A cut that continues to bleed after a couple of days can be concerning, as most minor injuries typically stop bleeding much sooner. While the body possesses an efficient natural mechanism to halt blood loss, several factors can interfere with this process, leading to prolonged bleeding.
The Body’s Natural Response: How Cuts Normally Stop Bleeding
When a blood vessel is injured, the body immediately initiates a complex process called hemostasis to stop the bleeding. The first response involves the rapid narrowing of the damaged blood vessels, known as vasoconstriction, which helps to reduce blood flow to the injured area. This immediate constriction is a crucial step in limiting blood loss.
Next, small cell fragments called platelets activate. These platelets become sticky and adhere to the injured site to form a temporary plug. They also release chemical signals that attract more platelets, strengthening the seal.
The third stage involves blood coagulation, where a series of proteins known as clotting factors work in a cascade to form a stable clot. These factors convert a protein called fibrinogen into fibrin, creating a mesh-like net around the platelet plug. This fibrin mesh traps red blood cells, forming a stable blood clot that effectively seals the wound and prevents further bleeding. As the wound heals beneath this protective layer, the body gradually breaks down and dissolves the clot.
Why Bleeding Might Persist
Several factors can disrupt the body’s natural clotting process. Wound characteristics are significant. Deeper, larger, or jagged cuts damage more blood vessels and tissue, making it harder for a stable clot to form. Wounds located over joints or in highly vascularized areas, such as the scalp or face, may bleed more profusely or experience repeated disruption of the clot due to movement or abundant blood supply.
Certain medications interfere with blood clotting. Anticoagulants, often referred to as blood thinners, like warfarin, dabigatran, rivaroxaban, and apixaban, directly inhibit the function of clotting factors. Antiplatelet drugs, such as aspirin and clopidogrel, work by preventing platelets from clumping together effectively. Additionally, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen also affect platelet function and increase bleeding risk. Some antibiotics and antidepressants (SSRIs) can similarly contribute to a higher tendency for bleeding.
Underlying medical conditions can also impair the body’s ability to form clots. Genetic bleeding disorders, such as hemophilia and von Willebrand disease, result from a deficiency or dysfunction of specific clotting factors or proteins essential for platelet adhesion. Liver disease can compromise clotting because the liver produces many of the necessary clotting proteins. A deficiency in vitamin K, a nutrient essential for the production of several clotting factors, can also lead to prolonged bleeding.
Poor wound care practices or repeated trauma to the injured area can prevent a clot from stabilizing. Picking at scabs, frequently removing dressings, or re-injuring the cut can dislodge the fragile clot that has begun to form, restarting the bleeding.
An infection in the wound can impede healing and cause continued bleeding or discharge. Bacteria can introduce inflammation, which disrupts the delicate balance required for clot formation and tissue repair. Signs of infection might include increasing redness, warmth, swelling, escalating pain, or pus/cloudy fluid.
What to Do for a Persistently Bleeding Cut
If a cut continues to bleed, apply firm, direct pressure to the wound. Use a clean cloth, sterile gauze, or even your hand, pressing down continuously for at least 10 to 15 minutes without lifting to check. This pressure helps the platelets and clotting factors to form a stable clot.
Elevating the injured area above the heart, if practical, can further help to slow the bleeding. For instance, raising an arm or leg can reduce blood flow to the wound due to gravity. Once the bleeding has significantly slowed or stopped, gently clean the wound. Use mild soap and warm running water to rinse away any visible dirt or debris, avoiding harsh antiseptics like hydrogen peroxide or iodine, which can damage delicate new tissue.
After cleaning, protect the wound by applying a sterile bandage. An antibiotic ointment can be used to minimize the risk of infection, but it is not always necessary for minor cuts. Change the dressing daily or if it becomes wet or dirty, ensuring the wound remains clean and dry to facilitate healing. It is important to avoid disturbing the newly formed clot by refraining from picking at scabs or repeatedly checking the wound’s progress, as this can disrupt the healing process and restart bleeding.
When Professional Medical Help is Needed
While many cuts can be managed at home, certain situations warrant immediate medical attention. If the bleeding does not stop after 10 to 15 minutes of firm, continuous direct pressure, it is important to seek professional help. Wounds that are deep, gape open, involve muscle or bone, or are located over a joint may require stitches or specialized closure.
Signs of infection, such as increasing redness, warmth, swelling, pain that worsens after 48 hours, or the presence of pus or foul-smelling discharge, indicate a need for medical assessment. The development of red streaks spreading from the wound also suggests a spreading infection. If there is numbness, tingling, or an inability to move a body part near the wound, it could signal nerve or tendon damage.
Medical attention is also necessary if there are foreign objects embedded in the wound, such as glass or dirt, which should not be removed at home. Animal or human bites carry a high risk of infection and should always be evaluated by a healthcare professional. Individuals with known bleeding disorders or those taking blood-thinning medications should consult a doctor if they experience prolonged bleeding, even from minor cuts. Tetanus vaccination status is important; a booster may be recommended for deep or dirty wounds if the last shot was more than five to ten years ago, or if vaccination history is uncertain.