Much self-control needed to avoid scratching!

September 27, 2010 4:57 PM

I scraped my wrist eight days ago. The gash itself is healing up alright, albeit a bit slower than I'd like, and it looks like it might scar a little. But the surrounding area is red, blotchy, and bumpy like a rash, and it itches terribly. Should I be concerned?

I got the scrape on a trailer jack when my hand slipped while cranking it. Obviously, the metal might be a concern. I don't have any documentation of tetanus shots but I'm 95% confident I've had one in the last 7 years (which I've heard, but not confirmed, is the period the shot is good for).

After I got the cut it bled a little. It took me a couple hours before I was able to clean the wound. I applied hydrogen peroxide and an adhesive bandage. Since then I've been applying Neosporin to the cut daily, with a fresh adhesive bandage over it each time.

It's not the greatest picture, but this is what the wound looks like now. You can see the inflamed patches surrounding the cut. It's redder in real life than it appears in that photo. You are not my doctor, but should I go see him about this or will it take care of itself? Can you recommend anything to help the itching go down?

posted by The Winsome Parker Lewis to health & fitness (24 answers total)

From those symptoms (especially the itchiness) it sounds like it's still infected, though the picture doesn't show as much redness as my infected cuts have. Not sure what the bumps indicate but they are very small. If that's all it does after eight days I'd wait it out some more to see if it gets worse. If it's worse, go; if not, don't worry.
posted by Hardcore Poser at 5:02 PM on September 27, 2010

It's infected, go to the doctor.
posted by facetious at 5:03 PM on September 27, 2010

BTW, my doctor here in Canada has said in the past that 10 years is the renewal time for tetanus shots.
posted by Hardcore Poser at 5:04 PM on September 27, 2010

If it's warm 'n red - and ESPECIALLY if it's spreading in any way - I'd hit up your doc sooner rather than later. Even if it's not an infection, cellulitus can start out that way, and it's a nasty little bugger.
posted by julthumbscrew at 5:05 PM on September 27, 2010

julthumbscrew, do you mean literally red, or is that a figure of speech? The temperature is normal.
posted by The Winsome Parker Lewis at 5:06 PM on September 27, 2010

*warm* I mean, not red. Sorry.
posted by The Winsome Parker Lewis at 5:07 PM on September 27, 2010

Those small red bumps occur for me when I keep a bandage on for too long. I think it's a reaction to either the latex or the adhesive in the bandage. It goes away when I let it air out and don't irritate it (irritants for me include hot water and liquid soap/detergents). Definitely don't scratch it. Keeping it covered up causes them to spread until they become a bigger problem than the cut that caused it.
posted by hindmost at 5:08 PM on September 27, 2010

Leave it uncovered and let it dry out. I think it will be fine.
posted by lee at 5:09 PM on September 27, 2010

Literally red - not, like, metaphorically. If it's cool, that's a pretty damned GOOD sign, actually - "red, hot and tender" are words you see popping up pretty frequently which tend to indicate an infection may be present. If it's pink, bumpy and itchy, that sounds more like normal healing... I know my wounds have gotten very ugly, bumpy and VERY itchy as they're trying to knit themselves back together. Yet again, IANAD and TINMA. :-)
posted by julthumbscrew at 5:09 PM on September 27, 2010

(Disclaimer- I have seen a doctor about this issue and thus can now treat it at home, IANAD, IANYD, YMMV, etc etc)
posted by hindmost at 5:10 PM on September 27, 2010

Fair enough, hindmost, I wondered if it might be the bandage. This is a new brand from the kind I normally get, but I figured it was too small a detail to be worth mentioning. I'll leave it uncovered so it can breathe now. Should I stop with the Neosporin as well?
posted by The Winsome Parker Lewis at 5:12 PM on September 27, 2010

Another vote for allergic to the bandage and probably irritated due to heat and sweat under there too.
posted by fshgrl at 5:19 PM on September 27, 2010

I would definitely leave it uncovered and without putting anything on it for at least a day and see how it goes before worrying about it. (Try not to fuss with it, too, which for me is always the hardest part!) If you're still concerned after that, take it to a doctor. IANAD either, of course.
posted by daisyk at 5:20 PM on September 27, 2010

Soak it in salt water a few times a day, and apply polysporin or equivalent before covering it back up. If it's still bothersome after a couple of full days of this, then see a doctor, but I'd bet it'll be fine. Salt water is the best home remedy for irritated injuries.
posted by L'Estrange Fruit at 5:22 PM on September 27, 2010 [1 favorite]

