Road Rash

What is road rash?

Road rash is a specific type of friction burn you can get from paved surfaces. It can happen when asphalt, cement or concrete rubs against your skin hard enough to physically damage it and generate heat. Road rash can be a severe issue when the burn is deeper, especially if it also covers a larger amount of your body’s surface area.

Like all burns, experts classify road rash severity based on how deep the burn goes. The severity levels are:

• Superficial. This affects the epidermis, the outermost layer of your skin.
• Partial thickness. These burns affect the epidermis and the dermis just underneath. Superficial partial-thickness burns only affect the upper dermis. Deep partial-thickness burns cause damage down into the lower dermis.
• Full thickness. These burns damage the epidermis, dermis and the fat layer underneath your skin.

In very severe cases, road rash can extend beyond the fat layer underneath your skin, damaging tissues like muscle and bone underneath.

What are the symptoms of road rash?

Road rash can cause the following symptoms:

• Pain. Superficial and partial-thickness road rash burns are very painful. Full-thickness road rash burns don’t hurt, but the tissue around them can.
• Skin color changes. Light-skinned people may have red or pinkish skin with superficial road rash. Darker-skinned individuals may develop a reddish tinge to their skin. Darker-skinned people may also have burned skin that appears lighter while it heals. Lighter-skinned people may have partial-thickness burns that look darker red or reddish-brown. Full-thickness burns can make your skin darker and charred or pale and ashy or gray.
• Blistering. Superficial partial-thickness road rash can cause your skin to blister like a thermal burn does. These blisters fill with a yellowish fluid and it’s normal for them to eventually break open on their own.
• Debris embedding. Road rash damages your skin surface, allowing gravel, dirt or other debris to lodge in the burned skin.

What causes road rash?

You can get road rash if you fall onto a paved surface while doing any of the following:

• Jogging or running (especially at faster speeds)
• Riding a two-wheeled vehicle like a motorcycle, bicycle or moped
• Using other wheeled recreational items like skateboards, rollerblades, scooters, etc

When you fall during one of these activities, you hit the pavement, but you don’t stop immediately. Instead, your momentum drags you along the paved surface, creating friction.

Road rash can be particularly severe because it takes a lot of physical force for you to slide on a paved surface. And the longer the distance you slide on the paved surface or the faster you move doing so, the worse the burn will be.

What are the complications of road rash?

When severe, road rash can cause many complications. They include:

• Infections. The physical force it takes to get road rash can also embed dirt, debris and germs forcefully into your skin. That makes it easy for road rash to become infected.
• Traumatic tattooing. Embedded debris and foreign objects can stay behind in your skin as road rash heals. When they remain visible beneath your skin even after the injury heals, that’s traumatic tattooing.
• Scarring. Road rash, especially full-thickness burns from it, can cause significant tissue damage. Deeper burns that take longer to heal are more likely to scar.

Severe or life-threatening complications

Like flame or scalding burns, severe road rash can put a strain on your body systems. Large partial-thickness and full-thickness burns can cause life-threatening complications like:

• Shock (due to fluid loss from the burn, blood loss from related injuries, or both)
• Hypothermia (severe skin damage disrupts how your body regulates its internal temperature)
• Organ failure (waste products left behind when tissues break down can strain your kidneys, which try to filter the waste out)

How is road rash diagnosed?

A healthcare provider can diagnose road rash by looking at the injury and learning more about how it happened. In many cases, people with road rash aren’t conscious because of their injuries. Providers instead will rely on official reports from first responders or loved ones who saw you get hurt.

Lab and imaging tests are also likely if you have road rash. That’s because they can help diagnose or rule out related injuries or complications. Blood or urine tests may help detect toxic effects from the burn before they can affect your internal organs. And imaging scans like X-rays or computed tomography (CT) scans can detect bone fractures or internal injuries.

How is road rash treated?

Like with all burns, the treatment for road rash depends strongly on a few factors:

• How severe the burn is
• If it is severe, how much of your body surface area it affects
• Any other injuries you currently have
• Your health history
• Your personal preferences

Superficial road rash burns need minimal or no treatment. You can treat these yourself at home.

• Run cold water over the burn for a few minutes immediately after it happens.
• Make sure there’s no grit or dirt in the damaged skin.
• Cover the burn with a sterile bandage or clean cloth. Make sure the coverings you use aren’t too tight. If they are, it can affect how your burn heals.
• You can use over-the-counter pain medications like acetaminophen (Tylenol®) for pain. Ibuprofen (Advil® or Motrin®) or naproxen (Aleve®) can help pain and inflammation.

You may also be able to self-treat partial-thickness road rash burns if they’re small enough. A good guideline is whether you can cover them with your hand. If they’re larger than your hand, they need professional care. And full-thickness burns always require expert medical attention. The care they need can include:

• Pain management. Prescription pain medications may be necessary to manage your pain.
• Cleaning and debridement. Your burn can get infected if there’s any debris, like dirt or grit, in the wound. Your burn may need cleaning and debridement to avoid complications.
• Bandaging. Partial-thickness and full-thickness burns damage your skin, meaning it can’t do its job of keeping things like germs outside of your body. Bandages are a stand-in to protect your body when your skin can’t.
• Surgery. Deeper burns often take too long to heal on their own without surgery to help. You may need surgeries like skin grafting to help your burn heal.

Your healthcare provider is the best source of information about your specific case. They can provide information and guidance that are specific to your case.

Can road rash be prevented?

There are several things you can do to prevent road rash or at least lower your risk of getting it. They include:

• Wear the right clothing for the activity. Certain types of clothing are made specifically to protect motorcyclists from road rash and other injuries.
• Don’t neglect other kinds of safety gear. Elbow and knee pads and helmets can protect you from road rash if you’re rollerblading, skateboarding and more.
• Enjoy the road safely. Traveling at safe speeds, giving the road your full attention and being aware of your surroundings can all spare you from serious injury.

What can I expect if I have a road rash?

The shallower the road rash burn, the less time your recovery should take. Superficial burns should heal within a couple of days. Deeper burns can take weeks or more. Other factors can also influence what you can expect and how long it takes you to recover. Your healthcare provider is the best source of information about what you can and should expect after getting road rash. They can also guide you on what to do to help make your recovery as easy and fast as possible.

What’s the outlook for road rash?

The outlook for road rash depends mainly on how deep and large the burn is. But road rash commonly happens along with other injuries like broken bones, lacerations and more. Those other injuries may heavily influence the outlook for your case. Your healthcare provider can tell you more about the outlook for your case and what’s affecting it.

How do I take care of myself if I have road rash?

If you have road rash, it’s important to handle it the right way. Superficial burns are a lot like scrapes and you can self-treat them at home.

But if your burn is — or you think it could be — more severe, you shouldn’t hesitate to get medical attention. Call your healthcare provider or get medical care if:

• Your burn might be partial thickness or deeper and it’s bigger than you can cover with your hand
• Over-the-counter medications aren’t enough to manage the pain
• You see a lot of debris or other foreign substances in the burn and it’s hard to get them out
• If you’ve been self-treating your burn for a couple of days and it still doesn’t seem to be healing

You need emergency medical attention if you have a road rash friction burn that might be partial thickness or deeper and the burn is:

• On your head, face, ears, hands, feet or on a sensitive area like your groin or buttocks
• Larger than you can cover with your hand
• Shows signs of infection like color changes, has a foul or sour smell, is oozing fluid or pus, or if you have a fever
• If you have severe pain, especially if the pain feels worse than what you’d expect from the burn

What questions should I ask my doctor?

Some questions you can ask your healthcare provider include:

• What can I do to help my road rash heal?
• Can or should I do anything to self-treat it?
• Does my road rash need treatment and, if yes, what do you recommend?
• What’s the recovery timeline for my road rash?
• What are the symptoms I should watch for that mean I need emergency medical care?