Xylazine is a medication only approved for use in veterinary medicine, often used as a sedative for animals. Commonly referred to as tranq and tranq dope, it is increasingly being found in the recreational drug supply being used by humans, most often mixed with opioids such as fentanyl. Xylazine enhances the euphoric and sedative effects of drugs such as opioids and is cheap to produce.
Xylazine abuse can lead to severe effects, including respiratory depression, severe low blood pressure, extremely slow heart rate, and increased risk of overdose death when combined with other substances. Repeated use of xylazine reduces blood flow to the skin, leading to severe tissue damage, ulcers, and necrosis, often referred to as "skin rot".
- Xylazine use can lead to wounds in the skin caused by its constricting effects on blood vessels, preventing adequate flow.
- Treating xylazine wounds at home involves keeping the wounds clean, dressed, and moist.
- Professional treatment for xylazine wounds may include treating infection, removing dead skin, and in severe cases, skin grafts or amputations.
How xylazine abuse affects the skin
Xylazine is often mixed with street drugs, particularly opioids such as fentanyl and heroin. People using these substances can develop addictions to opioids and xylazine, contributing to increased and continued substance use. Some people may be unaware that they are taking xylazine, while others may seek drugs combined with xylazine.[1]
Xylazine causes sedating effects, impacting breathing, heart rate, and blood pressure. It is often injected but can also be ingested orally or inhaled nasally.
Xylazine has been found to cause wounds on the skin that can become worse with continued xylazine use and inadequate treatment, potentially resulting in infection and severe consequences. These wounds can occur whether xylazine is injected or taken in other ways and may appear on parts of the body away from injection sites.[2]
How are xylazine wounds different from other drug wounds?
Unlike drugs that cause skin damage caused by repetitive scratching, such as methamphetamine, xylazine wounds are believed to be caused by vasoconstriction of peripheral blood vessels, meaning that the drug causes blood vessels to narrow, slowing or blocking blood flow. Because of this, skin health is reduced and wounds in the skin cannot heal properly, making it more likely to become infected. In severe cases, parts of the skin begin to die, known as necrosis.[3][4]
Proper wound treatment can help reduce and stop wound progression and help foster adequate healing. Without treatment, and particularly if xylazine use is continued, wounds can get increasingly worse, growing in size, becoming infected and necrotic, and may be life-threatening.[5]
What do xylazine wounds look like?
Xylazine wounds tend to look like blisters or burns on the skin. The appearance of the wound can change if it progresses and worsens. Typically, xylazine wounds will emerge as several small lesions in the skin, like pinpoint holes. If these are not treated, they can become larger and may join together to become one large open wound.[2][5]
As the wound worsens, it can present as:[2][5][6]
- Scabs
- Bruises
- Burns
- Large open sores
- Blisters
- Pieces of dead skin
- Blackening skin
- Peeling skin
- Redness around the wound
- Pus or discharge from the wound
- Increased size
Stages of xylazine wound development
| Stage 1 | Stage 2 | Stage 3 |
|---|---|---|
| Pinpoint holes in the skin | Open wound, growing in size | Larger open wound |
| Some soreness | Scabbing | Very red and sore |
| Irritation | Redness | Blackened dead pieces of skin |
Treating xylazine wounds
When a xylazine wound emerges, it may be possible to manage this at home without professional treatment. However, if the wound worsens and progresses to stage two or three, professional treatment is required, to prevent severe effects.
Signs that professional treatment is required include:[6][7]
- Wounds that are growing in size
- Signs of infection, such as fever, redness, smell from the wound, pus or discharge, severe swelling
- Numbness or tingling around the wound
- Impaired movement of the limbs
- Skin falling off or blackening
- Visible muscle or bone
Medical guidelines for treating xylazine wounds
There are currently no specific guidelines on managing xylazine wounds, although general wound management is reported to be effective and appropriate. This can include:[4][5][7]
- Cleaning and dressing the wound
- Prescribing antibiotics to treat infection
- Removing dead or infected skin
- Skin grafting or flap cover to repair large open wounds
- Amputation in very severe cases, such as extreme necrosis or nerve damage
Xylazine wound management at home
Managing xylazine wounds at home can help prevent infection and wound progression. This can include: [5][6]
- Ensuring hands are clean before touching the wound
- Cleaning the wound daily with soap and water or saline solution
- Not using alcohol-based products to clean the wound as this can dry it out
- Patting the wound dry after cleaning
- Using ointments, antiseptic cream, or petroleum jelly to keep the wound moist
- Covering the wound with a bandage or plaster, ensuring this is secure but not too tight
- Covering the bandage with a wrap or clothing to keep it dry and protected
- Changing the bandage every 1-3 days as needed
You may wish to draw around each wound with a permanent marker, to help you track any changes in size.
Where to find treatment for xylazine addiction
Reducing and stopping xylazine use, particularly by injection, can significantly improve the healing and recovery of wounds. People experiencing xylazine addiction may wish to utilize substance use treatments such as:
- Inpatient rehab or outpatient treatment to help with detox, withdrawal, and recovery
- Support groups to access support, advice, and a space to communicate openly with others in similar situations
- Therapy to help manage cravings and withdrawal, treat underlying mental health issues contributing to substance use, and learn coping strategies
- Medications to help manage withdrawal, including psychological and physical symptoms
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