Substance Use

What is Skin Popping? Risks, Scars and Complications

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Learn the Risks and Complications of Skin Popping

Skin popping is the practice of injecting a drug under the skin. Many substances can be injected subcutaneously, including cocaine, steroids, and heroin. Illicit drug injections of any kind can be dangerous, however. They can lead to a higher risk of HIV/AIDS, liver disease, overdose, infections, and addiction.

While some believe that skin popping is safer than injecting a drug into a vein, it puts users at an increased risk of skin infections, such as Candida folliculitis. Xylazine, in particular, can lead to life-threatening skin ulcers, deep wounds, necrosis, and amputations. 

If you or a loved one is skin popping, it’s important to understand the health risks associated with this type of drug use. Recognizing the signs of injection drug use among your friends or family members could save a life.

Are you or a loved one struggling with injectable drug use? Zinnia Health can help. Call our free, confidential helpline 24/7 at (855) 430-9439 to learn more about the treatment options available in your area.

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What is Skin Popping?

Skin popping refers to a specific type of drug injection known as subcutaneous drug abuse. This type of soft tissue injection is administered directly under the skin (subcutaneously). This makes it different from an intravenous injection, which goes directly into the bloodstream.

There are different skin-popping methods, such as:

  • Intradermal injections, which go into the dermis (second skin layer)
  • Subcutaneous injections, which go into the fat layer under the skin
  • Intramuscular injections, which go into muscle tissue

Many people believe that skin popping is safer than injecting drugs into their veins, but the reality is that this method of drug use doesn’t pose fewer risks, just a different set of potential complications. Skin-popping can still lead to addiction, overdose, and death due to drug use or the complications associated with the injections themselves.

Why Do People Try Skin Popping?

Compared to intravenous drug use, skin popping doesn’t give much of a “rush,” as the drug is absorbed more slowly. This means the effects can last longer, and there is a reduced chance of overdose. However, overdose can still happen, especially if a person takes more of a drug to get the same “rush” they’d feel if injecting directly into a vein.

If a person has been injecting drugs into their veins for a long time, the skin can harden, making injections more difficult. In those cases, a person may switch to skin popping so it’s easier to administer the drugs.

Another reason a person may try skin popping is that they are so addicted to a substance that they experience withdrawal symptoms soon after their last dose. Since skin popping leads to slower drug absorption, it can stave off withdrawal symptoms longer.

Is Skin Popping Safer Than Intravenous Drug Use?

Many people choose skin popping over injecting drugs directly into their veins because they believe it’s safer. In reality, there is no safe way to inject an illicit drug. Both intravenous drug use and skin-popping methods can lead to severe complications.

According to the National Institute of Health (NIH), “A study showed the odds of abscess or cellulitis among drug users using skin popping was almost five times the odds of those who used intravenous injection.” In other words, skin popping puts individuals at a greater risk of serious infections than injecting drugs into a vein.

Any type of injectable drug use can lead to drug addiction, a high risk of overdose, and potentially permanent health conditions.

What Substances Are Common for Injection Drug Users?

The substances most commonly injected in the muscle, dermis, or subcutaneous fat layer include:

  • Opiates: Morphine, heroin (including black tar heroin), and other opiates are most often used intravenously, and those using them intradermally may have to take more to experience the same high, which puts them at a higher risk of overdose.
  • Cocaine: As a stimulant, injecting cocaine can cause Fournier’s gangrene, cerebral hemorrhage, arrhythmias, and myocardial infarction.
  • Anabolic steroids: People who use anabolic steroids most commonly take them by “muscling” them or injecting them into the muscle (intramuscularly). This type of drug use can lead to abscesses, lesions, and scarring of the muscle tissue.
  • Barbiturates: As a central nervous system depressant, barbiturates can reduce inhibitions and make a person feel drunk. When injected into the muscles, the effects can be longer lasting compared to pills or intravenous injections.

All of these substances come with inherent risks no matter how they are taken, but injecting them is one of the most dangerous routes of administration due to the complications caused by repeated injections and poor hygiene associated with non-medical needle use.

