Track Marks (12 Picures): How To Prevent & Get Rid of Track Marks

Clinical Reviewer

What Are Track Marks?

Track marks are the visual damage left at the injection site of Intravenous (IV) drug use. Track marks include bruising, scarring, discoloration and scabs. Heroin tracks are usually caused by dirty, blunt or repeatedly using needles that are in the same vein.

What Do Track Marks Look Like?

Track mark is a general term. Many skin or vein issues and scarring at the site of IV drug use are included.

Characteristics of Track Marks New

Open Sores

Open wounds at the spot of injection, multiple sores indicate chronic use and may be slow to heal

Track Mark Sores

Bruising

A sign the vein was missed or punctured through both sides of the vein known as “blown vein”

Track Mark Bruise

Characteristics of Track Marks Old (Track Mark Scars)

Darkening of Veins

Frequent injections can cause veins to darken over time 

Hyperpigmentation

Skin can become darker than the surrounding skin

Indented Veins

Prolonged injection can damage and weaken veins

Veins may also collapse from chronic IV drug use. A Collapsed Vein does not leave any track mark. There is simply no longer blood flow through that vein. If you try to shoot up into a collapsed vein, you won’t be able to draw blood. Collapsed veins can cause circulation issues, though new veins may eventually form to bypass the permanently scared collapsed vein.

Track Mark Patterns

The arms (especially the inner elbow) are the most common area for IV drug injection. As the arm veins become difficult or painful to inject drugs, some turn to veins in their legs, hands, neck, chest, groin or feet (including between the toes). These areas may also be preferred because they are easier to hide.

Old and New Track Marks On Arms

Pictures of Heroin Track Marks on Arms

These track mark images show a range of needle injection bruising, needle mark redness, puncture wounds and track mark scars. Bruising and scabbing are an indication of recent IV drug injection. Track marks also can lead to permanent scarring that is still visible years after IV drug use. 

Track Mark Infections

Infections from IV drug use can be life-treatening if not treated quickly! Treatment can be as simple as antibiotics, but must be given before the infection spreads. Infections are not the same as track marks, but can leave scars.

Cellulitis

A bacterial infection that enters through skin breaks and causes symptoms like expanded red, swollen and warm skin, often accompanied by fever, red spots and dimpling. 

Abscess

A concentrated, painful collection of pus, presents as a swollen, raised, typically pus-filled mass, causing symptoms like pain, warmth, redness, swelling and fever.

How to Inject Without Track Marks

Understanding proper injection techniques and cleaning needles and skin can help prevent heroin track marks and permanent scarring. Chronic IV drug use can lead to poor circulation and poor immune system response, making track marks more likely, even if injecting properly. 

Proper Injection Angle

25 Degree Angle for Vein Injections

How to Get Rid of Track Marks

Recent track mark injuries should heal, but scars may never go away. Permanent track mark scars can be covered or the use of lasers may help.

How Long Do Track Marks Last?

Open wounds and bruising should heal within a few days to a couple of weeks. Scars can fade over months and years, but may never go away. 

Track Mark Timeline
Mild marks (like needle pricks) Typically within a few days to a week
Bruising Usually within a week, sometimes several weeks
More severe skin damage or infection Several weeks to a few months with potential for permanent scarring
Scarring May never fully disappear, but can fade over the course of several months to years

How to Heal Track Marks

The first steps involve healing the skin, then reducing the impact of the scar. Of course, to truly heal track marks, IV drug use must be stopped. The more IV used when there are active track marks, the more likely to cause permanent damage.

If there is an open wound:

If there is bruising:

For track mark scars:

Laser Track Mark Removals

Emerging research shows that certain lasers improve the blue-gray and brown hyperpigmentation caused by IV heroin use. For example, a New York dermatologist found positive results after five sessions with a Q-switched Nd:YAG 1064 nm laser.

