CUTS AND SCRAPES
MOST RUN-OF-THE-MILL CUTS AND SCRAPES - what doctdrs refer to as abrasions - usually need only a good washing with lots of tepid water. If the wound bleeds, apply direct, steady pressure for 10 minutes. If it continues to bleed, seek medical help; you may need stitches. If foreign objects became embedded in your skin, try to remove the using a clean flannel, sterile gauze or tweezers. Left where they are, such invaders can lead to discomfort, infection, scarring and, in the case of tarmac, permanent tattooing.
Wounds heal faster when left open to the air, so don't cover them with a bandage unless you plan on digging in the garden, changing the oil in your car, or doing something else to make the cut dirty.
IT'S RED, IT HURTS, WHAT IS IT?
Abscesses, also called boils, are tender red lumps in the skin. They typically range from 1 to 2 centimetres in diameter. They can result from a cut that becomes infected. Puncture wounds are particularly prone to infection, because they don't bleed enough to wash out bacteria. Abscesses can also result from infection in a hair follicle or skin pore. Staph bacteria (Staphylococcus aureus) are often to blame.
So is that what you have? The borders of a boil will feel well-defined because your body is walling off the infection that's present. After a week or so, the skin overlying the abscess becomes thinner; the abscess begins to look like a pimple. A few days later, the thinned skin ruptures and the pus drains out, relieving both the infection and the pain. Sometimes doctors hasten this process by lancing a boil, or cutting it open with a scalpel. But don't try this at home - you might make things worse.
You can hasten the healing of boils at home by applying hot herbal compresses. Make a tea of an antimicrobial herb such as Oregon graperoot or thyme leaves. Or add 5 drops of tea tree oil or grapefruit seed extract per 1/4 litre of hot water. Wet a clean cloth in this hot-to-tolerance solution and apply to the abscess until the compress cools. Repeat three times in one session; aim for three sessions a day. Because infection is walled off in an abscess, it's unlikely that these herbs' antimicrobial properties will be absorbed deep into the skin, but the warmth will increase healing circulation to the abscess site. Should the abscess begin to drain, such herbal compresses can help clear infection and prevent its spread. Caution: do not squeeze an abscess or boil. This only increases the pain and spreads the infection. Once the abscess opens, it usually drains on its own, but you can gently compress the sides. If the abscess resulted from a puncture wound, is on your face, or you develop a fever or red streaks leading away from the wound, see a doctor.
Ointments and salves, whether conventional or herbal, can help prevent scabs from breaking open when abrasions involve areas subject to repeated stretching, such as elbows and knees. Herbs used externally in poultices, compresses, gels or salves can speed healing and inhibit micro-organisms. In the case of puncture wounds, however, do not apply herbs that hasten wound closure, such as comfrey or aloe, because rapid closure seals in microbes. Instead, choose herbs with antimicrobial properties to fight infections let the wound gradually close.
DRUG TREATMENT
For superficial cuts and scrapes, you won't need to take any drugs by mouth - unless the wound becomes infected. In that case, it may require oral antibiotics. But there are some drawbacks to a few of the usual first-aid remedies you may have learned about.
Hydrogen peroxide. Although a commonly used first-aid remedy, this fizzy fluid can interfere with blood clotting and is only mildly antimicrobial.
Rubbing alcohol. This stuff stings! Not only can it actually damage tissue, but it also inhibits blood clotting and is not a very good antiseptic.
Antibiotic-containing ointments. These include bacitracin, polymyxin B (Polyfax), framycetin (Soframycin), mupirocin (Bactroban), neomycin sulphate (Cicatrin, Graneodin). These ointments are used to prevent infection (usually not necessary in minor scrapes) and keep the wound moist. Allergy to any of the component antibiotics can lead to local redness, itching and swelling.
Topical analgesics. These include such products as Dettol Antiseptic Pain Relief, and many others. They often come in combination with a topical antiseptic, so they help prevent infection and relieve pain, but the pain relief is usually brief.
HERBAL REMEDIES
Aloe (Aloe vera)
Well known for its beneficial effect on burns, aloe also reduces inflammation and feels soothing, plus it's antibacterial. It contains allantoin, a substance that stimulates cellular proliferation; studies have shown it to hasten wound healing. Slice a fresh aloe leaf lengthways and apply the gel generously, or use a commercial preparation of pure aloe vera gel. In both cases, apply as needed.
