What is a friction burn, and how do you treat it?

What are friction burns, and how are they different from other burns?

Friction burns are a hybrid of blunt trauma and heat that is worsened by high speed. A rub burn or a friction burn is a wound caused by the skin coming into contact with an abrasive surface when either the person or the surface is moving at high speed, resulting in rubbed raw, burned, blistered or deeply wounded skin. Friction burns are not classified as thermal burns or abrasions because they are technically a bit of both! An abrasion is the scraping or wearing away of the skin, while a thermal burn is a burn caused by coming into contact with extreme heat or a hot object. Friction burns work by rubbing the skin and building up heat from the contact until the skin begins to burn, even if the surface itself was not hot, to begin with. Because of this, friction burns are typically cared for in the same way as thermal (heat) burns, even though they are considered abrasions.

What are common types of friction and rub burns?

Friction burns can happen to any age group at home, outside and on the go. Many of the most common places to get friction burns are carpets, treadmills and asphalt or concrete.

Road rash

Road rash is a type of friction burn that occurs mainly to motorcyclists when they get into motor vehicle accidents. When not wearing the proper padded clothing, motorcyclists are at an increased risk of road rash, even in a minor accident. The temperature of the asphalt or concrete dramatically contributes to the severity of the burn. If the ground is hot, the road rash or friction burn will be more severe than if the ground is cooler. Even if proper clothing and protection are worn, friction burns can burn through the clothing depending on the speed the motorcyclist is going and the temperature of the asphalt.

Along with motor vehicle accidents, road rash can also affect children riding their bikes, skates, skateboards and scooters. Friction burns can occur if children don’t wear knee pads, elbow pads, helmets and other safety gear and happen to fall while using these types of sports- or play-equipment.

At home

Friction burns occurring at home or indoors are common, especially for children. Houses with carpet or exercise equipment pose the highest risk for at-home friction burns. Owners of treadmills should take particular care that the exercise equipment is kept away from children or that children are always supervised when using it. Full thickness injuries on children’s hands from treadmills are common. Along with that, the safety cord should always be worn when the treadmill is in use. The safety cord should clip to your clothing. In case of a fall, the safety cord will detach from the treadmill, turning it off.

Sports and outdoors

Friction burns occur in many indoor and outdoor sports and activities, including baseball/softball, basketball, volleyball, gymnastics and soccer. It’s easy to get friction burns by sliding across surfaces such as grass and artificial grass, trampolines, gym floors and sand.

Recent viral challenges and pranks

Over the years, several internet challenges and trends have involved the self-infliction or infliction of a friction burn. Some to be aware of are:

• The eraser challenge: this challenge has children rub an eraser on their arm or hand. This can cause painful first- and second-degree burns depending on how long the challenge goes on and how young the child is—younger children have more sensitive skin than older children.
• Treadmill Pac-Man: several viral videos show kids lining up food on the treadmill before turning it on and trying to catch the food in their mouths. This can lead to severe friction burns to the face as they attempt to eat the food off a moving treadmill.
• Jumping on moving treadmills: treadmills should always be at a stop before attempting to get on them. Jumping on a fast-moving treadmill can cause the user to fall and, if not attached to the safety cord, receive severe friction burns as the treadmill continues to move.

Friction burn degrees

First-degree friction burn

A minor burn degree, first-degree burns affect the outermost layer of skin known as the epidermis. The skin will look red and feel tender. However, there won’t be any wetness or blistering. This burn should heal on its own but can be treated with some topical medication. It is a superficial wound and is unlikely to leave scarring.

Second-degree friction burn

Second-degree friction burns affect the outer layer of skin (the epidermis) and the deeper layer of skin known as the dermis. The wound will not only appear red but will also look shiny or wet. It will be painful to the touch and may blister over time. Depending on how deep the burn is, this burn may require medical intervention to heal. There is a possibility of scarring.

Third-degree friction burn

Damaging or destroying both the epidermis and dermis, third-degree friction burns are deep and usually painless from the damage to the nerves. Instead of a red and shiny wound bed, this burn might appear black, brown, white or yellow, depending on the cause of injury and how deep it is. Third-degree friction burns require medical intervention to help heal. There is a high possibility of scarring.

Friction burn treatment

Minor friction burns, such as first-degree burns, can be treated at home by running lukewarm water over the affected area and then covering it with a pain-relieving antibacterial topical ointment or cream.

Burns that have developed blistering should be seen by a medical professional. Do your best not to pop the blisters, as this could open the door for infection. Second-degree friction burn treatment might include debriding or cleaning the wound bed, applying medicated topical ointments or creams and applying dry sterile bandages. Or, if the burn is more severe, it may require a skin graft. This will likely be an outpatient procedure, but overnight stays can happen depending on the size and severity of the wound.

Third-degree friction burns are considered medical emergencies and will most likely require medical intervention to heal. This might include debriding or cleaning the wound bed and placing skin grafts on the wounds. Overnight stays in the hospital likely depend on the size and severity of the injury.

The healing stages of friction burns

For minor friction burns:

1. The burn may look red, swollen and wet.
2. The swelling should go down over time, and the wound will start to dry out, forming a scab.
3. The skin or scab may be itchy, as this usually occurs when the skin is healing.
4. Do not pick at the scab. This can increase the chances of infection and scarring.
5. If instead of scabbing and healing, the wound continues to change colors, feel tender or become increasingly painful, or if something new presents, such as oozing or a foul smell, please seek medical attention immediately because there is a chance the wound is infected.

For severe friction burns:

1. Severe friction burns are deep and may affect the subcutaneous layers of tissue. They cannot heal independently and must be treated by medical professionals. If left untreated, an infection may set in and cause severe complications.
2. Severe friction burns will likely be debrided or cleaned. This medical procedure involves removing foreign debris and dead tissue from the wound bed.
3. Once that has been done, your surgeon may decide your wound needs a skin graft to heal. There are two types of skin grafts you are likely to get: a cadaver skin graft (human skin from a deceased organ donor) or an autograft (your skin from a healthy location on your body).
4. The skin graft may be temporary and, if that is the case, will be removed in a few weeks to reveal healthy, new skin underneath. If the skin graft is permanent, the skin graft will not be taken off. Both should be cared for at home according to directions given to you by your surgeon.
5. There will likely be scarring. Scar revision options are available if the scarring is dramatic and affects your appearance or functionality.