Lacerations: Home Care vs Emergency

Natalie Wescott
Sep 5
12 min read

Updated: Sep 7

2 nurses, 1 topic: Lacerations

This post is a collaboration with Liz (@run.on.essentials), a trauma nurse. With Liz’s expertise caring for severe lacerations that require emergency intervention, and my own experience in the ER providing day-to-day wound and laceration care, we’ve combined our knowledge to create this guide. Our goal is to help you confidently assess lacerations, know when they can be managed at home, and recognize the situations that require urgent medical attention.

As always, this is not medical advice.

**Note: there are photos of wounds in this post

What is a Laceration?

A laceration is a wound caused by a cut or tear in the skin, often from something sharp (like glass, metal, or a knife) or from blunt trauma that splits the skin. Unlike a simple scrape or abrasion, a laceration goes through the top layer of skin and often into deeper layers, sometimes involving fat, muscle, or even bone.

Types of Lacerations

Clean (simple) laceration: Straight, smooth edges, like a cut from a kitchen knife. These often heal more easily and with less scarring.
Jagged (complex) laceration: Irregular, torn edges, often from broken glass, rough metal, or blunt trauma. These are harder to close and more prone to infection.
Avulsion: A type of laceration where a piece of skin and tissue is partially or completely torn away.
Puncture-associated laceration: Caused when a sharp object punctures the skin and also tears it (like stepping on a nail that rips the skin). Higher risk of infection since bacteria can get trapped deep inside.
Deep laceration: Extends beyond the skin into muscle, tendon, or bone. These almost always require medical care because of bleeding risk, infection risk, or functional damage.
Amputation: requires immediate medical attention. Control bleeding. Put the severed body part in a bag and place the bag on ice. Do not put the body part directly on ice.

How to Assess a Laceration (size, depth, and bleeding)

Size: Many people are told that any cut longer than ½ inch automatically needs medical attention. In reality, if you have proper wound care supplies and know what to look for, many lacerations can safely be managed at home. When considering size alone (length or width), the key is whether the wound edges can be held together with butterfly bandages or Steri-Strips. If the cut is gaping open and won’t stay closed, that’s a strong sign it may need stitches.

Depth: When assessing a laceration, depth is just as important as length or width. Two key factors to consider are how well the wound can be cleaned and whether deeper structures are involved.

Ability to clean: If dirt, debris, or bacteria remain trapped inside a deep wound, the risk of infection increases significantly. Shallow lacerations are usually easier to rinse and keep clean, while deeper ones can hide contamination you can’t easily reach at home.
Internal involvement: A laceration that extends beyond the skin and fat layers raises more concern.
- Muscles look red, thick, and meaty. If these are visible or damaged, the wound should be evaluated in the ER.
- Tendons appear white, shiny, and taut, almost like cords or bands. Damage here can limit movement and usually requires surgical repair.
- Nerves may be involved if there is numbness, tingling, or loss of function near the wound.

Any wound that is deep enough to expose muscle, tendon, or bone, or one where you notice difficulty moving the affected body part should be seen in the ER.

Bleeding: One of the biggest concerns with lacerations is how much they bleed. Most cuts will ooze or trickle, but spurting blood usually means an arterial bleed. These can cause rapid blood loss and need to be taken seriously. These are often dramatic, with bright red blood that spurts in rhythm with the heartbeat. For smaller arterial bleeds, firm direct pressure for 10–15 minutes is often enough to stop it. If the bleeding is severe and won’t stop with pressure, a tourniquet may be needed.

Helpful tools:
- Tourniquet: Commercial versions are best (like a CAT or SOF-T tourniquet), but in an emergency you can improvise with items at home. A belt, scarf, or strip of cloth paired with a sturdy stick or pen can work to tighten and hold pressure above the wound. Tourniquets are reserved for life-threatening bleeds when direct pressure fails.
  - Video example of how to make a tourniquet at home in an emergency: https://www.youtube.com/shorts/p9tAOenrGYo?feature=share
- Kaolin clay: Very effective for heavy bleeding. In the ER, we use “QuikClot,” a kaolin-infused gauze. Kaolin activates clotting factor XII, helping the body form clots faster
- Helichrysum essential oil: Useful for smaller, stubborn bleeds. It helps constrict vessels and slows blood flow so natural clotting can take place.

