Ow

July 10, 2008 2:31 PM

Could this scab be infected?

I bit it on the street in front of my house on Sunday, and scraped up my elbow (classic case of road rash). I soaked the wound for about a half hour or so, and cleaned it with soap and water, but there were still some dirt particles that would not come off.

Two days later, the wound had developed a nice, if painful, dry scab. It hurt like hell, but seemed to be healing. Yesterday, I noticed the scab was yellowish, but still dry. I have been applying antibiotic ointment and trying to keep it clean.

Today, however, two tiny parts of the scab have broken and started leaking yellow pus. The scab still hurts. It has, however, been getting a bit smaller.

I don't have any of the other signs of infection: no red line to my heart, no growing pinkish area, no heat, no bad smell.

I know that you are not my doctor, but to be honest, I would rather not spend the $50 emergency-room copay if this is "normal."

So I guess I'm not asking if it's infected, but whether or not this is "normal," or if it's something that requires immediate medical attention.

posted by lunasol to Health & Fitness (16 answers total)

What is it that's worrying you? The pus? Fairly normal I would say. Heat is what you're looking for, you'll know yourself if the area gets "angry," for want of a better word.
posted by fire&wings at 2:41 PM on July 10, 2008

Response by poster: F&W, yeah, the pus is what's worrying me...no heat.
posted by lunasol at 2:43 PM on July 10, 2008

The typical IANAD stuff ...... Yes it probably is, but I've had this happen a million times, and I doubt it's truly serious. You probably have dirt etc stuck beneath the scab. Make sure you clean it VERY well every day (even if the scab comes off some, although dont TRY to scrub it off), treat it with some hydrogen peroxide and keep it bandaged. IMHO, you'll be fine. That being said... wait for it..... couldnt hurt to drop that $50 and consult with someone who actually knows what they're talking about, especially if it gets any worse at all. My two cents.
posted by elendil71 at 2:47 PM on July 10, 2008

As an avid biker in my younger days, I am well-acquainted with road rash, and am well acquainted with infection.

I've never experienced a "red line to my heart"; that would be frightening. And while an infected wound (road rash) doesn't smell great, neither is it frighteningly pungent. So that would be bad, too.

Elbow and knee wounds take some time to heal, because you need to bend your limbs, so it could be a little of that.

The best thing to do is to slather the wound with polysporin and use a non-stick bandage. After a couple of days, take the bandage off so the wound can dry out and heal a little faster.
posted by KokuRyu at 2:52 PM on July 10, 2008

Maybe it's because I didn't wear shoes until I was 15. Maybe it's because I have had tons of abrasions and wounds that I didn't clean right away, I only got more dirt in them, that I'm not worried about a little bit of pus on a scab. No biggie. No worries. This is normal. Of course, I can't say for sure. Nobody can, but my gut tells me that this is no big deal.
posted by LoriFLA at 2:53 PM on July 10, 2008

I would monitor it but a little bit of pus isn't something to worry about if there aren't other more obvious signs of infection. I've had countless falls over the years and a bit of pus here and there was the norm. The one infected wound I've had was a tiny nick given to me by a stray cat, and I knew pretty quickly something was up. Red, throbbing and angry. IANAD but I think you will know by the feel of the wound if it is infected rather than just relying on inspection, there will be a noticeable change.
posted by fire&wings at 2:57 PM on July 10, 2008

Here in Australia, it wouldn't be uncommon to show it to a pharmacist and ask him or her to recommend a product to treat it. Of course, if you're dying, they'll suggest you get immediate medical attention, otherwise, you'll probably end up with a nice tube of some antiseptic, and a slightly expensive sticky bandage.
posted by b33j at 3:42 PM on July 10, 2008

I think you've got all four hallmarks of an infection well nailed so you know what to look for - I'm just chiming in with a tip my PA-type brother left me with: if you're worried about whether the redness is getting bigger or smaller, trace the outline of the red/not-red interface with a permanent marker and watch it over time.

For what it's worth, I just fell off of my bike a few weeks ago and a similar thing happened - a small blister-y thing leaked some pus when I pulled the grit out of it and all is fine now.
posted by oreonax at 4:41 PM on July 10, 2008

you probably should have kept the wound moist to avoid the dryness and cracking and general owiness. this also may have prevented the infection you probably have now. just for future reference.

you are probably fine. just keep it clean and keep putting a&d ointment on it. you know the signs of infection, so if you develop any of those, you should probably cough up the dough.
posted by misanthropicsarah at 4:52 PM on July 10, 2008

IANAD. I've heard that if you put hydrogen peroxide on the wound and it foams, it's infected. But the hydrogen peroxide will help kill the infection. I think HP is great (you can see it working!), but if you can't take the sharp pain of the HP, get some Polysporin to put on the wound. Both are good things to have around. Just keep putting them on, in moderation, until the wound gets tiny. I wouldn't worry too much about an infection though (and I'm a hypochondriac!), especially since you said the wound is already getting smaller.
posted by pised at 8:24 PM on July 10, 2008

I think my mom would say that your wound is "cleaning itself", making a little pus to get the bits of dirt out. I don't know if that's really what happens. P.S. Once I got a tiny splinter on the bottom of my foot that got infected, and when a pale red line started developing upward along a blood vessel...that's when I went to the doctor and got some antibiotics. It hurt but wasn't a huge deal.
posted by dreamyshade at 11:22 PM on July 10, 2008

Always have a bottle of Hydrogen Peroxide around to splash on any fresh wound. With the prevalence of staph infections abound these days it's no time to take any cut lightly. If you want to be bold - scrape the scab off douse with Hydrogen Peroxide, top with Neosporin and start anew. That's what we used to do back in my school yard days. A wound hardly ever heals when there is infection under a scab. Take this advice at your own risk, IANAD.
posted by any major dude at 11:34 PM on July 10, 2008

Response by poster: OK, so for the most part the consensus seems to be that it may be a bit infected, but I should be ok with regular applications of antibiotic cream. I've been applying neosporin and tea tree oil once a day each. I might also start soaking it every night to alleviate some of the crustiness.

BTW, I never knew wounds could heal without a scab - always thought that was a necessity.

Thanks!
posted by lunasol at 8:28 AM on July 11, 2008

Not your doc but IAA RN: Do NOT use hydrogen peroxide on a wound. It kills resident flora, some of your own cells, as well as the pathogens - the good and the bad. You don't want to kill the good. Resident flora take up space so that pathogens cannot set up shop. Soap and water and a little antibiotic ointment is just fine. Just like what you're doing. Using H2O2 on open cuts is a great way to open yourself up to foreign infection.

That pus could easily be the waste product of your own white blood cells repairing the site. The site getting smaller is also a good sign.
posted by dog food sugar at 7:51 PM on July 11, 2008

dog food sugar, I've never had any problems using Hydrogen Peroxide and at 3% it's pretty harmless. As long as you use it in conjunction with antibiotic cream there will be no problems. I assume you are a bio person since my wife who also has her degree in bio had the same reservations about using it on wounds but now 2 kids later she's sold on it's infection fighting properties.
posted by any major dude at 2:46 PM on July 13, 2008

Response by poster: For posterity: it healed up nicely after this, and within a few weeks was completely healed over. It's still a bit pink, but otherwise fine.
posted by lunasol at 3:54 PM on August 21, 2008