Head wounds range from minor abrasions and contusions to deep lacerations. The scalp contains a rich network of blood vessels near the surface, meaning even a small cut can result in a surprising amount of bleeding. This high vascularity can make a seemingly minor injury look severe due to the volume of blood loss. Assessing the severity of the injury is the first step in effective care.
Triage: Recognizing Emergency Situations
The immediate priority after any head injury is to assess quickly for signs of severe trauma or internal damage requiring emergency medical services. Certain physical signs indicate a potential skull fracture or bleeding within the brain tissue, necessitating an immediate call for help. These red flags supersede care for the external wound.
A loss of consciousness, even if brief, is a clear signal that the injury is serious and professional medical evaluation is required. If the injured person experiences repeated vomiting or a headache that progressively worsens and is not relieved by standard pain medication, seek emergency care. Neurological changes are concerning and must be evaluated without delay.
Look for unequal pupil sizes, or any signs of seizure activity or convulsions. Slurred speech, sudden difficulty walking or maintaining balance, and profound confusion or agitation are warnings of an underlying brain injury. Any clear or straw-colored fluid draining from the nose or ears may signal a leak of cerebrospinal fluid and indicates a severe emergency.
Assess the physical wound for signs of severe trauma, such as a penetrating injury or a noticeable dent or deformation of the skull. While most scalp bleeding can be controlled, an inability to stop the flow after applying firm, continuous pressure for 10 to 15 minutes is considered a medical emergency. Do not remove any object that may be lodged in the wound, as this could lead to catastrophic blood loss.
Immediate Care for Minor Head Wounds
For wounds determined to be minor, with no evidence of severe trauma or internal injury, the first step is to control the bleeding. Apply firm, direct pressure to the cut using a clean cloth, sterile gauze, or a pressure dressing. Maintain this pressure for at least 10 minutes without lifting the material to check the wound, as this interrupts the clotting process.
Once the bleeding has stopped, the wound must be gently but thoroughly cleaned to prevent infection. Use mild soap and cool or lukewarm water to wash the area, allowing the water to run over the cut to flush out debris. Avoid scrubbing the wound, which can cause further tissue damage or force contaminants deeper into the skin.
Remove any visible dirt, gravel, or foreign material from the wound surface using clean tweezers, as retained debris can lead to infection or permanent scarring. After cleaning, apply a wrapped cold compress to the surrounding area for about 20 minutes to minimize swelling and reduce pain. Ensure the cold pack is never placed directly onto the open wound.
Apply a small amount of antibiotic ointment to the cleaned cut to provide a barrier against bacteria. Next, cover the wound with a sterile adhesive bandage or gauze secured with medical tape. The dressing should be secure enough to protect the area but not so tight that it restricts blood flow or causes discomfort.
Post-Injury Monitoring and Recovery
After immediate care, continuous monitoring is necessary to watch for delayed complications, which can occur hours or days after the initial injury. The dressing should be changed at least once daily, or whenever it becomes wet or dirty, using the opportunity to gently clean the wound surface again. Keeping the wound dry and covered reduces the risk of bacterial contamination.
Watch closely for signs of a developing wound infection, which commonly include increased redness or warmth spreading outward from the wound edges. Pain that worsens instead of improving, new or increased swelling, or the presence of pus or cloudy drainage indicate an infection requiring medical attention. A persistent fever is also a systemic sign of infection.
Monitoring must also extend to potential delayed concussion symptoms, which can manifest well after the initial incident. These neurological signs include:
- Persistent or recurring headaches.
- Changes in sleep patterns, such as sleeping much more or much less than usual.
- Unusual difficulty with concentration or memory.
- Increased sensitivity to bright light or loud noise, or feeling dizzy or off-balance.
If the head wound was deep, had gapping edges, or was longer than about half an inch, it likely required professional closure using sutures or surgical staples. These closures are typically removed by a healthcare provider within 7 to 10 days, depending on the wound’s location and the individual’s healing rate. Any worsening of symptoms, whether local to the wound or related to neurological function, should prompt a follow-up visit.