accident and, afterward, at home. If the wound is such that it doesn't require medical care, you can treat it as follows:

  1. Stop the bleeding. Road rash tends to ooze rather than actively bleed. Apply pressure with a bandage until the bleeding stops.
  2. Wash your hands with soap and water. Do this prior to treating the wound. This reduces the risk of infection.
  3. Rinse the wound. Place it under a stream of cold water to flush out debris. If needed, use a pair of tweezers to remove embedded grit. Take care not to leave any debris in the wound.
  4. Wash the wound with soap and water. Dab lightly to dry with a sterile gauze. Avoid hydrogen peroxide which doctors advise against for open wounds.
  5. Use a topical antibiotic. Options include bacitracin and neomycin available at drugstores. While triple antibiotic ointments like Neosporin may be used, they can cause allergy in some people.
  6. Bandage the wound. You can do so with sterile gauze and some dressing tape. Alternately, you can use a semipermeable dressing such as Tegaderm, Bioclusive, or Second Skin to cover the wound.
  7. Change the dressing daily. The goal is to keep the wound clean but slightly moist. This not only prevent infection, it improves tissue formation and reduces the risk of scarring.

    Unless your doctor tells you otherwise, you can manage pain with Tylenol (ibuprofen) or a nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) or Aleve (naproxen).

    Follow-Up Care

    After an abrasion, you should consider getting a tetanus shot if you are unsure when you had your last. Tetanus booster shots last for around 10 years. If you have had an injury where the epidermis is compromised, there is a chance that the spores of the tetanus bacteria (Clostridium tetani) may have entered the wound.

    Despite what some may tell you, stepping on a rusty nail is not the only way to get tetanus. The bacterium is readily found in the dust, soil, and even saliva.

    During healing, the damaged tissues will undergo repair from the lower layers up. As new skin cells develop, the outer edges of the wound may get hard and form scabs. Do not pick at them. Instead, continue applying the topical antibiotic for the first few days, and, as the oozing stops, switch to a petroleum jelly to help keep the skin soft.

    When the wound in amply closed, you can remove the bandage and use a normal skin moisturizer to aid in the healing. Take care not to soak the wound in the shower or bath until fully healed.

    Treating Infection

    If, at any time, you experience signs of an infection, see a doctor. Symptoms include:

    • Redness and swelling
    • Pain and tenderness
    • Warm or hot skin
    • Oozing pus or fluid

    Fever, chills, nausea, and generalized body aches may also accompany. Treatment should be sought immediately and will typically involve a short course of a broad-spectrum oral antibiotic. If left untreated, the infection can lead to a potentially serious condition known as cellulitis.

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    Article Sources
    • U.S. National Library of Medicine. Wounds and Injuries. Bethesda, Maryland; updated August 14, 2018.