Cuts, Scrapes, and Scratches

What is a cut, scrape, or scratch?

Scrapes and scratches are areas of damage usually to just the upper layers of skin. They may go into the deeper layers of skin and they may bleed, but they don't gape open to expose the fatty tissue beneath the skin.

Cuts, or lacerations, are openings into or through the skin. Cuts may go only through the skin or they may go into the deeper fatty or muscle tissues.

What is the cause?

Scrapes and scratches happen when something harder than your skin comes into contact with it--for example, when you fall onto the sidewalk or when a nail or pet scratches you.

Cuts can occur from a variety of things. Most often they are caused by something sharp like glass or sharp metal that slices into your skin. Sometimes things that are not sharp can hit your skin with such force that the skin tears.

What are the symptoms?

The symptoms are:

• pain
• redness
• sometimes bleeding

How is it diagnosed?

Your healthcare provider will ask about what happened and examine you.

How is it treated?

The treatment of a cut depends on the depth of the cut. Shallow cuts that go just into the upper skin can be treated at home just as you would a scrape or scratch (see below). Deeper cuts may need to be closed with skin glue, stitches, or staples. There are no hard and fast rules about this because the treatment depends in part on where the cut is. For example, you may want a cut on your face to be closed carefully to lessen scarring. If it were on your foot you might not care so much about scarring. It also depends on how long and deep the cut is and how it happened. For example, very dirty wounds like animal bites are generally not closed because they are more likely to get infected.

When you have a scrape, scratch, or minor cut:

• Wash your hands thoroughly with soap and warm water for at least 15 seconds before you touch the area.
• Clean the wound as completely as possible with mild soap and warm water. Remove any bits of dirt, small pieces of rock, or other debris that you can easily see, but do not probe in the wound.
• Put pressure on the wound with a bandage or clean cloth until bleeding stops.
• When the bleeding has stopped, put an antibiotic ointment on the wound and cover it with a bandage.
• Keep the wound and the area around it clean and dry.
• If the wound is dirty or involved rusty metal and it has been more than 5 years since your last tetanus booster shot, or if you do not know when your last booster was, get another tetanus shot within 3 days of getting hurt. Try to get the shot the same day as the injury if possible. If it is not possible to get the shot within 3 days of the injury, get it as soon as you can.

Call or see your healthcare provider if:

• The wound keeps bleeding after 10 minutes of direct pressure, or the blood comes in spurts.
• A cut is gaping, deep, jagged, or at least a half inch long.
• A cut is over a joint or you can see bone.
• You have a cut on your face.
• A wound cannot be cleaned, is very dirty, or has something in it.
• You have a puncture wound, especially if you cannot tell how deep it is.
• You think you might have damaged a nerve or tendon.
• You have a scrape that covers a large area, for example, larger than 4 by 4 inches.
• After the injury you can’t move the part that was hurt (for example, you can’t bend or lift the tip of your finger) or you have lost feeling in the area that was hurt.
• It has been more than 5 years since your last tetanus shot.
• You might have been exposed to rabies.
• You have any question about whether a wound needs to be treated,

How can I take care of myself?

Clean the wound with warm water and mild soap 2 times every day. Pat it dry with a clean towel. When you are cleaning the wound, look for signs of infection such as increased swelling, redness, any drainage (like pus), or red streaks going away from the wound towards your heart.

Change the bandage daily, keeping the wound covered until it heals. If your bandage becomes wet or dirty, put a clean one on as soon as you can. If the bandage sticks when you try to take it off, use a clean washcloth soaked in warm water to help loosen the bandage edges.

Take acetaminophen or ibuprofen for the pain. Don't take aspirin if your cut, scratch, or scrape is bleeding a lot. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

If you had stitches, your healthcare provider will tell you how to care for your wound and when you need to come back to the office for removal of the stitches or staples. Depending on where the wound is, it will take about 5 to 14 days to heal.

If you have a cut that was glued shut, you can just wait for the glue to wear away.

Call your healthcare provider right away if:

• You start to have any signs or symptoms of infection. These include:
  • Your skin is redder or more painful.
  • You have red streaks from the wound going toward your heart.
  • The wound area is very warm to touch.
  • You have pus or other fluid coming from the wound area.
  • You have a fever higher than 101.5° F (38.6° C).
  • You have headache, chills, nausea, vomiting, or muscle aches.
• The wound seems to be opening up or you notice drainage.
• The wound bleeds for more than 10 minutes.
• The stitches or staples are loose.
• The adhesive film is loosening before it is supposed to.
• You have any symptoms that worry you.

Call your healthcare provider during office hours if a scrape or scratch hasn't healed after 2 weeks.