Skin glue, formally known as topical skin adhesive, offers a modern, quick, and generally painless alternative to traditional sutures for closing minor cuts and lacerations. This medical-grade material is a liquid compound, typically a cyanoacrylate monomer, that rapidly hardens into a strong, flexible film upon contact with the skin and body fluids. Its primary function is to hold the edges of a simple wound together, creating a protective, water-resistant barrier that supports natural healing. This method provides a good cosmetic outcome and eliminates the need for stitch removal.
Assessing If Skin Glue Is Appropriate
Skin glue is designed specifically for simple, superficial lacerations that have clean, straight edges and are under minimal tension. Ideal wounds are usually shorter than three centimeters and occur in areas that do not experience much movement or stretching. The adhesive works by forming a bridge across the top of the skin, not by strengthening the underlying tissue, so proper wound selection is paramount to success.
You must avoid using the adhesive on deep puncture wounds, animal bites, or any wound with jagged, contaminated, or actively bleeding edges. The glue should also not be applied to areas with dense hair, mucosal surfaces like the lips or inside the mouth, or areas subject to constant moisture, such as the armpit or groin. Wounds located directly over joints, such as the elbow or knee, are unsuitable because high tension from movement can cause the wound to pull apart.
Applying the Adhesive Step by Step
The wound must be thoroughly cleaned to remove any foreign debris or contaminants, often by irrigating it with a non-irritating solution like normal saline. It is necessary to achieve hemostasis, meaning all bleeding must be stopped completely, and the wound must be patted entirely dry with sterile gauze.
The cyanoacrylate adhesive reacts to moisture to polymerize, or harden, so any fluid on the skin’s surface will cause it to set prematurely or fail to bond correctly. Once the wound is clean and dry, the edges must be carefully approximated, or brought together, so they are perfectly aligned without overlapping or gapping. Maintaining this precise alignment with gentle finger pressure or forceps is necessary throughout the application.
To apply the adhesive, the applicator tip is gently brushed over the approximated wound edges, covering the length of the laceration and slightly extending onto the surrounding skin. The adhesive should form a thin, continuous film on the surface only, as getting the liquid glue inside the wound can impede healing and cause a foreign body reaction. A single, even coat is typically applied first, followed by one or two additional thin layers. Allow 30 to 60 seconds between each coat for partial polymerization. Applying multiple thin layers, rather than one thick layer, minimizes the sensation of heat that can occur when the adhesive hardens.
Post-Application Care and Protection
Allow the glue to fully set for several minutes until it is completely dry and no longer tacky. During this initial period, the wound edges must continue to be held together to ensure the strongest possible bond. After the glue has cured, the resulting film acts as a protective bandage.
For the first 24 to 48 hours, keeping the area completely dry is recommended to allow the bond to reach maximum strength. After that time, short showers are permitted, but the area should not be scrubbed or aggressively rubbed; instead, pat the wound gently to dry it. Soaking the wound, such as in a bath, hot tub, or swimming pool, must be strictly avoided as prolonged exposure to water will weaken the adhesive.
Topical products must be kept away from the glued wound because they can chemically dissolve the adhesive bond. This includes petroleum-based ointments, antibiotic creams, lotions, and any product containing alcohol. The area should also be protected from friction and rubbing from clothing or activities, which can cause the glue to peel off. Any signs of infection, such as increasing redness, swelling, warmth, excessive pain, or the presence of pus, require immediate medical attention.
How the Glue Naturally Wears Off
The skin glue is not designed to be removed manually; instead, it is formulated to flake off naturally as the skin heals beneath it. This process is directly linked to the body’s natural skin cell turnover cycle. As the superficial layers of the epidermis die and are shed, the adhesive film, which is bonded to these outermost cells, is carried away with them.
The adhesive typically remains on the skin for approximately five to ten days, though it can sometimes last for up to two weeks. It is necessary to resist the urge to pick, peel, or scratch at the glue, even as the edges begin to lift or curl. Forcibly removing the adhesive before the underlying wound has fully healed can tear the delicate, newly formed skin, reopening the cut and increasing the risk of scarring.
If a small amount of residual adhesive remains after the wound is completely closed, gentle, light application of petroleum jelly or mineral oil can help soften the glue. This method should only be used after the expected healing time has passed and only to address small, persistent flakes. Continued protection of the area from friction and harsh chemicals will allow the remaining adhesive to gradually slough off on its own.