Skin Injuries

Blisters
Bruise
Burns
Cuts and Scrapes
Foreign Object in the Skin
Puncture Wounds

Blisters

What is it?

A bubble on the skin filled with serum caused by friction, burning, or other damage.

Plan of Action:

If a blister isn't too painful, try to keep it intact. Unbroken skin over a blister may provide a natural barrier to bacteria and decreases the risk of infection. Cover it with a bandage or moleskin. Cut a piece of moleskin into a doughnut shape and place the pad so that it encircles and protects the blister. Then cover the blister and moleskin with gauze.

To relieve blister-related pain, drain the fluid while leaving the overlying skin intact. Here's how:

Wash your hands and the blister with soap and warm water.
Swab the blister with iodine.
Clean a sharp needle with rubbing alcohol.
Use the needle to prick the blister in several spots near the edge. Let the fluid drain, but leave the overlying skin in place.
Apply an ointment such as petroleum jelly to the blister and cover it with a nonstick gauze bandage. If a rash appears, stop using the ointment.
Follow-up care. Check the area every day for infection. After several days, use a tweezers and scissors sterilized with rubbing alcohol to cut away the dead skin. Apply more ointment and a bandage.

Prevention:

To prevent friction blisters on your feet, wear shoes that fit well. It also helps to use moisture-wicking socks. Try the various socks, shoes and insoles that are designed specifically to help reduce blistering. You might also try attaching moleskin to the inside of your shoes where it might rub. Or you can dust the inside of your socks with foot powder. Gloves help prevent blisters on your hands.

Bruise

What is it?

A bruise forms when blood vessels under the skin break. The trapped blood creates a bruise that's black, purple or blue then changes color as it heals.

Plan of Action:

Elevate the bruised area above heart level, if possible.
Apply an ice pack wrapped in a thin towel. Leave it in place for 20 minutes. Repeat several times for a day or two after the injury. This helps to reduce the swelling and pain.
If the bruised area is swelling, put an elastic bandage around it, but not too tight

If the skin isn't broken, you don't need to bandage a bruise. Consider taking a nonprescription pain reliever if needed.

Consult your health care provider if you:

Have very painful swelling in the bruised area
Suspect a bruise has been caused by child abuse, domestic violence or elder abuse
Are still experiencing pain three days after a seemingly minor injury
Have frequent, large or painful bruises
Have bruises that begin suddenly or seem to develop for no reason
Have a personal or family history of easy bruising or bleeding
Notice a lump form over the bruise, which may be a sign of pooling blood, also called a hematoma
Have unusual bleeding, such as from the nose or gums

Burns

What is it?

Tissue damage from hot liquids, the sun, flames, chemicals, electricity, steam and other causes.

Plan of Action:

Minor Burns

Cool the burn. Hold the area under cool (not cold) running water for about 10 minutes. If the burn is on the face, apply a cool, wet cloth until the pain eases. For a mouth burn from hot food or drink, put a piece of ice in the mouth for a few minutes.
Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.
Don't break blisters. Blisters help protect against infection. If a blister does break, gently clean the area with water and apply an antibiotic ointment.
Apply lotion. After the burn is cooled, apply a lotion, such as one with aloe vera or cocoa butter. This helps prevent drying and provides relief.
Bandage the burn. Cover the burn with a clean bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
If needed, take a nonprescription pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).

For major burns until emergency help arrives:

Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with the source of the burn. For electrical burns, make sure the power source is off before you approach the burned person. Don't try to remove clothing stuck in the burn.
Make certain that the person burned is breathing. If needed, begin rescue breathing if you know how.
Remove jewelry, belts and other tight items, especially from the burned area and the neck. Burned areas swell quickly.
Cover the burn. Loosely cover the area with gauze or a clean cloth.
Raise the burned area. Lift the wound above heart level if possible.
Watch for signs of shock. Signs and symptoms include cool, clammy skin, weak pulse and shallow breathing.

When to seek emergency care:

Call 911 or seek immediate care for major burns, which:

Are deep, involving all layers of the skin
Cause the skin to be dry and leathery
May appear charred or have patches of white, brown or black
Are larger than 3 inches (about 8 centimeters) in diameter
Cover the hands, feet, face, groin, buttocks or a major joint, or encircles an arm or leg
Are accompanied by smoke inhalation
Begin swelling very quickly

Electrical burns, including those caused by lightning, and major chemical burns need emergency medical care. A minor burn might need emergency care if it affects the eyes, mouth, hands or genital areas. Babies and older adults might need emergency care for minor burns as well.

Cuts and Scrapes

What is it?

A minor skin wound that may or may not draw blood.

Plan of Action:

1. Wash your hands. This helps avoid infection.

2. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If needed, apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding stops.

