Knees and concrete are natural enemies, and many children spend their childhoods picking the scabs that prove it. Skinned knees are so common, in fact, that many parents don’t even think about the proper way to treat them. They just provide a hug or a bit of reassurance along the lines of “It’s not bleeding.” But, as it happens, when it comes to the most common of boo-boos, the most effective treatment is so simple that it’s likely the one that many parents don’t even think to employ.
“Wash it gently with soap and water. No alcohol, no iodine. We don’t even recommend peroxide anymore. Just soap and water” says Dr. Howard Reinstein, a spokesman for the American Association of Pediatricians who serves as clinical faculty at Children’s Hospital Los Angeles and the UCLA Medical Center.
With children, though, chaos reigns, and even the act of simply washing a surface wound can be tough when a kid is dealing with a combination of pain, adrenaline, tears, and blood. A frightened child can make cleaning a skinned knee a Herculean task. But there are workarounds: the water can be applied with a gentle, misting spray bottle, which minimizes touching, or parents can basically bribe the kid into chilling out for long enough to swab the blood away.
“Use distraction,” says Reinstein. “It’s one of the few times where you could be like, ‘Tell you what, you can watch this video while I take care of this’ if it zones them out enough. Sugar tends to be a little bit of a sedative, too. At the moment you have to clean the thing, they can lick a lollipop.”
Once the wound is washed, parents can cover the hurt area with a band-aid or gauze, though Reinstein says that doing so isn’t necessary except to prevent the wound from rubbing against rough surfaces. Still, some non-stick gauze or a bandage with a preferred cartoon character on it can go a long way in psychologically comforting a child, and keep a seeping wound from staining sheets or sticking to pants. Reinstein also recommends antibiotic ointment, which can prevent infection and keep the wound slightly moist, though it, too, isn’t wholly necessary.
How to Treat a Skinned Knee
- Offer a child a distraction to calm them and allow you to work. Cell phone videos and a hit of sugar during treatment can have a sedative effect.
- Wash gently with soap and water and cover with a clean bandage. A spray bottle of water can help in cleaning and minimize pain from touching the wound.
- Wash for other signs of injury and infection such as sore joints, and red tender hot skin around the wound.
- Kissing the wound is fine as long as parents do not have cold sores or herpes.
Once treated, skinned knees generally are not something to worry about. However, a kid’s chaotic reaction can mask other ailments. Reinstein says that more serious injuries — fractures, torn ligaments — can be identified pretty quickly due to heightened and prolonged pain. But he stresses that parents should also keep an eye on the kid’s behavior, to monitor the healing of the knee itself, and to visit a doctor if things persist or worsen.
“They may limp for a day because they don’t want to stretch it out,” Reinstein notes. “But there shouldn’t be persistent knee pain or joint pain. If you have a wound infection it’s going to be red, tender, and feel hot.”
As for the healing touch of a parent’s kiss on the boo-boo, Reinstein says parents are clear to smooch that gaping, open wound if they want. With some exceptions, of course.
“If a person has open cold sores or herpes, they shouldn’t be kissing it,” he says. “Otherwise it’s fine.”