Head Wounds: Head wounds are unique because they tend to bleed a lot, even when the actual cut is small. This can look alarming, but in most cases it’s normal and not necessarily dangerous. The scalp and face have a rich blood supply, which is why bleeding can seem out of proportion to the size of the injury.

For kids especially, this can be stressful for parents, but remember: lots of blood doesn’t always mean it’s serious. What matters more is whether the cut can be cleaned, whether the edges come together, and whether there are signs of deeper injury (like loss of consciousness or vomiting).

When it comes to closing head lacerations, skin glue (like Dermabond or other brands) can be especially helpful. Unlike bandages or strips that kids might pull off, glue seals the wound securely and reduces the temptation to pick. It also tends to leave less scarring compared to traditional bandages when used properly.

Puncture wound care and Tetanus

**This is not a vaccine guide, and we do not give recommendations on whether to get vaccinated or not. Please be sure to personally research the effectiveness and safety of any vaccine before administration. This section is to relay facts about tetanus that every parent has the right to be informed of.

Tetanus is an extremely rare infection, and importantly, it is not contagious. It’s caused by anaerobic bacteria (Clostridium tetani) that primarily lives in the gastrointestinal tracts of animals and in soil contaminated with manure. Anaerobic means it cannot survive in the presence of oxygen.

This is why bleeding is actually protective. If a wound bleeds freely, oxygen-rich blood helps flush out bacteria and makes it very difficult for tetanus to survive. Instead of applying pressure immediately, it is best to allow the wound to bleed for a short time to naturally cleanse itself before moving on to cleaning. Once bleeding has slowed, gently rinse with clean water and mild soap. If the wound is especially dirty, a disinfectant may be used at this stage.

If a wound does not bleed and has been exposed to high-risk contamination, such as animal feces, the recommended first-line treatment is tetanus immunoglobulin (TIG). This provides immediate protection and is also used in the treatment of active tetanus.

If you go to an Urgent Care or ER, it will be recommended that you get a tetanus vaccine if you have not received one in the last 5 years. Be sure to know your rights as a patient or parent.

Puncture wound care: First let bleed, then clean with soap and water. Disinfect if needed.

Homeopathy:
- Ledum (Led) 30C
  - Give as soon as possible after a puncture wound to help reduce severity of symptoms
Plantain:
- A plantain poultice can be applied externally to the wound. It is soothing and can help draw out infection.
Antibacterial herbs:
- Berberine containing herbs such as goldenseal, barberry, oregon grape root, coptis
Essential oil:
- Tea tree oil: after cleaning, apply tea tree oil to the wound (dilute in young children). Apply multiple times a day for a few days to prevent or heal infection. (1)

When to seek medical attention for a laceration

Urgent Care: Urgent Care may still send you to the ER, but for lacerations that need stitches without underlying involvement, Urgent Care should be adequate.

Gaping wound edges that won’t stay closed with Steri-Strips or butterfly bandages.
Wounds over joints or areas that move a lot, which are harder to keep closed.
- Can attempt to use steri-strips at home, but stitches may be needed if the wound keeps opening and bleeding with movement.
Heavily contaminated wounds (dirt, glass, rust, or animal/human bites) if unable to properly clean at home.
Signs of infection (redness, swelling, pus, increasing pain) if the wound is already a day or two old.

ER:

Spurting blood that looks arterial (bright red blood pulsing with heartbeat).
Visible structures like fat, muscle, tendon, or bone.
Loss of function (inability to move fingers, toes, or joints near the injury).
Numbness or tingling near the wound (could indicate nerve involvement).
Lacerations on the face, lips, or eyelids, where cosmetic outcome or function is important.
Head lacerations combined with a significant head bump, loss of consciousness, confusion, or vomiting.