3. Clean the wound. Rinse the wound with water. Keeping the wound under running tap water will reduce the risk of infection. Wash around the wound with soap. But don't get soap in the wound. And don't use hydrogen peroxide or iodine, which can be irritating. Remove any dirt or debris with a tweezers cleaned with alcohol. See a doctor if you can't remove all debris.

4. Apply an antibiotic or petroleum jelly. Apply a thin layer of an antibiotic ointment or petroleum jelly to keep the surface moist and help prevent scarring. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.

5. Cover the wound. Apply a bandage, rolled gauze or gauze held in place with paper tape. Covering the wound keeps it clean. If the injury is just a minor scrape or scratch, leave it uncovered.

6. Change the dressing. Do this at least once a day or whenever the bandage becomes wet or dirty.

7. Get a tetanus shot. Get a tetanus shot if you haven't had one in the past five years and the wound is deep or dirty.

8. Watch for signs of infection. See a doctor if you see signs of infection on the skin or near the wound, such as redness, increasing pain, drainage, warmth or swelling.

Foreign Object in the Skin

What is it?

An object stuck under the skin such as wood splinters, thorns, slivers of metal or glass, and gravel.

Plan of Action:

Wash your hands and clean the area well with soap and water.
Use tweezers cleaned with rubbing alcohol to remove the object. Use a magnifying glass to help you see better.
If the object is under the surface of the skin, sterilize a clean, sharp needle by wiping it with rubbing alcohol. Use the needle to gently break the skin over the object and lift up the tip of the object.
Use a tweezers to grab the end of the object and remove it.
Wash the area again and pat dry. Apply petroleum jelly or an antibiotic ointment.

When to Seek Medical Help:

For a foreign object that seems to be more deeply embedded in the skin or muscle.

Don't try to remove the object. Doing so could cause further harm.
Bandage the wound. First put a piece of gauze over the object. Then, if it helps, put clean padding around the object before binding the wound securely with a bandage or a piece of clean cloth. Take care not to press too hard on the object.

In addition, seek medical help if:

The object is hard to see (as with clear glass) or doesn't come out easily (as with a fishhook).
The injury involves an eye or is close to an eye.
The wound is deep or dirty and the injured person's last tetanus vaccination was more than five years ago. The doctor may recommend a booster.

Puncture Wounds

What is it?

A wound made by a pointed object such as a nail. knife, or sharp tooth.

Plan of Action:

1. Wash your hands. This helps prevent infection.

2. Stop the bleeding. Apply gentle pressure with a clean bandage or cloth.

3. Clean the wound. Rinse the wound with clear water for 5 to 10 minutes. If dirt or debris remains in the wound, use a washcloth to gently scrub it off. See a doctor if you can't remove all of the dirt or debris.

4. Apply an antibiotic. Apply a thin layer of an antibiotic cream or ointment (Neosporin, Polysporin). For the first two days, rewash the area and reapply the antibiotic when you change the dressing.

5. Cover the wound. Bandages help keep the wound clean.

6. Change the dressing. Do this daily or whenever the bandage becomes wet or dirty.

7. Watch for signs of infection. See a doctor if the wound isn't healing or you notice any increasing pain, pus, swelling or fever. On light skin, spreading redness is a sign of infection. On dark skin, redness may not be apparent, or the infection's streaks may look purplish-gray or darker than your normal skin.

Seek prompt medical care:

Keeps bleeding after a few minutes of direct pressure
Is the result of an animal or human bite
Is deep and dirty
Is caused by a metal object
Is deep and to the head, neck, scrotum, chest, or abdomen
Is over a joint and could be deep

If the injured person hasn't had a tetanus shot in the past five years and the wound is deep or dirty, your doctor may recommend a booster. The injured person should have the booster shot within 48 hours of the injury.

If the wound was caused by a cat or a dog, try to confirm that its rabies vaccination is up to date. If it was caused by a wild animal, seek advice from your doctor about which animals are most likely to carry rabies.

Skin Injuries

Blisters

What is it?

A bubble on the skin filled with serum caused by friction, burning, or other damage.

Plan of Action:

To relieve blister-related pain, drain the fluid while leaving the overlying skin intact. Here's how:

Wash your hands and the blister with soap and warm water.

Swab the blister with iodine.

Clean a sharp needle with rubbing alcohol.

Use the needle to prick the blister in several spots near the edge. Let the fluid drain, but leave the overlying skin in place.

Apply an ointment such as petroleum jelly to the blister and cover it with a nonstick gauze bandage. If a rash appears, stop using the ointment.

Follow-up care. Check the area every day for infection. After several days, use a tweezers and scissors sterilized with rubbing alcohol to cut away the dead skin. Apply more ointment and a bandage.

Prevention:

Bruise

What is it?

