Road rash is the common term used for a skin abrasion—an area on the body where the skin has been scraped off. The injury is most likely to occur in outdoor activities performed on tarred surfaces, like skateboarding.

With road rash, the affected area usually looks raw and may bleed a little. The injury can be very painful but typically heals in a couple of weeks with at-home treatment. However, if the injury is deep and has caused damage to the nerve cells, medical attention may be necessary.

Symptoms of Road Rash

The affected area of skin will appear red, raw, and inflamed. Bleeding is also common. Pain and swelling are immediately felt and may last for several days.

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This video has been medically reviewed by Casey Gallagher, MD.

It’s not uncommon to feel no pain at the deepest part of the injured area. However, the skin around the edges of the rash can be extremely painful.

As with any injury that breaks the barrier of the skin, road rash can lead to infection.

Signs of a wound infection include:

  • Increased pain after the first daySwelling and increased rednessWarmthPus or fluid drainingFoul-smelling drainageFlu-like symptoms, such as fever, chills, and body aches

In rare cases, road rash may cause blood poisoning, a severe infection that spreads through the bloodstream. Septic shock (a potentially life-threatening condition that causes dangerously low blood pressure and organ failure) requires immediate medical attention to prevent complications—including death.

Causes

Road rash is usually the result of a fall or being dragged against pavement or dirt, as would happen in a biking accident or when playing a sport. When a person’s body comes in contact with the ground, any areas of exposed skin are vulnerable to scraping across the rough surface.

If a person falls or drags their arm across the tar, for example, the abrasiveness results in the top layer of skin getting peeled away.

Road rash injuries are more common in the spring and summer, as the warmer weather encourages more outdoor activity. Moreover, people tend to wear less and lighter clothing when participating in activities during the hotter months, and this means their skin is less protected if there’s an accident.

Treatment

Severe cases of road rash need to be treated by a healthcare provider. However, most mild cases can be treated on the playing field, the road, or wherever the injury occurred.

If the wound is not bleeding excessively and the pain is tolerable, you may also be able to wait and treat the wound once you arrive home. A standard first aid kit likely contains all the tools you’ll need to treat road rash.

First Aid

When confronted with the injury, review steps 1, 2, and 3 below before making a decision to treat road rash on your own. While road rash can look severe and cause quite a bit of pain, it is not usually life-threatening. Don’t let the presence of raw, bleeding wounds distract you from assessing the injured person’s state:

  • Stay safe: If a person is injured and becomes unconscious, do not move them. The only exception is if the area is unsafe and leaving them where they are would be a greater risk than moving them to a safer area.
  • Treat life-threatening injuries first: Make sure they are breathing and conscious. If any bleeding is bright red or spurts from the injury, it needs to be stopped right away.
  • Stop bleeding: Usually, road rash oozes rather than gushes blood. A little pressure with a bandage or any clean cloth should adequately control the bleeding.

If the injury does not seem serious enough to call 911, continue with the next steps (some of which may or may not be offered by the dispatcher in the event you do need to call 911).

Stop and Assess

If the injured person is unconscious, has problems breathing, or is bleeding severely, call 911 immediately. Follow the advice of the dispatcher before proceeding. He or she will instruct you on the best next steps to take while you wait for emergency medical services to arrive.

Rinse the Affected Area

Rinse the road rash with soapy water to help flush any dirt and debris out of the wound. It may help to soak the wound in soapy water before trying to remove any debris.

To do this, you may need to gently brush any foreign material from the skin. In rare cases, it may be necessary to remove debris with sterile tweezers (if possible, this should be done by a medical professional).

Cover the Wound

Put gauze on the wound and wrap it to hold it in place. Dry dressings work fine, but you may want to moisten the first layer with saline solution or sterile water. If you use a layer of moistened dressings, make sure to cover with dry gauze before wrapping.

Tetanus Shot

If the injured person has not recently had a tetanus shot, you may need to seek medical care. The person’s healthcare provider or an emergency room medical professional can provide a booster shot for tetanus—a serious bacterial infection that affects the nervous system and can be life-threatening.

Care and Healing

As road rash heals, the pain will lessen—although the area may be tender. In severe cases, a healthcare provider may prescribe pain medication. For mild cases, an over-the-counter pain reliever like Tylenol is likely enough. If the abrasion is at or near a part of the body that bends, like an elbow or knee, the joint may feel stiff and sore.

Road rash usually heals well and clears with minimal scarring, but it’s a good idea to keep an eye on the abrasion as it heals. After the first day, you can begin using an antibacterial ointment or vitamin E oil to promote healing.

Remove the old dressing and replace it with a new one at least once per day. Watch for signs of infection, such as increased redness and pain or a fever.

If an infection occurs, treatment usually requires an oral antibiotic. Untreated infections can lead to serious health complications that may be life-threatening.

Complications

Road rash is usually a superficial skin injury that doesn’t require any professional treatment. As long as you take good care of the wound and keep it clean and dry, it should heal on its own within two weeks.

However, if you have a more serious case of road rash, the injury may include deeper layers of skin. If road rash takes longer than two weeks to heal, you should see your healthcare provider.

Severe Cases

Severe road rash needs to be treated as a burn, which may mean reconstructive surgery is required. Skin grafting uses healthy skin from another part of the body. The donor site is usually an area easily hidden by clothing, such as the buttock or at the inside of the thigh.

The graft of healthy skin is transplanted onto the injured area and kept in place with gentle pressure and padded dressing, staples, or stitches. As it heals, new blood vessels grow to help new skin cells form and heal the wound.

When to See a Healthcare Provider

Seek medical attention for road rash if:

  • The wound is more than three times bigger than the palm of your hand.
  • It is on the face, hands, feet, or genitals.
  • Muscle or bone is visible.
  • Foreign objects, such as glass or small rocks, are embedded in the affected area.
  • There is excessive bleeding.
  • You notice signs of infection.

If you go to see your healthcare provider for road rash, they will assess the severity by performing a simple physical exam of the affected area.

After a more serious accident or injury, especially one that doesn’t seem to be healing or is causing a lot of pain, the healthcare provider may also perform X-rays and other imaging to check for other injuries, like a broken bone or a foreign object under the skin.

In rare cases where infection or more serious complications are suspected, your healthcare provider may also order blood tests and cultures, as well as monitor your vital signs, such as heart rate, pulse, and oxygen levels.

Frequently Asked Questions

  • Does road rash leave a scar?
  • Yes, it can scar. It can also leave discoloration, known as traumatic tattooing, which results when pigmented debris isn’t washed out of the wound. Scars from road rash may be similar to those left by burns—the worse the burn, the more likely the scar.
  • What should I put on road rash?
  • Put antibacterial ointment such as Neosporin on your wound when you first dress it. Be careful about ointment not recommended for burns such as Bactroban. As the wound heals, you can use vitamin E cream to help restore the skin.

Yes, it can scar. It can also leave discoloration, known as traumatic tattooing, which results when pigmented debris isn’t washed out of the wound. Scars from road rash may be similar to those left by burns—the worse the burn, the more likely the scar.

Put antibacterial ointment such as Neosporin on your wound when you first dress it. Be careful about ointment not recommended for burns such as Bactroban. As the wound heals, you can use vitamin E cream to help restore the skin.