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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 happen most often in warm weather or warm climates, when the skin on the arms and legs is more exposed. They are most often caused by accidents or falls. But they 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 5 to 9 years old are most affected.
Scrapes can happen on any part of the body, but they usually affect bony areas, such as the hands, forearms, elbows, knees, or shins. Scrapes on the head or face may look worse than they are and may bleed a lot because of the good blood supply to these areas. Controlling the bleeding will help you to see how serious the injury is. Scrapes are usually more painful than cuts. That's because scrapes tear a larger area of skin and expose more nerve endings.
How a scrape heals depends on how deep it is, how large it is, and where it is on your body. Sometimes the injury that caused the scrape also causes one or more cuts that may need to be treated by a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
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, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or 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 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.
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 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 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 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.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
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.
Minor scrapes can be treated at home. Home treatment can prevent infection and promote healing. How a scrape heals depends on how deep it is, how large it is, and where it is on your body.
Try these tips for treating a scrape.
Stop the bleeding.
Apply direct pressure to the wound.
Nonprescription products can be applied to the skin to help stop mild bleeding of minor cuts, lacerations, or scrapes. Before you buy or use these products, be sure to read the label carefully. Follow the label's instructions when you apply the product.
A scrape may continue to ooze small amounts of blood for up to 24 hours. It may ooze clear, yellowish, or blood-tinged fluid for several days.
- Clean the wound as soon as you can.
This lowers 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. It reduces 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 for wound cleaning can numb the area so that cleaning it 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 make it bleed more. But scrubbing is needed so you can clean the wound thoroughly.
- Don't use rubbing alcohol, hydrogen peroxide, iodine, or Mercurochrome. They can harm the tissue and slow healing.
- Check to see if other tissues have been injured.
These tissues include blood vessels, nerves, tendons, ligaments, joints, bones, and internal organs.
- Apply a bandage, if needed.
Most scrapes heal well and may not need a bandage. You may need to protect the scrape from dirt or irritation. Be sure to clean the scrape thoroughly before bandaging it. Cleaning reduces the chance that you'll get an infection under the bandage. Scrapes may heal with or without forming a scab.
If you use a bandage:
- Choose 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. 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. It will help prevent infection. If a bandage is stuck to a scab, soak it in warm water. Soaking will 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, you may need treatment from a doctor.
- Apply a thin layer of petroleum jelly, such as Vaseline, lightly to the wound. It will keep the bandage from sticking to the wound.
- Treat pain and swelling.
Prop up the injured area on a pillow anytime you sit or lie down. Try to keep the area at or above the level of your heart to reduce swelling.
If you are concerned that the injury is more serious, you may need to be checked by a doctor to see if you need stitches or a tetanus shot.
Need for a tetanus shot
To decide if you need a tetanus shot after a wound, first decide if the object that caused the wound was dirty or clean. An object is dirty if it has dirt, soil, spit, or feces on it. A clean object does not have dirt, soil, spit, or feces on it.
You will need a tetanus shot if:
- Your wound was caused by something that was clean and your last tetanus shot was longer than 10 years ago.
- Your wound was caused by something that was dirty and your last tetanus shot was longer than 5 years ago.
- You are not sure if your wound was caused by something clean or dirty and your last tetanus shot was longer than 5 years ago.
- You are not sure when you had your last tetanus shot.
- You did not get the first series of tetanus shots (primary vaccination series).
If you need a tetanus shot, call your doctor to arrange for a shot.
Some people may need tetanus immunoglobulin (IG) for a wound that is at high risk for developing tetanus. The immunoglobulin is usually only needed if you have not (or do not know if you have) completed the tetanus primary vaccination series.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- New or worse signs of infection, such as redness, warmth, swelling, pus, or a fever.
- New loss of function near the wound.
- Decreased blood flow, such as cool, pale skin near the wound.
- Pain gets worse.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: July 1, 2021
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
H. Michael O'Connor MD - Emergency Medicine
Martin J. Gabica MD - Family Medicine