A bruise forms when blood vessels under the skin break. The trapped blood creates a bruise that's black, purple or blue then changes color as it heals.

Plan of Action:

Elevate the bruised area above heart level, if possible.

Apply an ice pack wrapped in a thin towel. Leave it in place for 20 minutes. Repeat several times for a day or two after the injury. This helps to reduce the swelling and pain.

If the bruised area is swelling, put an elastic bandage around it, but not too tight

If the skin isn't broken, you don't need to bandage a bruise. Consider taking a nonprescription pain reliever if needed.

Consult your health care provider if you:

Have very painful swelling in the bruised area

Suspect a bruise has been caused by child abuse, domestic violence or elder abuse

Are still experiencing pain three days after a seemingly minor injury

Have frequent, large or painful bruises

Have bruises that begin suddenly or seem to develop for no reason

Have a personal or family history of easy bruising or bleeding

Notice a lump form over the bruise, which may be a sign of pooling blood, also called a hematoma

Have unusual bleeding, such as from the nose or gums

Burns

What is it?

Tissue damage from hot liquids, the sun, flames, chemicals, electricity, steam and other causes.

Plan of Action:

Minor Burns

Cool the burn. Hold the area under cool (not cold) running water for about 10 minutes. If the burn is on the face, apply a cool, wet cloth until the pain eases. For a mouth burn from hot food or drink, put a piece of ice in the mouth for a few minutes.

Remove rings or other tight items from the burned area. Try to do this quickly and gently, before the area swells.

Don't break blisters. Blisters help protect against infection. If a blister does break, gently clean the area with water and apply an antibiotic ointment.

Apply lotion. After the burn is cooled, apply a lotion, such as one with aloe vera or cocoa butter. This helps prevent drying and provides relief.

Bandage the burn. Cover the burn with a clean bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.

If needed, take a nonprescription pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).

For major burns until emergency help arrives:

Protect the burned person from further harm. If you can do so safely, make sure the person you're helping is not in contact with the source of the burn. For electrical burns, make sure the power source is off before you approach the burned person. Don't try to remove clothing stuck in the burn.

Make certain that the person burned is breathing. If needed, begin rescue breathing if you know how.

Remove jewelry, belts and other tight items, especially from the burned area and the neck. Burned areas swell quickly.

Cover the burn. Loosely cover the area with gauze or a clean cloth.

Raise the burned area. Lift the wound above heart level if possible.

Watch for signs of shock. Signs and symptoms include cool, clammy skin, weak pulse and shallow breathing.

When to seek emergency care:

Call 911 or seek immediate care for major burns, which:

Are deep, involving all layers of the skin

Cause the skin to be dry and leathery

May appear charred or have patches of white, brown or black

Are larger than 3 inches (about 8 centimeters) in diameter

Cover the hands, feet, face, groin, buttocks or a major joint, or encircles an arm or leg

Are accompanied by smoke inhalation

Begin swelling very quickly

Electrical burns, including those caused by lightning, and major chemical burns need emergency medical care. A minor burn might need emergency care if it affects the eyes, mouth, hands or genital areas. Babies and older adults might need emergency care for minor burns as well.

Cuts and Scrapes

What is it?

A minor skin wound that may or may not draw blood.

Plan of Action:

1. Wash your hands. This helps avoid infection.

2. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If needed, apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding stops.

4. Apply an antibiotic or petroleum jelly. Apply a thin layer of an antibiotic ointment or petroleum jelly to keep the surface moist and help prevent scarring. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.

5. Cover the wound. Apply a bandage, rolled gauze or gauze held in place with paper tape. Covering the wound keeps it clean. If the injury is just a minor scrape or scratch, leave it uncovered.

6. Change the dressing. Do this at least once a day or whenever the bandage becomes wet or dirty.

7. Get a tetanus shot. Get a tetanus shot if you haven't had one in the past five years and the wound is deep or dirty.

8. Watch for signs of infection. See a doctor if you see signs of infection on the skin or near the wound, such as redness, increasing pain, drainage, warmth or swelling.

Foreign Object in the Skin

What is it?

An object stuck under the skin such as wood splinters, thorns, slivers of metal or glass, and gravel.

Plan of Action:

Wash your hands and clean the area well with soap and water.

Use tweezers cleaned with rubbing alcohol to remove the object. Use a magnifying glass to help you see better.

If the object is under the surface of the skin, sterilize a clean, sharp needle by wiping it with rubbing alcohol. Use the needle to gently break the skin over the object and lift up the tip of the object.

Use a tweezers to grab the end of the object and remove it.

Wash the area again and pat dry. Apply petroleum jelly or an antibiotic ointment.

When to Seek Medical Help:

For a foreign object that seems to be more deeply embedded in the skin or muscle.