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Track marks are needle puncture wounds caused by the injection of substances. These can appear on any part of the body that has been used to inject drugs, such as the arms, legs, or groin. Recognizing track marks on someone can be an indicator of substance abuse. Professional support is available to treat track marks and reduce intravenous drug use.
- Track marks are small wounds caused by inserting needles into the skin to administer drugs.
- Injecting drugs can lead to many health risks, including infection, abscesses, clotting, and organ failure.
- Track marks can be healed with basic wound care techniques. Professional support can help manage substance use and addiction.
What are drug track marks?
‘Track marks’ is a common term for injection sites from drug use. Opioids, such as heroin, as well as other drugs like amphetamines and cocaine, might be administered via intravenous injection, meaning that the drug is delivered directly into a vein. Drugs can also be administered by ingestion, snorting, or smoking. [1]
Injecting drugs is the most dangerous administration method, as it can cause many serious and potentially fatal consequences. Track marks emerge where the drug has been injected, and they might be surrounded by bruises or scabs. They can appear at any injection site used on any part of the body. [2]
How track marks form
Track marks form initially from the needle puncture wound. If the individual continues to use the same site, this wound becomes increasingly irritated, causing darkening of the skin, bruises, scabs, or scars. [3]
Additionally, the way the drug is administered can impact the likelihood of visible track marks. For example: [1][4][5]
- Blunt needles: A blunt needle can require more pressure to puncture the skin.
- Dirty needles: Dirty needles are more likely to cause infection, which can lead to more marks and lesions.
- Contaminants: Liquids used to dissolve drugs or even the drugs themselves might contain contaminants, which can increase the risk of infection, abscess, or scarring.
- Needle insertion: If the needle misses the vein, several attempts may be required, causing multiple puncture wounds. Or the individual might move the needle in attempts to find the vein, causing more significant damage to the skin.
Common locations of track marks
The most common injection site is on the arms to the inside of the elbow. People might use other locations if they get an infection, want a site to heal, or want to hide track marks. Other locations of track marks that are less common but potentially more dangerous can include: [2][6]
- Hands
- Between the toes
- Groin
- Legs
- Neck
How to recognize track marks and substance misuse
Someone with visible needle puncture wounds, scabs or lesions, bruising, or collapsed veins may be using intravenous substances. Other signs of substance misuse might include extreme changes in mood or behavior, bloodshot eyes, pinpoint pupils, sudden weight or appetite changes, poor personal hygiene, and employment or financial issues. [1]
What track marks look like: Appearance and variability
The appearance of track marks can vary from person to person, and they are likely to worsen with repeated use or harmful administration methods. [5]
Initially, track marks will look like small puncture wounds in the skin, with little discoloration. Track marks are often seen in patterns, such as a line along a vein or a cluster. With repeated use, track marks become more visible and might also include: [1][5]
- Small, red sores or scabs
- Bruising around the wound
- Darkened veins
- Bruising or discoloration of the skin around the limb or area
- Scars from wounds or infections
How long do track marks last?
Track marks can heal within a few days or weeks. However, this can depend on the number of times the site has been used for drug administration, whether complications and infection have occurred and the cleanliness of the needle and injection site. Bruising might take several weeks to heal, and scars could remain indefinitely.
Health risks and complications
There are many health risks and complications that can occur as a result of injecting drugs.
Infections
Dirty needles, contaminated drugs, toxic substances in paraphernalia, or unclean skin can all increase the risk of infection or abscess when injecting drugs. Some bacterial and viral infections commonly associated with intravenous drug use, that may be fatal if not treated, include: [4][7]
- Hepatitis
- Human immunodeficiency virus (HIV)
- Bacteremia
- Necrotizing fasciitis
- Endocarditis
- Tetanus
- Wound botulism
Vein damage
With repeated use, veins can become damaged, which can lead to collapsed veins. A vein is likely collapsed if blood cannot be drawn from the vein or if it becomes sunken and cannot be located. [4]
Medical care: How to heal track marks
The first step to healing track marks is to refrain from using the site for further injections. People continuing to inject substances should wait for an injection site to heal before using it again, in order to help prevent track marks from forming or worsening and to avoid an increased risk of complications. [2]
To treat track marks, the site should be cleaned regularly with alcohol wipes or soap and water. Some wounds may require dressings or bandages to protect them. Keeping skin moisturized can help with scarring. [2]
Clotting, abscesses, bacterial infections, or other complications may require surgical intervention followed by medications. [7]
People who inject drugs may benefit from learning more about safer injection techniques, in order to help reduce the risk of health complications. Using new and sterile needles can help prevent track marks and infection. [5]
Addressing addiction and seeking help
People who are using drugs intravenously, especially those who experience health risks and complications, should seek medical assistance.
Professional support can help reduce and stop drug use, preventing further risks to physical and mental well-being, including potential fatality. Various treatments are available to help manage addiction.
People seeking help can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) or find treatments using the online locator.
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