Drug addiction can leave behind both emotional and physical scars. Sometimes, the physical scars occur in the form of track marks on the skin. This article discusses track mark identification and the risks of IV drug use. You will learn:

• What causes track marks
• What they look like
• How to identify them
• The risks of IV drug abuse
• Important safe injection techniques

If you or a loved one are struggling with addiction and ready to get help, don’t hesitate to contact our team at Moving Mountains Recovery today. Our dedicated admissions team is available 24 hours a day to help you take the first steps toward recovery.

What are Track Marks?

Track marks are bruising, discoloration, scabbing, and scarring that occur at the injection site of people who use intravenous (IV) drugs. They are caused by repeated injections in the same location, often with blunt or dirty needles, when drug users continue shooting up into the same vein.

While these bruises, scabs, and scars are widely known as “track marks,” the medical term for them is “venipuncture marks.” Medical professionals may use the term “venipuncture marks” to describe the physical consequences or side effects of IV drug abuse.

Track marks can appear on individuals who inject any kind of drugs, however, they are most widely associated with heroin or opioid use. People with track marks are at an increased risk of damaged or collapsed veins.

What Do Track Marks Look Like?

The visual appearance of track marks can vary depending on the user, their injection technique, and the age of the marks. 

Fresh marks may look like small, open wounds that lay directly on top of a vein. Bruising may also emanate around the wound site. There may be a single puncture mark or multiple in a cluster or straight line.

Old track marks can also vary in appearance. In heavy users, frequent injections cause the vein to darken over time. The vein and scar area may become indented as the vein becomes weaker. They will also have scarring along their veins and a buildup of scar tissue. Hyperpigmentation can also occur, leading to darkening skin in the affected areas.

IV drug abuse can lead to permanent scarring that is visible for decades, even after stopping IV drug use. Healed track marks often look like any other scar. They are lighter or darker than the surrounding skin (depending on the person’s skin color) and run along a vein.

Identifying Track Mark Patterns

Track marks can come in two different patterns:

1. Sequential – Track marks that follow a linear path along a vein are known as sequential marks. They appear in the form of a line.
2. Clusters – Cluster marks can occur when IV drug users make multiple attempts to hit a vein by injecting around the same area, leaving behind a cluster of puncture marks.

The inner elbow or crook of the arm is the most common site for injecting drugs. Veins are often visible and easy to reach in this area. However, as injecting in the inner arm becomes painful or difficult to inject in, individuals may switch injection sites. As a result, track marks can also be found on the lower arms, legs, neck, groin, or feet. Some people may prefer these injection sites instead of the arm because it is easier to hide the bruising and scarring.

How Long Do Track Marks Last?

Mild puncture wounds, such as those that result from one or two injections, will typically heal within a few days to a week. Bruising will also go away within a week. However, people with more severe track marks may experience permanent scarring that doesn’t go away. The scars may fade substantially over time, but in many cases, they never completely heal.

What Drugs Cause Track Marks?

Any drug that is injected into the body can cause track marks. After all, the marks are caused by repeated injections from the needle puncturing the skin, not the drug itself. 

Drugs commonly associated with IV drug use include:

• Heroin
• Fentanyl
• Prescription opioids
• Cocaine
• Methamphetamine (crystal meth)

Understanding the Risks of IV Drug Use

Injecting drugs, whether it’s heroin or meth, is incredibly dangerous to one’s health. Some of the risks of IV drug abuse include:

Infection

Infections from IV drug use are very common due to poor injection techniques such as “skin popping” (injecting under the skin instead of in a vein) and frequent use of blunt or dirty needles. They can be serious and life-threatening if not treated promptly. Infections can leave scars, too.

• Cellulitis – A bacterial skin infection that causes redness, swelling, and pain. It can spread quickly and may require antibiotics or hospitalization.
• Abscesses – Pockets of pus that form under the skin or in muscle tissue due to improper injection techniques. Abscesses may require draining or surgical intervention.
• Endocarditis – A dangerous infection of the heart’s inner lining, often caused by bacteria entering the bloodstream during injection.
• Septicemia – Also known as blood poisoning, septicemia is a severe infection in the bloodstream that can spread to other organs and be fatal without immediate treatment.
• Necrotizing Fasciitis – A rare but severe bacterial infection that destroys skin, muscle, and tissue, often referred to as “flesh-eating disease.” Immediate surgery is usually required.

