Treating Cuts and Scrapes in Children

Skinned knees, scraped elbows, and minor cuts are a normal part of childhood. While these injuries can look alarming (especially with the tears!), most can be treated at home with basic first aid. Knowing how to properly clean and care for wounds helps them heal faster and reduces infection risk.

Types of Minor Wounds AAP

Understanding the wound helps you treat it properly:

Abrasions (scrapes):

• Top layer of skin is rubbed off
• Common from falls on pavement
• Can be large but usually superficial
• May have dirt or debris embedded

Lacerations (cuts):

• Skin is torn or sliced
• Varies from shallow to deep
• May bleed more than scrapes
• Edges may be smooth or jagged

Puncture wounds:

• Small, deep wounds
• Caused by sharp objects (nails, needles, teeth)
• May not bleed much externally
• Higher infection risk

Avulsions:

• Skin is partially or completely torn away
• Can be serious
• Usually needs medical attention

Basic Wound Care Steps American Red Cross

Step 1: Stay Calm

• Your child takes cues from you
• A calm response helps them stay calm
• Talk reassuringly while you work

Step 2: Wash Your Hands

• Clean hands prevent introducing bacteria
• Use soap and water if available
• Hand sanitizer works if no water available

Step 3: Stop the Bleeding

• Apply gentle, direct pressure with clean cloth
• Maintain pressure for 10-15 minutes
• Don't peek—lifting the cloth disrupts clotting
• Elevate the injured area if possible
• Most bleeding stops within 10-20 minutes

Step 4: Clean the Wound

• Rinse with clean, running water
• Remove any visible dirt or debris
• Use tweezers (cleaned with alcohol) for stubborn debris
• Soap around (not in) the wound
• Don't use hydrogen peroxide or iodine (can damage tissue)

Step 5: Apply Antibiotic Ointment

• Thin layer of antibiotic ointment (like Neosporin or Polysporin)
• Keeps wound moist for healing
• Reduces infection risk
• Some children may be allergic—watch for reaction

Step 6: Cover the Wound

• Use an appropriately sized bandage
• Change daily or when wet/dirty
• Keeping wounds covered promotes faster healing
• Clean and rebandage until healed

When to Seek Medical Care AAP

Go to the emergency room for:

• Deep cuts that won't stop bleeding after 20 minutes of pressure
• Cuts with visible fat, muscle, or bone
• Cuts longer than 1/2 inch that gape open
• Cuts on face (may need plastic surgery for best cosmetic result)
• Wounds with embedded objects
• Animal or human bites
• Puncture wounds from dirty or rusty objects
• Signs of shock (pale, cold, clammy, rapid breathing)

See your pediatrician for:

• Wounds that may need stitches but aren't emergencies
• Any wound causing concern
• Increased redness, swelling, or pain after initial healing
• Fever
• Pus or discharge
• Red streaks spreading from wound

Tetanus considerations:

Call your pediatrician if your child:

• Hasn't had a tetanus shot in 5+ years AND has a dirty wound
• Hasn't had a tetanus shot in 10+ years for any wound
• Has a puncture wound from a rusty or dirty object
• Hasn't completed their tetanus vaccine series

When Stitches Are Needed AAP

Wounds that typically need stitches:

• Edges won't stay together
• Deeper than 1/4 inch
• Located on face, hands, joints, or genitals
• Gaping open when relaxed
• Caused by animal or human bite

Timing matters:

• Stitches work best within 6-8 hours
• Face wounds: up to 24 hours
• Delaying increases infection risk and scarring

What to expect:

• Area will be numbed
• Wound will be thoroughly cleaned
• Stitches, staples, or skin glue may be used
• Follow-up for stitch removal (usually 5-14 days)

Wound Healing and Care AAP

What normal healing looks like:

• Days 1-3: Red, swollen, tender—this is normal inflammation
• Days 3-5: Swelling decreases, scab may form
• Days 5-10: New skin forms, itching common
• Weeks 2-4: Scab falls off, pink skin underneath
• Months: Scar fades from pink to white

Ongoing wound care:

• Keep wound clean and dry (between dressing changes)
• Change bandages daily or when wet/dirty
• Continue antibiotic ointment for first few days
• Don't pick at scabs—let them fall off naturally
• Protect healing skin from sun (prevents darkening)

Signs of good healing:

• Decreasing redness and swelling
• Less pain over time
• Wound edges staying together
• No increase in drainage

Signs of Infection AAP

Watch for these warning signs:

• Increased redness spreading from the wound
• Swelling that gets worse, not better
• Warmth around the wound
• Pus (yellow, green, or cloudy drainage)
• Increasing pain (pain should decrease, not increase)
• Fever
• Red streaks extending from the wound
• Foul smell

If you see signs of infection:

• Contact your pediatrician
• Don't wait—infections can spread quickly
• Antibiotic treatment may be needed

Specific Wound Types

Scrapes/Road rash:

• May look worse than they are
• Thorough cleaning is essential
• Remove all dirt and debris (prevents "tattooing")
• May need gentle scrubbing
• Cover until healed (contrary to old "let it air out" advice)

Puncture wounds:

• Don't look serious but can be
• Difficult to clean deeply
• Higher infection and tetanus risk
• Watch carefully for infection
• Often need medical evaluation

Animal bites:

• Always see a doctor (high infection risk)
• Dogs, cats, and humans all have dangerous mouth bacteria
• May need antibiotics
• Rabies consideration for wild animals

Fingertip injuries:

• Common and bloody but usually heal well
• If nail bed is damaged, may need medical care
• Subungual hematoma (blood under nail) may need drainage

Pain Management AAP

Wounds hurt, and it's okay to manage pain:

Non-medication approaches:

• Distraction (TV, books, conversation)
• Ice wrapped in cloth (reduces swelling and numbs)
• Comfort and reassurance
• Let them hold a favorite toy

Pain relievers:

• Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil)
• Follow dosing instructions for weight/age
• Ibuprofen also helps with inflammation
• Don't use aspirin in children

During wound cleaning:

• Talk through what you're doing
• Let them help if appropriate
• Take breaks if needed
• Offer a reward after

Preventing Scars AAP

While some scarring is unavoidable:

• Keep wound moist (antibiotic ointment, covered)
• Protect from sun for at least a year (use SPF 30+)
• Don't pick at scabs
• Consider silicone sheets or gel for significant wounds
• Facial wounds may benefit from plastic surgery consultation

The Bottom Line

Most cuts and scrapes can be managed at home with basic first aid: stop the bleeding, clean thoroughly, apply antibiotic ointment, and cover until healed. Know when to seek medical care—deep wounds, facial wounds, animal bites, and signs of infection all warrant professional attention. And remember, those battle scars often become childhood stories they'll tell for years!

Clara is here to help you assess wounds and answer questions about wound care and healing!