How to Hide Track Marks

Bandaids and other first aids as well as covering clothing are the best opinion for recent track marks. Old track marks that are not open wounds can be covered with makeup or tattoos or even removed with lasers.

Clothing

Long sleeves or high socks is really the only safe way to cover recent track marks. Tricia N. says “I was always wearing long sleeves no matter how hot it was.”

Makeup

For scarred old track marks, makeup concealers can be a great option. Bobbi J. recommends Glamoflauge by Hard Candy. Jenie S. recommends Dermablend.

But, putting makeup on an open wound with a direct connection to the bloodstream is more likely to cause infection, which can be deadly. Makeup is only an appropriate option for scarring when the puncture wound has healed.

Tattoos

Some people opt to permanently cover up old track marks with tattoos. As with makeup, this option is only appropriate for scars and not open wounds.

Before & After of Track Marks on Legs Covered Up By Tattoos

Dealing With Track Marks

Track marks can be difficult to live with. The scars tell a story. It’s important to acknowledge and accept the emotions of seeing your track marks.

1. Stop IV Drug Use

Stopping drug use may feel impossible. At Symetria, it’s OK to start treatment even if you’re not fully committed to abstinence.  You get no judgment here.  If we can help you stop IV use even if you’re still using, that’s still a step in the right direction. 

Addiction Clinics Without Judgement

2. Heal Your Mind Too

Track marks can be difficult to live with. The scars tell a story. It’s important to acknowledge and accept the emotions of seeing your track marks.

One patient says: “I’m proud of my tracks…if people ask, I say I had some severe issues in my youth that I overcame. Most people commend those in recovery.”

Track marks may never go fully away, but therapy can help you see them in a more positive light.

Symetria doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

Hu, Y.-Y., Xu, F.-W., Wang, Y., Feng, Z.-X., Zhang, L.-Y., Zhao, W., Chen, C.-Y., Zhang, M.-X., He, G.-J., Wang, S.-J., & Tan, W.-Q. (2023). Comparisons of the effects of topical anti-scar drugs on post-surgical facial scar formation: a clinical investigation. American Journal of Translational Research15(2), 1204–1214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006765/

Viktoryia Kazlouskaya, Sagerman, P., Goldberg, G. N., & Gottesman, S. P. (2017). A case of heroin linear track hyperpigmentation: histopathology and treatment with Q-switched Nd:YAG 1064nm laser. International Journal of Dermatology57(3), 362–364. https://doi.org/10.1111/ijd.13861

Disclaimer
All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.

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9 Comments

  • I have very apparent and visible track marks on my middle and ring fingers on both hands. I have been clean for years but I always get sideways looks and underhanded questions that let me know people see them. I am embarrassed by it yet it is a part of my past. I am considering getting some tattoos that are extremely relevant to me to cover them. Any thoughts?

    1. A tattoo is an option to help conceal the scars. If you don’t want to just cover up the scarring, you can minimize the appearance of the scarring in a few ways. Apply sunscreen to the scar to protect it from UV light, because UV light darkens scars and makes them more noticeable. Moisturizers and scar gels can help a bit too. For very significant scarring, laser treatment is also an option.

    2. That’s the only way I have found to cover mine is with tattoos which I’m fine with I love tattoos I hate the staring but more than anything I hate my body the parts that still have bad scaring an anemic x IV user = baaaad marks 😞 .. if it’ll make you feel better and help with confidence do it! It’s a good way to cover them permanently love it.

    1. A clean wound heals best. Wash with soap and water regularly and apply a small amount of antibiotic ointment (i.e. bacitracin ointment) or Vaseline to the wound, then cover with a band aid. Perform the process at least once daily. Ice the wound or “missed” area for 15 minutes at a time (can repeat up to once every hour as needed) to reduce swelling and bruising for the first 48 hours.

    1. The feet are probably the easiest place to hide track marks the best with socks and shoes.

    1. Unfortunately, I’m not sure exactly why that would be happening, but I’ve heard of others reporting that as well.

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