I too vote for allergic to the bandage. I've started to get terrible rashes from adhesive bandages - they itch like crazy and last far longer than the injury.
posted by The Light Fantastic at 5:25 PM on September 27, 2010

you are having an allergic reaction to the neosporin, I've had this happen so many times. switch to plain bacitracin and you should see improvement.
posted by supermedusa at 5:35 PM on September 27, 2010 [1 favorite]

Not that kind of doctor, but it looks like an allergic reaction to me too - more pink than red, and discrete little bumps rather than a big zone of inflammation. In fact, it looks just like my reaction to latex and whatever is in bandage adhesive (which is probably more latex). Check out this picture of contact dermatitis on Wikipedia - looks pretty similar, doesn't it?
posted by Quietgal at 5:35 PM on September 27, 2010

Great advice, thanks for the help everyone. I knew I could count on AskMe!
posted by The Winsome Parker Lewis at 5:44 PM on September 27, 2010

Nthing allergic reaction. At one point I developed an allergic reaction to Neosporin, and it looked a lot like that. These days I'm really partial to Neosporin cream.
posted by booknerd at 6:06 PM on September 27, 2010

Nthing the Neosporin problem. I have to specifically avoid any ointment that claims to contain a pain killer or extra "healing factor" and the like - generic, store-brand triple antibiotic ointment is bacitracin, neomycin, and polymyxin (and doesn't bother me at all, in fact does it's job and helps me heal more betterer). Next time you have a cut, consider or at least keep an eye out if you continue using Neosporin.

That said - tetnus shots are renewed on a 10 year rotation, but if it has been more than 5 years and you have a puncture wound or are significantly concerned by potential exposure, your doctor will be happy to update your vaccine. (At least, mine was when I got a puncture wound in a pretty low risk environment.)
posted by maryr at 6:37 PM on September 27, 2010

RN here, though IANAD. Nor am I your RN. However, I have seen gazillions of these and I've given a gazillion tetanus shots.

Your injury looks pretty good to me. The itching is from new skin cells growing instead of allergy. It doesn't appear infected to my eyes. In the future, wash it thoroughly, treat with an antibacterial ointment, and cover it with a dressing until it's well healed. Neosporin is okay, but use the cream instead of the ointment because it's less irritating to tissue.

Julthumbscrew has it right - you are, in fact, looking for red, warm, and tender to touch as signs of infection. I just don't see them in the photo you provided.

L'Estrange Fruit: I've never heard of salt water immersion as a treatment for an open wound, irritating or otherwise. It's just not a good idea. We do sometimes use a very, very, very dilute solution of bleach to treat active infection in an open wound, but those are special cases and you should never try such a thing without a physician's advice.

On the tetanus booster question: everyone should have a tetanus-diphtheria (TD) booster every ten years, period. The diphtheria vaccine is only good for ten years too, and just about every family practice clinic gives the TD shot instead of only tetanus.

However, if you have an injury and it has been more than five years since your last TD booster, get another one.

Your likelihood of contracting tetanus is near zero from this injury since a) it wasn't very deep and b) it appears to have healed. The bacterium that causes tetanus is an obligate anaerobe, which means it cannot live long in an environment that contains oxygen. A scrape like this isn't really deep enough to give the microbes a chance to grow. It could happen, but you're out of danger for this round. :-)

Don't run to the doctor for a TD booster every time you get a cut or scrape, because it's possible to develop an allergy to tetanus toxoid (the stuff in the shot). Many people are allergic to it already or have developed an allergy in that manner, so if they do happen to be injured they can be in serious, serious trouble.
posted by lambchop1 at 7:01 PM on September 27, 2010 [3 favorites]

Should I stop with the Neosporin as well?

I once went to urgent care for a little wound like that (originally was an insect bite, I think) that was itchy and wouldn't heal after a few weeks, and the doc told me to stop putting Band-Aids and Neosporin on it and prescribed some extra-strength steroid cream.

IANAD, but the little itchy bumps you're developing around the wound look just like the little itchy bumps I started getting. I'd leave it uncovered for a day, then possibly begin treating it with 1-percent hydrocortisone cream (uncovered), and see if it begins to heal.
posted by limeonaire at 7:13 PM on September 27, 2010

HEAT is what you are looking to worry about. If it's hot it's infected. If it's just itchy and red it's probably just irritated and healing.
posted by fire&wings at 3:04 AM on September 28, 2010

lambchop1: I picked up saltwater immersion from my mother, who was also a nurse. Had no idea it wasn't a universal nursing principle, actually, but maybe it's a generational notion?
I've found it immensely useful throughout the years, but then I'm also prone to easy infection.
posted by L'Estrange Fruit at 6:26 AM on September 28, 2010