Complications of Skin Popping

Skin popping is dangerous because it introduces bacteria (germs) that multiply inside muscle, fat, or skin tissue, where there is a high risk of infections. For instance, skin popping often creates a high prevalence of abscesses, which can last for years after a person stops using.

Chronic complications of bacterial infections include:

  • Infections can spread throughout the body and reach the blood, bones, and heart
  • Tetanus, which can cause a person’s neck and jaw muscles to lock up, making it difficult to open their mouth or swallow
  • Wound botulism may occur when a certain type of bacteria (Clostridium botulinum) gets into the body and turns into a toxin that can cause weakness, trouble breathing, and even death
  • Necrotizing fasciitis, which is when inflammation in the muscle tissue results in the rapid destruction of overlying tissue (essentially causing muscle and skin to decay)

Other risks of skin popping include:

  • Necrosis (flesh death), especially in the fingers, if vasoconstrictive substances like cocaine are accidentally injected into small arteries
  • Amputation of limbs to stop the spread of serious infections
  • Permanent vascular (vein) damage at the injection site
  • Hepatitis A, Hepatitis B (HBV), and Hepatitis C (HCV) are also associated with injectable drugs

Would you like more information about drug use recovery? Contact Zinnia Health at (855) 430-9439 to speak to our caring recovery specialists and learn more about the treatment programs available to you.

Recognizing Skin Popping Scars

If you’re worried that a loved one may be using a skin-popping technique, it’s important to know the signs of injected drug use. Cureus provides photographs of skin-popping scars, and you can learn to recognize them by looking for:

  • Scar formation
  • Hyperpigmentation (darker-colored skin)
  • Small bruises
  • Lumps beneath the skin
  • Signs of infection, such as redness, blister-like sores, swelling, pus, extended wound healing times, and side effects such as fever. 

Those who use these drugs often alternate injection sites, making it harder to spot them. Common intravenous injection sites include the inner arms, back of the hands, wrists, and fingers.

Skin-popping, however, is typically done on the outer parts of the upper and lower arms and legs. Many will choose their lower extremities since the marks are easier to hide, which is why you should know the other signs of drug use. 

Signs of drug use and addiction include:

  • Changes in mood and behavior, like withdrawing from social activities
  • Reduced motivation to participate in work, school, and hobbies
  • Refusal to visit healthcare professionals for concerns like infections
  • Drug paraphernalia, including syringes, spoons and bottle caps, and lighters
  • Impairment, mood swings, and other signs that a person is under the influence of drugs

Many drugs can be injected, and they all affect the body differently. If you’re worried about a loved one, the best way to help them may be to start an open dialogue — talk about it in a non-threatening way. Even if they aren’t ready to quit, offering transportation to needle exchange programs and disposal sites can protect their health until they are.

Getting Help with Injectable Drug Use

Especially for those addicted to powerful opioids and opiates, such as heroin users, going straight to a regular addiction treatment program may not be enough.

Before entering rehab for injectable drug addiction:

Treatment Options for Drug Users

If a person has been cleared of active infections and other complications, they can choose from a variety of treatment programs to help them through the recovery process, including:

  • Inpatient detox at a hospital: These programs are often suggested for high-risk users. The stay in a hospital detox program is generally short-term and may only last for a week or two. During this time, a person can continue getting treatment for any complications experienced due to injectable drug use.
  • Inpatient rehab at a residential facility: These programs typically last a month or more and provide 24/7 care from a team of medical professionals and addiction recovery specialists. Services may include meditation, acupuncture, massage, and evidence-based treatment methods.
  • Outpatient detox with local treatment providers: These programs generally last for at least 90 days and may involve multiple appointments each day. If you have a strong support network and stable housing, along with reliable transportation, outpatient programs can be very beneficial in the recovery process.

Are you ready to take the next step in quitting drug use for good? We offer addiction treatment and supportive care at our inpatient facilities, along with group counseling and outpatient services to help curb cravings. Get in touch with Zinnia Health at (855) 430-9439 to learn more about how we can help you recover in a caring, confidential environment.

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