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Treating Skin Wounds in Children
From the time your child begins crawling and cruising around the furniture—then walking, running, climbing and biking—be prepared for scrapes and bruises. In spite of all your precautions, injuries can still happen.

Thankfully, most skin wounds are minor and heal on their own with simple care at home. The skin has many natural features that help protect children from serious injury and infection. For one, it's fairly tough and puncture-resistant. Young children's extra fat layer helps cushion their bumps and protect their bones and organs underneath from injury. When a break in the skin occurs, the bloodstream brings many components to stop the bleeding, fight infection and promote the growth of new skin to heal the wound.

There are several basic principles for treating children's skin wounds. Start off by staying calm and calming your child. Wash your own hands well before and after caring for your child's wound. Clean the wound well as a dirty wound can lead to infection and scarring. If the wound is bleeding, apply pressure with a clean cloth or bandage to stop the bleeding. Then cover the wound with a clean bandage. Check the wound every day. Keep it clean and dry, and make sure it's healing with no signs of infection (increased redness, warmth, swelling, pus drainage and pain). Call emergency medical services if your child has a serious injury; and call the doctor for signs of infection or if your child may not be up-to-date on his tetanus vaccine.

Here's more information about different types of skin wounds:

Bruises

A bruise occurs when a bump to the skin breaks small blood vessels under the skin, leaking blood into the tissues. The bruise may be tender for several days. Over the course of a week or two, it will change color from red/purple to green/yellow and fade away.

What to do at home:
  • Apply a cold compress or ice pack for 15 to 20 minutes to help reduce the swelling and pain. Cold packs and ice can be helpful, off and on, for the first 24 hours after the injury. If the bruise or swelling is on the lips or mouth, offer your child an ice cube or Popsicle to suck on.
  • If your child has a large bruise on an arm or leg, elevate the limb to help reduce swelling.
  • Don't press on or massage a bruise.
  • After the first day, warm compresses or a heating pad may help relieve discomfort from the bruise.
Call your doctor for: frequent or numerous bruises without any apparent cause; a very large bruise; persistent swelling or pain; a bruised and injured eye; inability to move a joint, or a possible broken bone.

Cuts and scrapes

Cuts and scrapes are tears in the skin. They can be superficial and involve only the top layer of skin, or deeper and involve lower levels of skin. Small and superficial cuts and scrapes usually heal within a week. But deeper and longer cuts may need more thorough cleaning, or stitches and antibiotics to stop the bleeding, prevent infection, help the cut heal successfully and minimize scarring.

What to do at home:
  • Wash cuts and scrapes with soap and water to remove dirt and germs. Do not use alcohol or peroxide, which can harm the skin tissue and sting.
  • Apply pressure with a clean cloth or bandage for 5 to 10 minutes to stop any bleeding.
  • Dab antibiotic ointment on the wound and cover with a clean bandage.
  • Check the wound each day and change the bandage to keep it clean and dry.
Call the doctor for: wounds that continue to bleed after 10 minutes of direct pressure; wounds that are deep, longer than ½ inch, gaping open or have jagged edges; large cuts on the face or located near the eye; wounds caused by a puncture with a dirty or rusty object, or an animal or human bite; wounds embedded with debris such as dirt or gravel. Also, if your child is in extreme pain, shows signs of infection or is not up-to-date on his tetanus shot.

Splinters

A splinter is a small sliver of wood, glass or other debris stuck underneath the skin. Splinters can usually be removed at home. The skin may be sensitive for several days, but usually heals within a week.

What to do at home:
  • Gently wash the area with soap and water.
  • Prepare a clean tweezers and needle for removing the splinter. Sterilize them with an alcohol wipe or over a flame, then let cool before using.
  • Remove the splinter:
  • If the tip of the splinter is sticking out of the skin, grab it with the tweezers and pull it out slowly at the same angle that it entered.

    If the splinter is close to the surface but underneath the skin, gently prick the skin over the splinter with the needle, then try to remove it with the tweezers.

  • Wash the wound again with soap and water.
Call the doctor for: a splinter that is deeply imbedded or one that you can't remove after several tries, signs of infection or if your child is not up-to-date on his tetanus shot.

Puncture wounds

A puncture wound is a deep wound made by a sharp object such as a nail, or a sharp piece of glass, metal or wood. Puncture wounds can become infected easily because dirt and germs are carried deep into the tissues, and antibiotics may be needed to prevent infection. A doctor should check all puncture wounds.

What to do at home:
  • Apply pressure with a clean cloth or bandage for 5 to 10 minutes to stop any bleeding.
  • Once bleeding has stopped, wash the area well with soap and water.
  • Cover the wound with a clean bandage.
Call emergency medical services or 911 for: puncture wounds with a large object, such as a stick or knife. Do not try to remove the object because it could cause further damage and bleeding.

Call the doctor for: all puncture wounds, signs of infection and to ensure your child is up-to-date on his tetanus shot.

Burns and scalds

Burns and scalds are damage to the skin caused by contact with a hot flame, object, liquid or steam; caustic chemicals, or electrical current. Burns can be superficial or deep; small or large. While most superficial and small burns can be cared for at home, deep and large burns are medical emergencies and require immediate evaluation and treatment.

What to do at home:
  • Remove the child from contact with the hot item. For electrical burns, disconnect the power and pull the child away from the power source with a wooden pole. Don't use your bare hands because you could also get electrocuted.
  • Gently remove the child's clothing around the burned skin, unless it is stuck to the skin. Remove any jewelry before swelling begins.
  • Run cool water over the burned skin for about 10 minutes or until the pain stops. Do not apply ice, butter, grease or other ointments, and do not rub the burn, which could make it worse.
  • Do not break open blisters, as they help protect the skin underneath from damage and infection. If the blister bursts, place an adhesive bandage or dressing on the area to keep it clean.
  • Cover the burn with a clean, dry gauze pad.
Call emergency medical services or 911 for: electrical burns or large, deep burns. After cooling the burn, keep the child warm with a clean sheet and blanket.

Call the doctor for: signs of infection or if your child is not up-to-date on his tetanus shot.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician