Cuts and scrapes and scars…oh my!

We are fast approaching summer (yay!), which means our kids will be out of school, hopefully off screens and outside playing and exploring. In the warmer months, I often see an increase in cuts and scrapes, and wanted to give parents a few reminders on how to treat these common injuries. Additionally, it’s good to know when a cut or scrape might need medical attention. Treating a cut or a scrape correctly will hopefully help prevent infection and/or scarring. 

Fun fact about skin: It’s the body’s biggest organ so taking care of cuts and scrapes is really important! 

Treating a cut or scrape

Almost all bleeding from small cuts or scrapes can be stopped by applying direct pressure with clean gauze or cloth for 5 to 10 minutes. Be careful not to check too soon, which can make it take longer for the bleeding to stop. 

Once the bleeding has stopped, clean the wound gently with warm water and soap until you clear all of dirt or debris. This should take a few minutes to make sure it’s clean. I know with smaller kids, sitting still while Mom or Dad cleans a cut can prove difficult. If you have a wiggly child, try putting them in the bath, which can offer enough distraction while you clean up the cut. Cleaning the skin is important to reduce the risk of infection. 

After you’ve thoroughly cleaned the cut or scrape, apply an antibacterial ointment to keep it moist and cover with a bandage until it heals or scabs, typically a few days. Make sure to switch the bandage every day and reapply ointment. 

Does my child need stitches? 

Sometimes an injury can cause a wound that requires stitches. Knowing what that looks like and responding in a timely manner is important. A few things to look for: 

• Cuts that won’t stop bleeding.
  
  
• If your child suffers a cut that is gaping open with visible dark red muscle or yellowish fat, it should be closed with stitches, even if it is small.
  
  
• If your child has a cut that is deep, gaping, or in a cosmetically sensitive area, take them to the emergency room. If you think there is an object embedded in the wound, it’s best to get emergency or urgent care that can handle this type of medical emergency. Don’t wait too long — the sooner the better.
  
  
• If you are unsure if your child should be seen in the emergency room, give your pediatrician a call, and we can help you decide the best treatment option. You can also video chat with a pediatric provider through Children’s Online Urgent Care and they can direct you to the appropriate location. 

Maybe not stitches, but see your pediatrician or urgent care

• Small cuts that are not gaping may not require actual stitches, but may still benefit from steri-strips or medical glue.
  
  
• Any cut that is gaping and is more than ½ inch long should probably be closed. Get a ruler and measure it if you are not sure. Cuts smaller than this may not require closure, but if they are gaping, then it is best to have them checked out.
  
  
• Just like with cuts and scrapes that can be managed with a bandage, if you determine your child’s wound requires medical assistance, it’s important to run it under water to clean any dirt, and then cover with gauze or cloth and tape to help suppress the bleeding. 

Healing

As your child’s cut heals, it’s common for it to be swollen, red in appearance and painful. This is pretty typical and a sign of the body’s immune system kicking in to protect the wound from infection. It’s important to keep the wound clean and dry to help the healing process. 

As it heals, a scab is likely to form. As tough as it might be for curious kids, don’t let them pick the scab. It’s protecting the skin underneath and helping it to heal by forming new tissue. Picking the scab will delay healing and may increase the likelihood of scarring. The scab will eventually dry up and fall off. When the scab has fallen off, sometimes a scar will be left. 

Infection

Despite cleaning and antibacterial ointment, some cuts and scrapes can get infected. The appearance and symptoms of an infected cut include: 

• Expanding redness around the wound
  
  
• Yellow or greenish-colored pus or cloudy wound drainage
  
  
• Red streaking spreading from the wound
  
  
• Increased swelling, tenderness or pain around the wound
  
  
• Fever

If your child has any of these symptoms, it’s important to see your pediatrician for treatment. 

Scarring 

Even though human skin is remarkable in its ability to heal, sometimes a cut can lead to scarring. Here are a few ways to prevent or minimize scarring. 

Sun protection: Cover, cover, cover! Damaged skin from a cut or scrape can become permanently discolored by the sun for six months to one year after an injury. It’s best to keep any wounds covered with clothing or a bandage as much as possible and avoid using sunscreen during initial healing. However, after about two weeks, it’s okay to use sunscreen on areas that are difficult to cover to minimize darkening of the scar, called “hyperpigmentation.” 

Scar massage: Scars may soften and flatten more quickly when they are massaged. To do this, use your fingers to apply moderate pressure and massage the scar in circles. Your pediatrician can show you how to do this or if you need reinforcement, YouTube has good tutorials. 

Silicone sheets or gels: Silicone sheets or gels may help soften, flatten and improve the coloration of a scar if used for at least 12 hours a day. You can find these at pharmacies or online. Ask your pediatrician if they recommend a certain kind for your child’s cut.

Tool kit

Cuts and scrapes are common in kids. Preparing a basic first aid kit can be a fun project for families to prepare for these situations. Older children can even carry a basic kit in their sports bag or a backpack when hiking so they can feel prepared if they get hurt. A few things I suggest for the tool kit include:

• Bandages in a few shapes and sizes
  
  
• Antibacterial ointment or cream
  
  
• Gauze for cleaning up and to apply pressure
  
  
• Non-aspirin pain relievers such as ibuprofen or acetaminophen. Make sure to follow proper dosing for your child’s age and weight. Aspirin is a blood thinner and shouldn’t be used.
  
  
• Distractions! Sometimes a stuffed animal or a small treat can be a great distraction for upset kiddos while you clean and dress the cut.

The good news about cuts and scrapes is that young bodies are adept at healing relatively quickly. Help your kids take care of their cuts and scrapes to ensure proper healing and as always, if you have any questions about a cut or any other issue, contact your child’s pediatrician. We are always here for you. 

Alecia Huettl, MD Pediatrician Bluemound Pediatrics

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.