How to treat road rash

Vicky Ware asks a Team Sky medic how best to manage and mend crash-damaged skin

(Image credit: Yuzuru SUNADA)

Unfortunately, if you ride enough, crashing is almost inevitable. The result is often lost skin where you have slid along the road. After suffering road rash, you’ll suffer a barrage of conflicting advice on how best to deal with the injury. Getting stuck to your bed sheets isn’t fun, so what’s the best way to heal road rash?

Team Sky’s head of medical practice, Dr Richard Usher, spoke to us about how pro cyclists deal with losing skin. Checking the rider isn’t more seriously hurt comes first. “You must check that there are no other injuries, stop any bleeding and temporarily cover the road rash until the wounds can be properly cleaned and dressed,” Usher advises.

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When it comes to cleaning road rash, further pain may be on the agenda. Sliding along dirty road surfaces results in grit being embedded in the cuts, but is scrubbing necessary? “Yes, you need to remove any obvious road gravel and stones and then scrub the wound with iodine, betadine or normal saline — so long as you’re not allergic,” Usher adds.

The essentials

  • Check for more serious injuries
  • Stop the bleeding
  • Scrub the wound clean
  • Cover for 24 hours
  • Consume protein for recovery
  • Keep riding

If you watch any Grand Tour, you’ll probably have seen a pro rider trussed up in bandages to cover road rash, but what dressings do the pros use? Usher says, “We use a variety of dressings containing alginate and silver, all supplied by Systagenix.” Alginate dressings contain derivatives of algae and are used on wounds that ooze liquid.

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As the dressing gets wet, it slowly forms a gel and absorbs liquid from the abrasion. Silver is anti-bacterial so will stop bacterial growth in the dressing and possible infection. Usher advises, “Best practice is to keep the wound covered for at least 24 hours. An iodine gauze will help to keep the wound clean.”

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Training takes its toll on your body, as does healing from injury. Inadequate recovery — poor nutrition, insufficient rest — may inhibit healing, as it deprives the body of essential building blocks for tissue repair: “Wounds can lose protein and require adequate nutrition for healing, so maintaining a good protein intake while healing is important.”

The good news is that gravel rash need not keep you off the bike for long, “so long as you observe the above guidelines,” concludes Usher.

Key points

Keeping the wound moist may promote scar-free healing. Research shows scab formation protects from infection but impedes new skin formation. A soft scab allows quicker skin growth; just keep it covered to prevent infection.

Clean the wound to make sure there is no grit left embedded in the tissue, and wash with iodine or saline solution to sterilise the site and prevent infection.

Cover the wound for at least 24 hours to ensure it is kept clean to prevent infection.

Tubular gauze may make you look like you’re wearing white fishnet stockings, but it can be worn on arms and legs to keep dressings in place. This is especially useful while riding your bike.

Alginate dressing will keep the road rash moist and promote healing while helping to prevent infection. If you’re unlucky enough to lose large areas of skin, more than one dressing may be required.

Get your nutrition right. Healing a wound requires the building blocks to rebuild skin and tissue along with the energy to power your immune system to do this job. Consuming enough protein ensures the wound heals quickly.

So long as you get your nutrition right there’s no need to stop riding your bike. Make sure you get enough rest to allow your body to recover properly from the wound and your training.

Michelle Arthurs-Brennan
Michelle Arthurs-Brennan

Cycling Weekly's Tech Editor Michelle Arthurs-Brennan is a traditional journalist by trade, having begun her career working for a local newspaper before spending a few years at Evans Cycles, then combining the two with a career in cycling journalism.

When not typing or testing, Michelle is a road racer who also enjoys track riding and the occasional time trial, though dabbles in off-road riding too (either on a mountain bike, or a 'gravel bike'). She is passionate about supporting grassroots women's racing and founded the women's road race team 1904rt.

Favourite bikes include a custom carbon Werking road bike as well as the Specialized Tarmac SL6. 

Height: 166cm

Weight: 56kg