Collapsed Vein

A collapsed vein occurs when a vein becomes damaged due to repeated trauma, usually from frequent injections or improper injection techniques. The walls of the vein can weaken and eventually close off, stopping blood flow through that vein. Once a vein collapses, it can no longer be used for injections, and blood flow in that area may be permanently reduced or stopped.

Symptoms of a collapsed vein include:

• Pain or tenderness around the injection site
• Swelling or bruising
• Visible darkening or discoloration of the vein
• Difficulty injecting into the vein
• Little to no blood flow through the vein

Disease Transmission

IV drug users sometimes share needles with other drug users. Needle-sharing poses the threat of blood-borne disease transmission. These diseases, especially when undetected, can be potentially life-threatening.

• Hepatitis B and C – These viral infections are spread through shared needles and can lead to chronic liver disease, cirrhosis, or liver cancer.
• HIV/AIDS – Sharing needles can transmit HIV, leading to weakened immune function and increased susceptibility to infections and certain cancers.
• Tuberculosis (TB) – Though typically a respiratory disease, TB can spread through IV drug use, especially in cases where users have weakened immune systems due to co-infection with HIV.

Harm Reduction Techniques for Safer Injection

In this day and age, during which fentanyl is found in many illicit drugs and is driving more overdose deaths than the U.S. has ever seen, injecting drugs is extremely dangerous. You truly never know when your next injection will be your last. 

The only way to prevent the appearance of track marks on your skin and the long-term effects of IV drug abuse is to get sober. However, certain harm reduction strategies can minimize the risks and help you protect yourself and your body long enough until you become willing to seek help.

• Use a new needle every time – Always use a sterile needle for each injection to prevent infections and reduce the risk of vein damage.
• Rotate injection sites – Changing the location of injections helps prevent vein collapse and reduces the likelihood of scarring or abscesses. Don’t inject into the same vein every time.
• Inject at the proper angle – Injecting at a 25 to 30-degree angle into a vein minimizes the risk of missing the vein or causing injury.
• Don’t dig – If you miss a vein, avoid repeatedly probing the area, as this can cause damage and increase the risk of infection.
• Don’t share needles – Sharing needles can transmit dangerous blood-borne diseases like HIV and hepatitis B and C.
• Keep the injection site clean – Clean the skin with alcohol swabs before injecting to reduce the risk of infections and abscess formation.

It’s important to note that chronic IV drug use will lead to long-term health complications, even if the person is injecting properly.

How to Treat Injection Sites

Properly caring for fresh injection wounds can help prevent physical damage and minimize long-term risks. While an infection will require medical treatment and antibiotics, the following steps can help you care for irritated injection sites:

• Wash your hands before touching the wound
• Apply a warm compress to reduce bruising
• Apply a cold compress to reduce swelling
• Clean the area with mild soap and warm water, both before and after injecting
• Elevate the injection site to promote better blood flow
• Eat a balanced, nutritious diet to promote a healthy immune system
• Cover fresh wounds with a bandage

Ways to Cover Up Track Marks When You’re in Recovery

After getting sober, you might feel self-conscious about the lasting marks addiction has left on your body. Track marks, in particular, can make you feel exposed, as if everyone can see your past, so it’s natural to want to conceal them. Fortunately, there are steps you can take to reduce the appearance of these marks and hide them.

• Keep your skin moisturized
• Use scar creams or treatments (you may even contact your dermatologist!)
• Apply makeup
• Get a tattoo to cover it up–a skilled tattoo artist can create a meaningful design that not only covers your scars but symbolizes your strength and recovery

Moving Mountains Recovery is Here When You’re Ready to Get Help

At Moving Mountains Recovery, we understand how hard it can be to take the first step toward sobriety. Whether you’re struggling with addiction or ready to leave it behind, we’re here to support you every step of the way. Our compassionate team provides personalized treatment plans that address the root causes of addiction while helping you build the skills for a healthy, fulfilling life. Whenever you’re ready, we’ll be here to help you move forward. Contact us today to get started.