Persistent Scabbing Wound: Causes and Treatment Options

A scabbed wound is not healing?

Hello, doctor! I have a wound on my coccyx that keeps scabbing and falling off, and it never seems to heal.
Additionally, it becomes painful if pressed or bumped.
I also feel discomfort after sitting for long periods.
Could you please tell me what symptoms this might indicate and how it should be treated?

Lara, 10~19 year old female. Ask Date: 2020/02/26

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to determine the issue.
If it is causing significant distress, please seek medical attention as soon as possible.
A proper examination is necessary to understand the problem and to determine the appropriate treatment.

Reply Date: 2020/02/26

More Info

Persistent scabbing wounds, especially in sensitive areas like the coccyx (tailbone), can be quite troublesome and may indicate underlying issues that need to be addressed. Based on your description, it seems that the wound is not healing properly, which can be due to several factors.

Possible Causes
1. Pressure Ulcers: If you are sitting for long periods, the constant pressure on the coccyx can lead to pressure ulcers (also known as bedsores). These occur when blood flow to the area is restricted, leading to tissue damage and delayed healing.

2. Infection: If the wound is not healing and is producing scabs that fall off repeatedly, there may be an infection present. Signs of infection include increased redness, warmth, swelling, and possibly discharge from the wound.

3. Underlying Health Conditions: Conditions such as diabetes or vascular diseases can impair wound healing. If you have any chronic health issues, they could be contributing to the problem.

4. Improper Wound Care: If the wound is not being cleaned and dressed properly, it may not heal effectively. Moisture balance is crucial for wound healing; too much moisture can lead to maceration, while too little can cause the wound to dry out and form scabs.

Treatment Options
1. Wound Care: Proper wound care is essential. Clean the wound gently with saline or mild soap and water. Avoid using alcohol or hydrogen peroxide, as these can irritate the tissue. After cleaning, apply a suitable dressing that maintains a moist environment, which can promote healing.

2. Pressure Relief: If prolonged sitting is causing the issue, consider using a cushion designed to relieve pressure on the coccyx. These cushions can help distribute weight more evenly and reduce pressure on the area.

3. Topical Treatments: Depending on the condition of the wound, topical antibiotics may be recommended if there is a risk of infection. Additionally, products containing hydrogel or hydrocolloid can help maintain moisture and promote healing.

4. Medical Evaluation: Since the wound has persisted and is causing pain, it is advisable to consult a healthcare professional. They may perform a thorough examination, possibly including imaging studies, to rule out any underlying issues such as abscesses or deeper tissue damage.

5. Nutrition: Ensure you are consuming a balanced diet rich in vitamins and minerals that support wound healing, such as vitamin C, zinc, and protein. Staying hydrated is also crucial.

6. Physical Therapy: If the pain is significant and affects your mobility, physical therapy may help strengthen the surrounding muscles and improve blood flow to the area.

Conclusion
Persistent scabbing wounds can be a sign of underlying issues that require attention. It is crucial to maintain proper wound care, relieve pressure, and seek medical advice to ensure that the wound heals effectively. If the situation does not improve or worsens, do not hesitate to seek further medical evaluation. Your health and comfort are paramount, and addressing these concerns early can prevent more serious complications down the line.

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