Why the delayed wound response (and then healing) from a rugburn (I already saw a doctor)

NOT a medical advice thread, I already saw a doctor.

A few days ago I was going down the stairs and slipped hard. Got a really nasty rugburn on my hip and left hand.

The one on my left hand - hurt a good amount, bled at the time of injury. I washed it and went to bed.The next morning - You would swear there was no injury at all. The skin at the injury site was a bit pink, but no pain, no scab, no blood, no nothing. Huh. I must have a mutant healing factor, or something.

Yesterday - I woke up and the wound was screaming. Bright red, swollen, oozing. This was what made me see the doctor - concerns about infection and all that. I didn’t get enough time with him, but after describing it and him examining, he said “It’s fine. Just keep putting Neosporin on it”. Which I did. And by the end of the day, swelling was gone, pain was mostly gone, no more oozing and there’s a proper scab forming.

My question - and if I had had more time with the MD I would have asked - what caused that delayed response? Why did it go from injury - nothing - wound? Was it an infection? Is there something unique about friction injuries that makes them present late?

Maybe you irritated it in your sleep by rubbing your hand against the sheets/pillow? That’s my best guess.

Bright red, swollen, oozing

You had an infection that resulted in swelling which began pressing on your pain receptors which sent a signal to your brain that you have an injury.

A more thorough cleaning of the would site would have prevented the infection.

No, you didn’t have an infection. Red and oozing doesn’t mean an infection. It means you’re leaking plasma and the surrounding tissues are inflamed. You’re more likely to get an infection under those circumstances, which is why putting the Neosporin on it is a good idea.

The skin of the palm of the hand and the sole of the foot is different from the skin on other parts of the body. It has five layers, not four. It also has a better blood supply. My guess is that the injury on your hand healed faster because the skin on your hand is both sturdier and better equipped to heal. After all, you need your hand in good working order more than you need a random patch of your hip.

I’d also add that you’re much better able to defend your hand from injury than your hip. Fall on your hand, and you’ve got all the muscles in your arm and shoulder to act as shock absorbers, taking the brunt of the impact and sparing the hand. Your hip doesn’t have a recoil system, so it’s going to take the full force of the blow, and the injury probably extended further down into the skin and the subcutaneous layer than it could have on your hand.

I now want hips with recoil.


To clarify, the wound wasn’t on the palm side of my hand, it was on the back side.

I did the full “Neosporin treatment” probably 3 times / day for 2 days

The wound on my hand is healing well. After the delayed inflamed response, it formed a nice scab and everything seems copacetic.

The other rugburn - on my hip - is mostly healed by now. I can’t see it, but it doesn’t hurt anymore so I figure it’s healed.

For what it’s worth, sleep can seemingly aggravate injuries for a number of reasons.

First off is you’re largely stationary, so your muscles can’t “push” plasma or loose blood out of the injured area, exacerbating swelling.

Second, is blood flow is increased to the area to deliver macrophages to help sanitize the wound, as well as release hormones which cause new capillaries and connective tissue to form, so it’s a pretty happening area anyway.

Third, is that your muscles tend to lock up on a wound to stabilize it and prevent compounding it by tossing and turning at night, which can induce muscle fatigue and potentially cramping. That’s more common with breaks, tendon injuries, or deep cuts though.
As an example, I’m recovering from a hyper-extended index finger. the volar plate was injured and I got a pretty big bruise, but the pain was from the muscles in my finger, and the swollen tissues pressing on the injury when I moved it. It didn’t hurt when it was stationary, just when I moved it. It was also very stiff in the mornings, but soak it in hot water, and it loosens right up.