Cayenne (Capsicum annuum)
This spice contains the pain-relieving component capsaicin, which speeds wound healing, inhibits bleeding, improves circulation and fights infection. One experiment that compared capsaicin cream with other topical agents such as bacitracin, silver sulfadiazine and aloe vera gel found that capsaicin cream produced the fastest rate of skin regrowth, making it the leader for closing wounds quickly. However, cayenne burns open wounds, eyes and sensitive genital tissues; on the other hand, a cayenne-containing cream might benefit an abscess by promoting circulation and easing pain (for more on abscesses, see 'It's Red, It Hurts, What is It?' on page 192). Whichever product you purchase, follow the manufacturer's directions on how often to apply.
Calendula (Calendula officinalis)
Anti-inflammatory, astringent and antiseptic, calendula promotes new skin growth and inhibits bleeding. You can use the fresh or dried flowers in a salve or compress, or look for commercial creams or lotions that contain it. Apply them according to manufacturer's directions (usually as often as needed).
Comfrey (Symphytum officinale)
Another allantoin-containing herb, comfrey speeds healing. It can safely be used externally in salves, compresses and poultices. To make a comfrey-leaf poultice, wrap fresh or dried leaves in a clean, wet cloth and apply.
Echinacea (Echinacea purpurea, E. angustifolia, E. pallida)
Usually taken internally for its immune-boosting qualities, echinacea is mildly antiseptic, improves wound healing, decreases inflammation and has a numbing effect. You can use a tincture of this herb topically, though it may sting. A glycerin extract avoids this drawback, but may be a bit sticky. If infection from a wound threatens, take the herb internally. Typical dosage: 1 teaspoon of liquid extract three times per day; or 2 teaspoons of tincture (preferably one made from the root) three times per day; or 300 milligrams of solid extract in capsules three times per day. Caution: people allergic to ragweed may also be allergic to echinacea. Those with autoimmune disorders should not take it internally.
Garlic (Allium sativum)
Try applying a crushed clove of this microbe-fighter to a boil or abscess; tape it in place for an hour or two. Bear two things in mind: one, the antibiotic components may not penetrate to the heart of an abscess; two, the garlic may irritate your skin. If irritation occurs, discontinue. Garlic's near relative, onion, can be used in a similar way.
Gotu Kola (Centella asiatica)
Extracts of this herb have become popular in Europe for both internal and external use in the healing of wounds. The active compound, asiatic acid, is particularly effective in stimulating synthesis of collagen, a prominent component of the deeper layers of skin. Typical dosage: up to eight 400- to 500-milligram capsules per day; or 20 to 40 drops of tincture up to two times per day.
Grapefruit Seed Extract
With broad antimicrobial action against bacteria such as streptococci, staphylococci and tetanus, this extract is available as a concentrate, skin cleanser, ointment and antiseptic spray. Follow the manufacturer's recommendations for dosage.
Honey
Though it's a bee product, not a herb, honey is a time-honoured wound healer. Scientific studies confirm that it speeds healing and fights infection. In an Israeli study, health-care workers applied fresh, unprocessed honey to the open, infected wounds of infants that had failed to heal with conventional treatment. After five days of twicedaily honey applications, all infants were much improved. Three weeks later, all wounds had healed. Of course, this can be a messy remedy; it's likely to attract both pets and pests! To keep them away, cover the wound with gauze and tape in place.
Oregon Graperoot (Mahonia aquifolium)
Like its relatives barberry and goldenseal, this herb is antiinflammatory and infection fighting. Its liquid extract can be applied to abrasions and, if infection threatens, the extract can be taken internally. There's not much research yet to support a typical internal dose, so follow manufacturer's or practitioner's recommendations.
Plantain (Plantago spp.)
This weed contains antimicrobial and anti-inflammatory substances and the tissue-knitting substance allantoin. Tear a leaf and you'll see it's also mucilaginous, or gooey. You can mash a few leaves into a poultice and apply to a wound. Herbalist Sunny Mavor, co-author of Kids, Herbs, and Health, calls plantain 'a backyard bandage'.
Tea Tree Oil (Melaleuca alternifolia)
This oil from an Australian shrub is a good antiseptic, particularly useful for treating or preventing bacterial skin infections. Simply apply the undiluted oil to a scrape or cut, as needed.
Thyme (Thymus vulgaris)
Smell that pungent, clean scent? Thyme contains volatile oils with potent antimicrobial action. You can wash a wound with a tea made of the leaves (steep 1 teaspoon in % litre of hot water for 10 minutes) or with a cup of water containing 3 to 5 drops of thyme essential oil.
