Which over‑the‑counter topical cream or ointment should I use for a contusion and cut from a fall?

Over-the-Counter Topical Treatment for Bruises and Cuts from a Fall

For a simple cut or abrasion from a fall, thoroughly irrigate the wound with clean water, then apply plain petrolatum (petroleum jelly) or a petrolatum-based ointment and cover with a clean dressing. For bruises (contusions), apply cold therapy with an ice-water mixture for up to 20 minutes.

Wound Care for Cuts and Abrasions

Initial Cleaning

Superficial wounds and abrasions should be thoroughly irrigated with a large volume of warm or room-temperature potable water until there is no foreign matter in the wound 1. If running water is unavailable, use any source of clean water. You can use soap with the water, but it's not required 1.

Topical Treatment Options

Plain petrolatum (white petroleum jelly) is the preferred first-line topical treatment for simple cuts and abrasions. Research demonstrates that:

• Petrolatum-based ointments without antibiotics are equally effective as antibiotic ointments for wound healing after dermatologic procedures 2
• Plain white petrolatum causes significantly less wound redness (12%) compared to combination petrolatum products like Aquaphor (52%) 3
• Wounds heal better with less infection when covered with an ointment and clean occlusive dressing 1

Antibiotic ointments are generally unnecessary for clean wounds from falls. The evidence shows:

• Topical antibiotics like Neosporin or Polysporin provide no additional healing benefit over plain petrolatum for clean wounds 4, 2
• Antibiotic ointments carry risks of allergic contact dermatitis and may contribute to antibiotic resistance 2
• One study reported allergic contact dermatitis after Polysporin treatment and increased burning sensation compared to petrolatum alone 2

Exception: Apply antibiotic ointment only if the wound is an abrasion or superficial injury AND the person has no known allergies to the antibiotic 1. For children with secondarily infected skin lesions (such as infected lacerations), mupirocin 2% topical ointment can be used 5.

Dressing Application

After applying petrolatum, loosely cover the wound with a clean, nonadherent dressing 1, 6. This protects the wound and reduces pain while promoting healing.

Bruise (Contusion) Treatment

Apply cold therapy using an ice-water mixture for bruises and soft tissue injuries:

• Use a plastic bag or damp cloth filled with a mixture of ice and water—this is more effective than ice alone 1
• Limit each application to 20 minutes maximum 1
• If 20 minutes is uncomfortable, limit to 10 minutes 1
• Place a barrier (thin towel) between the cold container and skin to prevent cold injury 1
• Cold application decreases hemorrhage, edema, pain, and disability 1

Avoid refreezable gel packs—they do not cool as effectively as an ice-water mixture 1.

Important Caveats

When to Seek Medical Care

Activate emergency services or seek immediate medical attention if:

• The wound is deep or won't stop bleeding with direct pressure
• The wound involves the face, hands, feet, or genitals 6
• Signs of infection develop (increasing redness, warmth, pus, fever)
• The person hasn't had a tetanus vaccination within 10 years 7

What NOT to Use

• Do not use topical NSAIDs (like diclofenac gel) for acute bruises—while they may provide some pain relief, the evidence for superiority over placebo in acute sports injuries is inconsistent 8
• Avoid elevation and pressure points for bleeding control—these are not recommended as they may compromise the proven intervention of direct pressure 1
• Do not apply heat to fresh bruises or contusions—cold application is superior for acute injuries 1

Tetanus Consideration

Tetanus toxoid should be administered if the person hasn't received vaccination within 10 years 7. This is particularly important for wounds contaminated with dirt or debris.

Practical Algorithm

1. For cuts/abrasions: Clean with water → Apply plain petrolatum → Cover with clean dressing
2. For bruises: Apply ice-water mixture for up to 20 minutes with a barrier cloth
3. Monitor for infection signs over the next few days
4. Seek medical care if wound is deep, won't stop bleeding, or shows signs of infection