For children under 5 years old, it’s best to look for a pediatric urgent care or ER if one is available. While most urgent cares and ERs can perform stitches, pediatric facilities usually have more experience working with little ones and helping keep them calm. In many cases, young children may need to be gently restrained or even given mild sedation to safely and effectively repair the wound. That said, if it’s a true emergency, such as uncontrolled bleeding, a deep or severe laceration, or signs of shock, the closest ER is always the right choice, even if it isn’t a pediatric facility. Stabilization and bleeding control come first, and transfer to a pediatric center can be arranged if needed.

This is a simple laceration with clean straight edges that is appropriate to treat at home

While this wound is small, the white at the top is exposed tendon (common in hand injuries)

Check for the ability to move the pinky finger. After cleaning, see if the edges can be held together with steri-strips. Because it is on a knuckle, the movement may make healing difficult, therefore requiring sutures.

This wound has clean straight edges but has visible fat and possibly bone involvement.

These puncture wounds appear deep and likely have underlying involvement. It is important to clean the wounds thoroughly. Because of the gaping edges and depth, this will require sutures.

Wound Care

In General: bleeding helps to clean out wounds, letting small wounds bleed helps prevent infections and remove debris.

Laceration Care:

Pause before cleaning: If the bleeding was significant and took time to stop, it’s wise to wait an additional 10–15 minutes after bleeding has been controlled before beginning the cleaning process.
Gentle cleansing: Rinse the wound carefully with mild soap and water. Avoid scrubbing or rubbing, as this can reopen tissue.
Disinfection: Routine disinfectants are generally not recommended unless the wound has been exposed to a high-risk contaminant (such as animal feces or a bite). Harsh disinfectants can damage healthy tissue and kill beneficial bacteria that aid healing. If I were concerned that a wound was dirty enough to need disinfecting, I would use hypochlorous acid or a small amount of hydrogen peroxide.
Topical support: Applying a healing salve made with herbs or essential oils can support the body’s natural immune response and encourage tissue repair. (recommendations below)
Closure: Small wounds may be closed with Steri-Strips, butterfly bandages, or skin glue if the edges come together easily.
Covering vs. air exposure: A wound may be lightly covered for the first 24–48 hours to prevent reopening and reduce infection risk. After that, allowing the wound to be open to air often promotes faster healing and can reduce scarring.

What NOT to do for Laceration Care:

Don’t use rubbing alcohol: While it may seem like a good disinfectant, it actually damages healthy tissue, slows down the healing process, and is very painful.
Don’t scrub the wound: Vigorous rubbing can cause tissue trauma and may restart bleeding. Stick to gentle rinsing only.
Don’t close a contaminated wound: If dirt, debris, or bite bacteria remain inside, sealing the wound (with glue, strips, or sutures) can trap infection. These wounds often need professional evaluation.
Don’t keep the wound covered too long: A bandage is helpful in the first day or two, but leaving it covered constantly can keep the wound moist and delay proper healing.
Don’t ignore signs of infection: Redness, swelling, warmth, pus, or increasing pain after the first day are reasons to start home infection treatment or get medical care.

Homeopathic Remedies for Lacerations

Arnica montana: Classic remedy for trauma, bruising, and soreness around the wound. Often used right after an injury to reduce shock, pain, and swelling.
Calendula officinalis: One of the top remedies for wound healing. Known to reduce pain, prevent infection, and encourage tissue repair. Can be given internally in pellet form or applied externally as a diluted tincture or ointment.
Staphysagria: Helpful for clean, surgical-type cuts (such as knife or glass lacerations). Often used post-suturing or after incisions to help with pain and promote healing.
Hypericum perforatum: Excellent for wounds involving nerve-rich areas (fingers, toes, lips) where there is sharp, shooting pain. Supports nerve healing and reduces pain intensity.
Ledum palustre: Considered when puncture wounds or lacerations are caused by sharp objects (nails, tools, animal bites) and there is concern for infection.

