Road rash, a common skin abrasion, results from the body sliding across a rough surface, such as pavement or concrete. This friction can strip away layers of skin, leading to an injury that can be painful. While many instances of road rash heal without lasting marks, scarring is a possibility that depends on several factors related to the wound’s depth and care.
How Road Rash Affects Skin
Skin has multiple layers: the epidermis (outermost) and the dermis (containing connective tissue, blood vessels, nerves, and hair follicles). Road rash depth varies, from superficial abrasions affecting only the epidermis to deeper wounds extending into the dermis. Superficial road rash, like a first-degree burn, involves redness and minor bleeding.
Deeper abrasions, like second-degree burns, penetrate the dermis, exposing raw tissue, and causing more bleeding and pain. In severe cases, road rash can even reach deeper tissues like fat, muscle, or bone, which are considered third-degree injuries. The body’s healing process involves blood clotting (hemostasis), inflammation to clear damaged cells, new tissue formation (proliferation), and maturation or remodeling for strengthening.
Why Some Road Rash Scars
Scarring from road rash is primarily influenced by the depth of the wound. If the injury extends into the dermis, the likelihood of scar formation increases because the body produces new fibrous tissue, mainly collagen, to repair the damage. This new tissue can differ in texture and appearance from the surrounding healthy skin. The presence of foreign objects like dirt, gravel, or asphalt embedded in the wound can also lead to a type of scarring called traumatic tattooing if not thoroughly cleaned.
Infection increases scarring risk by prolonging inflammation. Wounds on high-tension or frequently moving areas, such as joints, may also scar more due to continuous stress. Genetic predisposition also plays a role, as some are more prone to developing raised scars like hypertrophic or keloid scars.
Minimizing Scarring from Road Rash
Immediate and proper first aid minimizes scarring. The wound should be thoroughly cleaned with lukewarm water and mild soap to remove dirt, debris, and foreign particles. Removing embedded debris helps prevent traumatic tattooing and infection. After cleaning, apply an antibiotic ointment and cover the wound with a sterile, non-stick dressing. This keeps the area moist, promoting faster healing and reducing scab formation, which aids scar prevention.
Regular dressing changes keep the wound clean and allow monitoring for infection signs, such as increased redness, swelling, pus, or persistent pain. If these signs appear, seek medical attention, as infection can significantly worsen scarring. Protecting healing skin from sun exposure helps, as UV rays can increase pigmentation and make a developing scar more noticeable.
Treating Road Rash Scars
Even with diligent care, road rash can result in various types of scars. These include hypertrophic scars (raised, red, within injury boundaries), keloid scars (raised, extending beyond edges), atrophic scars (depressions), or simple discoloration.
Initial management of new scars involves gentle massage with a moisturizer and applying silicone sheets or gels. These topical treatments can help flatten, soften, and lighten the scar over time. For more prominent or bothersome scars, professional interventions may be considered. These options include laser therapy, dermabrasion, or steroid injections, which a healthcare professional can recommend.