Open Wound on the Back

Caring for an open wound on your back

Because the back is hard to reach, ask someone to help you see and dress the wound, or use two mirrors.

1. Stop any bleeding with firm pressure using a clean cloth for 10 minutes.
2. Rinse with clean running water for several minutes. A shower is fine. Wash the skin around it with mild soap.
3. Apply petroleum jelly to keep the wound moist. This speeds healing and reduces scarring.
4. Cover with a nonstick dressing and change it daily or when wet or dirty.
5. Avoid friction from bra straps, waistbands and backpacks over the wound.
6. Check it daily for signs of infection: spreading redness, warmth, swelling, pus or increasing pain.

Get a tetanus booster if your last dose was more than 5 years ago and the wound is dirty, or more than 10 years ago for a clean wound.

What causes open wounds on the back

Injuries

Falls onto the back, sports injuries, scrapes against rough surfaces, and cuts from glass or metal. A deep laceration may need stitches, and a penetrating wound to the back can injure the lungs, kidneys or spine.

Burst cysts and boils

• Epidermoid (sebaceous) cysts are common on the upper back. They can become inflamed, swell, burst and leave an open, smelly wound. See sebaceous cyst.
• Boils and carbuncles are infected hair follicles, often from Staphylococcus aureus. They form painful red lumps that drain pus and leave a crater.
• Acne on the back can leave open sores when spots are picked or squeezed.

Pressure sores

In people who spend long periods lying down or sitting in a wheelchair, pressure cuts off blood flow to skin over bony areas: the lower back, tailbone, shoulder blades and spine. Damage starts as redness that does not fade when pressed and can progress to an open wound and deep ulcer. See pressure ulcers.

Shingles

Shingles causes a band of painful blisters on one side of the back or chest. The blisters burst and crust, leaving raw areas that heal over 2 to 4 weeks. Pain or tingling often comes a few days before the rash.

Itchy skin conditions

Eczema, insect bites, scabies, dry skin, and conditions such as prurigo nodularis cause scratching that breaks the skin. A sore in the middle of the back that keeps reopening is often from scratching during sleep.

Pilonidal disease

At the top of the buttock crease, ingrown hairs and debris can form a pilonidal cyst or abscess that drains through small openings. It is most common in young men and can recur. See pilonidal cyst.

Skin cancer

The back is a common site for skin cancer because it gets sun exposure and is rarely checked. A basal cell carcinoma may look like a pearly bump or a sore that bleeds, crusts, heals partly and reopens. Squamous cell carcinoma and melanoma can also ulcerate. Any sore that does not heal within a month needs examining.

Other causes

• Surgical wounds that open (wound dehiscence) or become infected
• Spider bites and other bites, though true spider-bite ulcers are uncommon
• Radiation skin damage after radiotherapy
• Blistering diseases such as pemphigus or bullous pemphigoid

Clues to the cause

When a back wound needs a doctor

A clinician will look at the wound and ask how it started, how long it has been there, whether it hurts, itches or drains, and about diabetes, mobility, smoking and medicines that affect healing (such as steroids). They may swab it for bacteria, drain an abscess, close a fresh cut, prescribe antibiotics or antivirals, or take a skin biopsy if cancer is possible.

Wounds heal more slowly with diabetes, poor circulation, smoking, poor nutrition, older age and steroid treatment. A wound infection needs prompt treatment.

Preventing back wounds

• Check your back skin monthly with a mirror or a partner's help, especially for moles and non-healing sores.
• Use sunscreen on the back and shoulders.
• Change position at least every 2 hours if bedbound, and use pressure-relieving mattresses.
• Treat itchy skin promptly and keep nails short.
• Do not squeeze cysts or boils.

Frequently asked questions

What causes an open wound on the back with no injury?

Common causes are a burst cyst or boil, scratched itchy skin, shingles blisters, picked acne, and pressure sores in people who lie down for long periods. A sore that bleeds, crusts and never fully heals can be skin cancer, so any wound lasting more than a few weeks should be checked.

Why did an open wound appear in the middle of my back?

The middle of the back is a frequent spot for scratched patches, because it itches and is easy to scratch during sleep. Sebaceous cysts, boils and shingles also appear here. If you cannot recall an injury and the sore persists or keeps coming back, see a doctor.

How do I treat an open wound on my back at home?

Rinse it with clean running water, keep it moist with petroleum jelly, and cover it with a nonstick dressing changed daily. Ask someone to help you check it for redness, swelling, pus or increasing pain. Avoid friction from straps and tight clothing.

When should I see a doctor about a sore on my back?

See a doctor if the wound is deep or gaping, shows signs of infection, comes with fever, does not heal within 2 to 3 weeks, keeps reopening, or sits in a mole or new growth. Anyone with diabetes or poor circulation should get non-healing wounds checked early.

Can a back wound be skin cancer?

Yes. Basal cell carcinoma, the most common skin cancer, often appears on sun-exposed skin such as the upper back as a sore that bleeds, scabs and returns. It is slow-growing and very treatable when found early, so any persistent sore deserves a skin check.