Wound Care Products:

Liz’s Healing Salve: I personally use an olive oil based herbal infusion with plantain, yarrow, echinacea, comfrey, calendula, rosemary, infused on low heat in a crockpot for 8 hours, thickened with a couple tablespoons of bees wax pellets, Then add tea tree and frankincense essential oils once the infusion has cooled a bit. These all address preventing infection and skin repair. I have used this on diaper rashes, dog bites, cat bites, cat and chicken scratches, lacerations, dog and raccoon bites on chickens, even bumble foot on chickens (a staph infection that gets inside their feet). Pretty much any wound I've ever encountered.

Active Skin Repair: NWESCOTT for 10% off

Made with hypochlorous acid (HOCl), an incredible naturally occurring acid that your body already creates to support healing. Simply spray on the cut to promote healing and act as a mild disinfectant.

Earthley All-purpose salve: Natalie10off for 10% off

Made with soothing calendula, chamomile flowers, and lavender buds. Mixed with nourishing olive oil, candelilla wax, and castor oil, to assist the natural healing processes of the body.

Clozex Emergency Laceration Kit

Skin closure device for a wound up to 1 1/2 inches length

Senvok Wound Closure Device

Close the laceration, protect the wound, and keep secure even with joint flexion.

Butterfly bandages :

Great to hold laceration edges together

Steri Strips:

Great to hold laceration edges together

Skin glue :

Great for head lacerations

Compression bandages

Kaolin Clay Quikclot

This is a kaolin clay infused gauze that activates clotting factor XII, helping the body form clots faster

Helichrysum essential oil

Useful for smaller, stubborn bleeds. It helps constrict vessels and slows blood flow so natural clotting can take place.

Long term or Post-repair care:

Apply a healing salve to the wound once or twice daily for several days, or up to a week, as part of the morning and evening routine. Whenever possible, allow the wound to remain open to air, as this supports faster healing and can reduce scarring.

If scarring is a concern, especially for wounds on the face or from deeper injuries, certain herbs and oils are known for their ability to support skin repair and regeneration:

Helichrysum: sometimes called “immortelle,” it encourages skin cell renewal and is one of the best essential oils for reducing scar formation.
Yarrow: known as the “soldier’s wound herb,” it helps stop bleeding, fights infection, and promotes tissue healing.
Frankincense: supports collagen production and elasticity, making scars less noticeable.
Myrrh: has antimicrobial and anti-inflammatory properties that protect healing tissue.
Plantain: a common “backyard herb” with drawing and soothing qualities, it calms irritation and speeds tissue repair.

All of these herbs and oils can be applied directly to a healing wound and are blended into the healing salve for ease of use. Consistent application is key. Skin remodeling takes weeks, so continuing supportive care even after the wound has closed can improve long-term results.

Once a wound has fully closed and the skin has sealed (usually after 1–2 weeks, depending on depth), the focus shifts to minimizing scarring and supporting healthy skin remodeling. Scar tissue takes time to mature, so consistent care over weeks to months makes the biggest difference.

Red light therapy: stimulate collagen production and blood flow to the area for healing.
- LumeBox: code runonessentials for 41% off!
Microabrasion: Can use a microabrasion roller on clean skin (once the open wound is healed) to stimulate collagen and increase blood flow.
Scar massage: After the wound is closed and no scabs remain, gently massage the area with clean fingers and a natural oil or salve. This helps break up excess scar tissue, increases circulation, and encourages the skin to lay flat rather than raised.
Moisture support: Oils, lotions, and balms can help nourish the skin and improve elasticity.
Sun protection: New skin is fragile and can darken or discolor easily when exposed to sunlight. Keep scars covered or apply a non-toxic mineral sunscreen for at least the first year.
Patience with healing: Scars often look red or raised in the first few weeks but typically fade and flatten over time. Continued use of herbal salves and oils supports this natural process.

We created this guide to help you feel confident in caring for lacerations at home and in recognizing when professional medical care is necessary. As a parent, being prepared before accidents happen makes all the difference in knowing how to respond and protect your child.

Sources: