How to deal with road rash

Helping you get back on the bike after you’ve been burned

If you’ve ever come off your bike at speed, you’ve probably experienced road rash, the burn/skin abrasion that results from contact with the ground.

In most cases it’s not too painful straight after the fall, but once you get home, the suffering really starts. It’s painful because of the number of nerve ends that have become exposed.

Clothing offers a degree of protection, but thin Lycra is little help. You can protect your hands, however, by always wearing gloves.

Treatment

The first step for treating road rash is to be properly prepared for it:

Shave: Cleaning debris out of wounds is an awful lot easier without hairs in the way. It’s one of the main reasons for cyclists shaving their legs.

Treatment kit: Keep a stock of the basic kit at home (see the list below). All of the items can be bought at a decent chemists or online suppliers.

If you get a dose of road rash, assess the severity of the wound and if it’s larger than your palm, seek medical advice.

Dr Prentice Steffen, a physician with experience of working with professional cycling teams, warns that road rash, although painful, should be low on a rider’s list of priorities.

“Don’t let road rash divert attention away from potentially more serious injuries such as head, spine or internal damage,” he says. “Skin comes last in the evaluation of an injured cyclist.”

If you’re treating yourself, the first step is the most important – clean the wound as thoroughly as possible. Do this by both ‘jetting’ the syringe/saline solution over the wound and using sterile wipes.

Once you’ve got rid of the visible muck, clean the wound generally using a mild antibacterial soap, a washcloth and lots of water. Then pat the wound dry.

Dr Steffen agrees: “In the vast majority of cases, it’s a myth that road rash needs to be scrubbed. Betadine and peroxide are too harsh; soap and water is sufficient. Gels and sprays do little.

"There are rare cases where debris becomes embedded in the wound and needs more attention; this should be done in an emergency department with pain medication, the proper equipment and experience.”

Dressing the wound

If using a healing hydrocolloid dressing, apply it and leave in place until healing has occurred. It’ll drop off in a week or so to reveal new pink skin. You do not need to remove the dressing or reclean the wound.

If you’re using more traditional dressings, apply a thin coating of antibiotic ointment once the wound is clean, followed by a non-adhesive gauze pad and then hold that in place with a combination of micropore tape and Surgifix tubular bandage. Then monitor the healing process, cleaning and redressing the wound daily.

Dr Steffen sums up: “There are three phases to road rash care. The first is to be bandaged 24/7. Phase two is covered during the day and open-to-the-air at night. Third is unbandaged 24/7, dried up and scabbed over.”

Keep an eye out for spreading redness, swelling, an increase in pain, pus or foul smelling drainage. All of these are signs of infection and if they’re present, you should consult a doctor immediately.

Once the scab has come off, new pink epidermis will be revealed. This skin has not yet fully healed and over-exposure to sunlight can cause permanent pigment change. Protect it with sun block or clothing and apply a moisturiser. Also bear in mind that you and your road rash are individual, and what works for you might not work for a mate. 

Treatment kit

Road rash isn’t pleasant, but you can limit your pain by being prepared

  • Phials of saline solution
  • Syringe
  • Sterile wipes
  • Anti-bacterial soap
  • Antibiotic ointment (Neosporin)
  • Dressings (Hydrocolloid dressings such as Duoderm make the healing process much easier. A cheaper alternative are non-adhesive gauze pads, but you’ll have to clean and redress the wound daily)

This article was originally published in Cycling Plus magazine, available on Apple Newsstand and Zinio.

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