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Skin Injuries

“I burned my hand pretty bad this year cooking, I dropped the potholder right before grabbing the oven rack! I put cold water and ice on it. It kept blistering and burning anyway. I ended up going to the Health Center. The nurse gave me something to put on the burn. It helped a lot.”

Aimee S., Franklin Pierce College

Skin injuries can be as minor as a simple scrape or as major as a 3rd degree burn. The quicker you treat an injury, the faster the healing occurs.

Illustration of skin layers showing a cut, a puncture and a scrape.

Signs, Symptoms & Causes

The signs, symptoms, and causes of skin injuries vary depending on the type of injury.

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Cuts – Cuts slice the skin open. This causes bleeding and pain. Cuts need to be cleaned, closed, and covered with a bandage so they don’t get infected. Stitches may be needed for cuts that are deep, are longer than an inch, or are in an area of the body that bends, such as the elbow or knee. When appropriate, a topical tissue adhesive may be used instead of stitches to “super glue” the area.

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Scrapes – Scrapes are less serious than cuts, but more painful because more sensitive nerve endings are involved.

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Punctures – Punctures are stab wounds. They can be shallow ones, such as from a splinter or deep ones, such as from stepping on a nail. Puncture wounds hurt and bleed.

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Bruises – Bruises are caused by broken blood vessels that bleed into the tissue under the skin. Common causes are falls or being hit by some force. A bruise causes black and blue or red skin. As it heals, the skin turns yellowish-green. Pain or tenderness and possible swelling also occurs.

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Burns – Burns can be caused from dry heat (fire), moist heat (steam, hot liquids), electricity, chemicals, and the sun (sunburn).

  • With a 1st degree burn, your skin will be red, swollen, painful, and sensitive to touch. This usually heals in 1 to 2 days.

  • With a 2nd degree burn, the outer and lower skin layers are affected. Your skin will be painful, swollen, red, blistered, and/or be weepy/watery.

  • With a 3rd degree burn, your skin will be black and white and charred. You will have less pain because the nerves have been destroyed.

Illustrations of skin layers showing a 1st degree, 2nd degree and a 3rd degree burn.

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Animal and Human Bites – The most common of these bites in the United States are from dogs, cats, and humans. Common symptoms are pain and bleeding. Wounds from animal and human bites can easily get infected. Rabies can result if the bite was from a warm-blooded animal who was infected with the rabies virus.

 

Treatment

Treatment varies depending on the cause and how severe the injury is. Simple wounds can be treated with self-care. An antibiotic is prescribed for an infection.

Questions to Ask

Do the following signs of shock occur with an injury?

  • Pale or blue-colored lips, skin, and/or fingernails

  • Cool and moist skin

  • Weak, but fast pulse

  • Rapid, shallow breathing

  • Weakness, trembling, restlessness, confusion

  • Difficulty standing or inability to stand due to dizziness

  • Loss of consciousness

Yes. Get Immediate Care.

No.

 
Does an animal bite cause severe bleeding or severely mangled skin or has a human bite punctured the skin? Yes. Get Immediate Care.

No.

 

Do any of the following describe the injury?

  • There is severe bleeding or blood spurts from the wound. (Apply direct pressure on the wound site while seeking care.)

  • Bleeding continues after pressure has been applied to the wound for more than 10 minutes or bleeding continues after 20 minutes of applied pressure to what seems to be a minor cut.

  • A deep cut or puncture appears to go down to the muscle or bone and/or is located on the scalp or face.

  • A cut is longer than an inch and is located on an area of the body that bends, such as the elbow, knee, or finger.

  • The skin on the edges of the cut hangs open.

  • A burn (3rd degree) results in charred black and white skin, little or no pain, and exposure of tissue under the skin.

  • A burn (2nd degree) causes painful, swollen, and red skin with blisters that cover more than 10 square inches of skin area or is on the face, hands, feet, genitals, or any joint.

Yes. Get Immediate Care.

No.

 
Was the bite from a pet that has not been immunized against rabies or from an animal known to carry rabies in your area? (Check with your local health department, hospital, or emergency department if you are not sure.) Yes. Get Immediate Care.

No.

 

A day or two after the skin injury, do one or more of these signs of an infection occur?

  • Fever

  • Redness or red streaks that extend from the wound site

  • Swelling, increased pain, or tenderness at and around the wound site

  • Increased pain

  • General ill feeling

Yes. See Provider.

No.

 
Was the cut or puncture from dirty or contaminated objects, such as rusty nails or objects in the soil or did a puncture go through a shoe, especially a rubber-soled one? {Note: You will need a tetanus shot if you have not had one within 10 years.} Yes. See Provider.

No.

 

With a skin injury, are any of the following conditions present?

  • With a second-degree burn, more than the outer skin layer has been affected; more than 3 inches in diameter of the skin has been burned; or blisters have formed.

  • The burn does not improve after 2 days.

  • Bruises appear often and easily; take longer than 2 weeks to go away; or over a year’s time, more than 2 or 3 bruises appear for no apparent reason.

  • Vision problems occur with a bruise near the eye.

Yes. See Provider.

 

Self-Care

For Human Bites Before Immediate Care:

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Wash the wound area with soap and water for at least 5 minutes, but don’t scrub hard.

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Rinse the wound area with running water or with an antiseptic solution, such as Betadine.

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Cover the wound area with sterile gauze, taping only the ends in place.

{Note: All human bites need immediate care.}

For Minor Cuts and Scrapes:

bullet Clean in and around the wound thoroughly with soap and water.
bullet Press on the cut to stop the bleeding for up to 10 minutes. Use sterile gauze or a clean cloth. Don’t use dry gauze. It can stick to the wound. Don’t use a bandage to apply pressure.
bullet If still bleeding, press on the cut again. Get medical help if it still bleeds after applying pressure for 10 more minutes. Lift the part of the body with the cut higher than the heart, if practical.
bullet After the bleeding has stopped, and when it is clean and dry, apply a first aid cream.
bullet Put one or more bandages on the cut. The edges of the cut skin should touch, but not overlap. Use a butterfly bandage if you have one.
bullet For scrapes, make a bandage from gauze and first aid tape. Leave it on for 24 hours. Change the bandage at least every day or two. Keep the bandage clean and dry.

For Punctures that Cause Minor Bleeding:

bullet Let the wound bleed to cleanse itself.
bullet Remove the object that caused the puncture. Use clean, sterile tweezers. To sterilize them, hold a lit match or flame to the ends of the tweezers. Let them cool and wipe the ends with sterile gauze. {Note: Don’t pull anything out of a puncture wound if blood gushes from it or it has been bleeding badly. Get emergency care!}
bullet Clean the wound area with warm, soapy water 2 to 4 times a day for several days. After cleaning it, dry the wound area well and apply an antibacterial cream.

For Bruises:

bullet Apply a cold pack to the bruised area as soon as possible and within 15 minutes of the injury. Keep the cold pack on for 10 minutes at a time. Apply pressure to the cold pack. Take it off for 30 to 60 minutes. Repeat several times for 2 days.
bullet Rest the bruised area and raise it above the level of the heart, if practical.
bullet Two days after the injury, use warm compresses. Do this for 20 minutes at a time.
bullet Do not bandage a bruise.
bullet Try to avoid hitting the bruised area again.

For First-Degree Burns:

bullet Immerse the affected area in cold (not ice) water until the pain subsides. If the affected area is dirty, gently wash it with soapy water first.
bullet Keep the area uncovered and elevated, if possible. Apply a dry dressing, if necessary, to protect the area from dirt, etc.
bullet Do not use butter or ointments, such as Vaseline. You can, though, apply aloe vera 3 to 4 times a day.
bullet Don’t use local anesthetic sprays and creams.

For Second-Degree Burns (that are not extensive and are less than 3" in diameter):

bullet Immerse the affected area in cold (not ice) water until the pain subsides.
bullet Dip clean cloths in cold water, wring them out, and apply them to the burned area for as long as an hour. Blot the area dry. Do not rub.
bullet Don’t use antiseptic sprays or creams.
bullet Do not break any blisters. If the blisters break on their own, apply an antibacterial spray or ointment and keep the area wrapped with a sterile dressing.
bullet Once dried, dress the area with a single layer of loose gauze that does not stick to the skin. Keep it in place with bandage tape that is placed well away from the burned area.
bullet Change the dressing the next day and every 2 days after that.
bullet Prop the burned area higher than the rest of the body, if possible.

For Animal Bites:

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Wash the bite with soap and warm water for 5 minutes. If the bite is deep, flush with water for 10 minutes. Dry the wound with a clean towel. Then get immediate care.

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If the wound is swollen, apply ice wrapped in a towel for 10 minutes.

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If someone’s pet bit you and you know the owner, find out if the pet has been vaccinated for rabies.

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Report the incident to the animal control or local health department.

ComputerFor Information, Contact:

MEDLINEplus® Health Information
www.medlineplus.gov
Search for “First Aid / Emergencies.”

{Note: For all bites, cuts, scrapes, punctures, and burns, be sure your tetanus shot is up-to-date. Call your health care provider or your school’s health service to check.}