How to Treat a Gnarly Road Rash

My attempts at managing road rash and making it less painful

They say as soon as you start road biking it’s a matter of time before you have to deal with road rash. I’ve been actively cycling for 5 years and my first bad accident was about 6 weeks ago....and it was gnarly. Adios, leg modeling career!

Having been an athlete my entire life, I always considered my pain tolerance to be high. Then my back wheel had a catastrophic failure while I was on a descent, my tire blew, and I slid, fast and far. I am lucky not to have had any broken bones from the accident, but wow, I had never experienced any pain like that of bad road rash!

Being basically couch-bound for the first few days after the accident, I read all the articles and forum posts I could find, and talked with nurse, doctor, and dermatologist friends of mine for suggestions on how to recover the fastest, easiest and healthiest. So, though I wish the experience of road rash on no one, below are some tips and products I found most helpful through my recovery.

[Note - I’m purposely placing injury photos at the bottom of the page for those of you who want content but don’t want to see my gnarly leg.]

Before I get into it, know that you’re going to need patience. Doctors estimated that it would take 7-10 days before the initial skin healed over and my wounds would stop bleeding. While this was accurate for many of my lighter rashes, I was still wrapping my shin 4.5 weeks after the accident. Whatever your healing timeline is, it’s going to be longer than you want, and it’s going to be uncomfortable. 

Cleaning

  • Whether it’s small and shallow enough to clean yourself, or if like me you need to have professionals help, clean it as best as you can as soon after the accident as you can. There is a lot of conflicting advice out there about the use of hydrogen peroxide or scrubbing to clean the wounds. Though my clinic doused me in hydrogen peroxide (and it was as painful as you can imagine) my research concluded that cleaning with a mild soap and trying not to aggravate the wound too much is what matters most. 
  • Clean and wash it daily. It sucks, it is unbearably painful at times, and it is necessary. 
  • Have patience with the cleaning/dressing process. For 3 weeks, it took me over an hour to undress, clean, and redress my wounds, every day.

Dressing wounds

  • Keep them moist. Whether using products like Aquaphor, Vaseline, or good old petroleum jelly, it is super important to keep them moist. It allows the skin to heal from the inside-out and reduces scabbing, which in turn should reduce (or at least minimize) long-term scarring. 
  • Healing ointment - Anyone who is active should have Brave Soldier Antiseptic Healing Ointment in their medicine cabinet. Through great marketing, we assume we should put Neosporin on our wounds, however a dermatologist friend of mine said many of us actually have skin reactions to Neosporin. Through a lot of digging online, I found Brave Soldier, and it is awesome. It is made with all of the right kinds of oils (tea tree, lavender, hemp seed oil, aloe vera, etc., etc.) and helps fight infection and reduces scar tissue.
  • Tegaderm - [I did not use these] There are a lot of forums and comments about how great this stuff is. My wounds were a little too big for the patches, and doctor and nurse friends of mine said new research indicates it is better to let the wounds breathe for the brief amount of time (in my case an hour) before covering them back up. Your call here. 
  • Oil Emulsion dressings are a lifesaver. I put them on after I cleaned and dry my wounds, added Brave Soldier healing ointment, then added more petroleum jelly. (I probably went overboard adding more petroleum jelly, because Brave Soldier has a ton in it, but I was in pain and I didn’t care about going overboard.) The oil emulsion pads make the undressing of the wounds much easier. If they get stuck, lightly soak them in water and they’ll come off a lot easier.  I could only find these at my local clinic and on Amazon, but apparently you can pick them up at Target and Walmart, too. Stock up. For about 2.5 weeks I was going through 7 pads a day.
  • Find a non-adherent dressing like Tefla. Many gauze brands advertise that they are non-stick gauze, but I made that mistake once and will never do it again. You want something that has no softness to it (like cotton) that will stick to your wounds. 
  • Rolled gauze - All the oil you’re putting on your wounds makes things slippery! Because my wounds are on my legs and arms, I began to have reactions/blistering from the tape I was using to hold the Tefla pads in place. I started using rolled gauze and wrapped it around and on top of the Tefla pads to keep everything in place. You’ll go through a lot of them. 
  • Finally, good old ace bandages. They hold everything in place it is one more layer to prevent particles from getting into your clean wounds. I went through a lot of these. The first several days after my accident, my wounds were oozing and my bleeding through all of my dressings and into the ace bandages. Gross I know, but it is what it is, and using them helped me. 

Scar Management - Now that my wounds have healed enough to no longer need to be covered, I’m focusing on scar management, and I'll likely continue to do so for a long time.

  • Zinc sunscreen - Sun is bad for scars. Cover them up and find a zinc sunscreen. I am an active runner and it sucks to wear leggings running in the heat, and I wear one leg warmer when I ride my bike which looks silly, but it’s temporary. Get familiar with a good zinc sunscreen. Remember that most clothes do not provide much UV protection.

  • Mederma & Essential Oils - All of the doctors I saw suggested I start using Mederma right away, which I did. I was also told by a dermatologist friend that doesn’t work that well and I’d be better off using essential oils. I don’t really have an opinion one way or another, so I’m using both. Through some research, I found that frankincense oil is a good one for wound healing and skin cell growth. I’m new to the essentials oil scene, so I’m trying it. It smells nice, at least.

  • Keep it moist. The newly formed skin is very thin and my body still has a lot of healing to go. Keeping it moisturized is helping to prevent the new skin layers that are forming to peel off when I change my clothes.

I hope some of these tips help. If you're going through a bad accident and you’re in pain and/or annoyed at the process of keeping your wounds clean, I'm sorry, and you’re not alone. It sucks.

On to gnarly leg photos! 

Day of - at hospital:



One week post-accident:



About 2 weeks post-accident:



One month post-accident:

Published: June 8, 2018

Please respect the places you find on The Outbound Collective.

Always practice Leave No Trace ethics on your adventures. Be aware of local regulations and don't damage these amazing places for the sake of a photograph. Learn More

Kristi TeplitzAdmin

San Francisco