What Are Track Marks?
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
Bruising
A sign the vein was missed or punctured through both sides of the vein known as “blown vein”
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
- Sequential Marks: Sometimes track marks follow a linear path along a vein that was frequently used for needle injection.
- Cluster of Puncture Wounds: Multiple attempts to access a vein might leave marks that patients sometimes call track mark scabies, though the needle marks are not actually scabies.
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.
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.
- If your skin looks like the pictures above, go immediately to urgent care or a hospital.
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.
- Rotate IV Sites: Don’t use the same injection site. Rotating sites gives the skin time to heal between injections.
- Inject At The Correct Angle: A 25-degree angle is recommended to avoid going too deep or too shallow, which can cause more damage to the skin and underlying tissues.
Proper Injection Angle
25 Degree Angle for Vein Injections
- Don’t "Dig": If you miss the vein, don’t continue to move the needle around in an attempt to find it. This causes additional trauma to the area and increases the risk of bruising and scarring.
- Use New, Clean Needles: A new, sharp needle will cause less damage to the skin. Reusing or sharing needles can cause infections.
- Apply Pressure Post-Injection: After removing the needle, immediately apply light pressure with a clean, dry gauze or cotton ball to the injection site. This helps prevent bruising. Don’t rub the area, as this can cause more bruising.
- Keep Area Clean: Wipe with an alcohol swab before injecting, use a bandage to cover open wounds and watch for signs of infection.
- Hydrate and Moisturize: Drinking plenty of water before injecting can make your veins more visible and accessible. Keeping your skin moisturized can also maintain its elasticity, making it less prone to tearing or scarring.
- Build Muscle: Exercising the area will build muscle that pushes the vein out making it easier to see and access. (Even reps of squeezing a ball every day can help build arm muscles).
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:
- Wash with soap and water regularly to keep the area clean and prevent infection.
- Use hydrogen peroxide initially if the wound is at high risk for infection, like if a non-sterile needle was used. Hydrogen peroxide can kill bacteria to prevent life-threatening infection, but it also slows healing by killing healthy cells. Don’t continually use hydrogen peroxide.
- Use petroleum jelly (Vaseline) after cleaning the wound to keep the wound moist which promotes healing and prevents the bandage from sticking to the wound.
- Use bandages to keep the wounds clean and protected from irritation and bacteria.
If there is bruising:
- Use ice during the first 24-48 hours to reduce swelling, applied as much as possible the first day, then 4-5 times a day for the next day or two.
- Keep the limb elevated above the heart as much as possible to minimize swelling.
For track mark scars:
- Use a quality moisturizer to help the skin stay hydrated.
- Try silicone gel pads, which are sold online and at pharmacies without a prescription. Silicone gels are known to improve the appearance and texture or scars, especially darkening of skin that is common with track mark scarring. ⓘ
- Always apply sunscreen or cover to protect the area from the sun because UV rays can slow healing and further darken the scar.
- Consider lasers if wanting better results.
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.
3 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?
Is there an old remedy to make fresh mark disappear almost and how to treat misses
Where do they hide track marks the best