Road Rash from Cycling - Avoid Scars Before It’s Too Late

Road Rash from Cycling - Avoid Scars Before It’s Too Late

Road rash is a fairly inevitable part of cycling. Some day, some how, you will likely come off your bike. If you’re reading this, you’ve had road rash, currently have it or you’re going to have it. Road rash is something like going to the spa and getting a deep exfoliating treatment…for free! Actually it’s not like that at all. It hurts, it bleeds, it weeps, and, depending on how you take care of it, it SCARS!

So, let’s minimize that scarring with some knowledge:

Degrees of Road Rash

Like burns and murder, road rash has different degrees:

First: Probably looks like a really bad sunburn. The surface of the skin is red, but not bleeding. The skin is not broken. Treatment isn’t really required here, though you’ll want to clean it just to be safe.

Second: Skin is broken and bleeding. People flinch when they look at you. However, the deep layer of skin is intact. This guide is for second degree road rash.

Third: Skin is gone daddy gone. You can see fat layers and tissue. Head straight to the ER; damage like this can mean grafting.

Cleaning

There are a number of things you want to avoid, like infection and tattooing. Tattooing is when you rash your face and embed dirt or street grit in your face. You want that gone or it will heal with the stain of the dirt underneath. This means light scrubbing. It’s unpleasant, but necessary to avoid both tattooing and infection. For bad road rash, you’ll want to see a physician first, perhaps in the ER. They can clean it properly and scrape out any dirt. A note about hydrogen peroxide: There seems to be some debate about using hydrogen peroxide to clean the wound as it can damage tissue.

What to use to clean:

Iodine Scrubber. Iodine scrubber are great for cleaning dirt from road rash. Call your local pharmacy to see if they’re stocked.

Shur-Clens or 0.9 sodium chloride: Ideally, you want to irrigate the area to properly cleanse the area. If you’ve got a syringe handy, this will help give the liquid pressure which will help get the grit out. The area must be completely cleaned out. If necessary, use clean gauze to gently scrub the area. Do not scrub vigorously, as this can cause more tissue damage.

Gauze:No scrubber? Gauze is not only useful for covering but also for scrubbing. Use mild soap and water and scrub with a bit of pressure behind it. (Don’t go overboard, you don’t want to cause more tissue to the area.)

Once everything is clean…

Old wisdom about wounds like road rash, was to let things “dry out” and scab over. This is just plain wrong. Why?

• Scabs crack, and cracking scabs hurt and itch. Why add more hurt to the mix?

• Scabbed areas are essentially dead areas, so they’re not getting oxygen so take longer to heal properly.

What you want to do with a wound like this is keep it moist. Once a wound has scabbed over, you diminish the skin’s ability to heal. So…

Moist and covered:

To keep the wound moist, use something like Aquaphor, which is sometimes referred to as “the dermatologist’s duct tape”. Stay away from Neosporin. The rate of people who are allergic to Neosporin is significant enough (about 20%) that you’ll want to avoid it. Apparently the allergy appears very similar to poison oak. If you’re a mountain biker treating your road rash (and using Neosporin) you may think, oh great, poison oak too!? And now you’re on something for the poison oak as well, when in fact it’s the allergy to the Neosporin. You can also apparently develop an allergy to Neosporin even if you’ve never been allergic in the past. You can cover with gauze, but this isn’t critical. You will however want to clean off wound as it weeps which will happen for a couple of days. Then reapply Aquaphor.

Second degree road rash generally takes about three weeks to heal. At that point the skin will still look strange, discolored and the texture may feel rough in places. Some people advocate using things like Mederma at this point to help minimize scarring. You may also hear people recommending Vitamin E. Other products used to treat scarring.

Bio Oil
Prefer On
Scar Zone
Sudden Change
Palmer’s Cocoa Butter

A note about Vitamin E: Vitamin E (either the serum or fresh from the capsule) has been proven to do…absolutely nothing. This is if you are a believer in randomized, placebo-controlled, double blind studies.

Other considerations:

Duoderm, Tegaderm and other Dressings:

It’s likely that parts of your road rash are worse than othersFor that, you’ll want something like Duoderm. Duoderm is a dressing generally used for leg ulcers and other wounds that are slow to heal. It’s commonly used for wounds on diabetics. Duoderm is treated with some kind of gooey adhesive which apparently helps skin heal. With something like Duoderm and Tegaderm, you don’t need any ointment, in fact this will keep it from sticking. Tegaderm works much the same way as Duoderm. I’ve heard conflicting things about which is better. Both products are expensive and hard to find. Your regular drugstores might stock it in the pharmacy. Often the best bet is online. , Both these types of dressings come in pieces that can be cut to size. You can shower in the Duoderm, wear clothes, sleep in it, whatever. Generally you’ll want to put a new one on every couple of days. Peel SLOWLY, clean the wound and reapply another patch. Johnson & Johnson and Curad both make adhesive dressings that are decidedly cheaper. They are reviewed well, though not as popular as Duoderm. Finally, consider silicone sheeting once things are more healed. This will help flatten out scars and help with discoloration.

Sunscreen:

You don’t want to radiate the skin while it’s healing. Stay out of the sun as much as you can, especially during the first weeks and months. Wear a hat. If you refuse to wear a hat, slather up with sunscreen, with a minimum SPF of 30.

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