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what are track marks

Everything to Know About Track Marks

Most drug users don’t start injecting drugs. However, those seeking to get a quick high can eventually progress to intravenous drugs. Unlike other types of addictions, this one leaves physical signs visible for anyone to see. Here’s what you need to know about track marks and what they can tell you about someone’s addiction.

What Are Track Marks?

Track marks are scar tissue that follows the path of veins. These marks are caused by chronic intravenous drug use. In most cases, the marks appear in the forearms but can appear anywhere on the body where repeated injections of heroin or meth occur. They are often the most visible telltale sign of substance use disorders.

What Causes Track Marks?

A classic telltale sign of IV drug abuse is track marks on arms. These scars are most common in heroin users, but any drug that an addict is routinely injecting can and will cause these marks. Old needles, those who share needles and impure drugs, can also increase the risk of these marks appearing.

Common drug addictions that cause injection marks include:

Many addicts try to convince family and friends that their bodies’ marks occurred after first-time use, but this is not medically possible. All marks and scars are the results of continual drug use over a significant time.

Fundamentally, the act of continually injecting a needle into the same spot disrupts the skin, bruising and eventually mutilating the veins in that area. 

They are easy to identify by their dark pigmentation and bruising. Their appearances can vary, depending on:

  • The frequency people use injection drugs
  • How recently
  • How sensitive their skin is
  • Any underlying health conditions that cause bruising

How Addicts Hide Track Marks

The indicators of using drugs intravenously are very noticeable, and most heroin addicts go to great lengths to hide them. Heroin abusers try and spread out injection sites and limit the extent of the marks and start shooting heroin in non-conventional areas of the body.

Alternative injection sites include but are not limited to the groin, neck, hands, feet, and toes. Areas that are conventionally covered by clothing and make-up are the places most injections occur. Many addicts will cover their scars by wearing long sleeves regardless of the weather.

Signs of IV Drug Use

Physical signs of intravenous use are easy to notice and they’re often a definite sign that someone is abusing drugs. Besides the track marks, signs like poor hygiene, flaky skin, and dilated pupils are common symptoms of IV drug use. Other signs include:

  • Skin popping: it’s common for individuals abusing drugs not to care for their picture wounds. This often leads to skin infections, cysts, and ulcers. They can also cause something known as skin popping, which happens when they inject a muscle instead of the vein. It literally causes scar tissue to build up and it looks like small bumps on the skin. 
  • Vein damage: as you’ll see below, collapsed veins can be quite dangerous. Vein damage can occur due to repeated injections to the same site. It can also happen when they accidentally burst a vein, so they cause bruising. 
  • Weight loss: most people with a substance use disorder will experience a decrease in appetite that causes unexplained, sudden weight loss. 

Are Track Marks Dangerous?

Beyond the fact that injection marks indicate severe drug addiction, they can lead to other health problems. They can cause collapsed veins, which occur when the lining is damaged, and blood clots start forming. 


When using dirty or dull needles, users have a higher risk of infection, sometimes known as skin popping. Most of the time, people using drugs intravenously use substances contaminated with bacteria or fungi, which causes infections. When someone faces a blood infection, it can quickly escalate if such infection travels to the brain, heart, or other major organs. Also, puncture wounds are susceptible to infections. 

Collapsed Veins

The result of repeated punctures, which prevents the vein walls from staying open to maximize blood flow. Collapsed veins require medical treatment. When left untreated, they can cause circulation problems that might lead to heart issues, strokes, kidney disease, and more. The cyanosis of the limbs, or blue skin, is due to a lack of oxygen supply. 


Scar tissue usually forms with frequent injections, significantly if the puncture site hasn’t healed. Scar tissue can be extensive and even prevent some veins from being used for intravenous access again.


An abscess is a swollen mass that happens due to an underlying infection. Most of the time, they’re the result of bacterial infections and are usually painful. Abscesses need a surgical procedure to be drained and release the buildup of pus. Antibiotics are also required to help the body get rid of the infection.

What to Do?

The moment you see family or friends with injection marks anywhere in their bodies, speak up. They are the first sign of shooting drugs, among other symptoms like weight loss. If someone you love has any marks and is addicted to drugs, the scars and bruises are the least of their concerns. Make sure you remember to:

  • Speak with them when they’re not under the influence
  • Research drug treatment facilities in your area
  • Contact an interventionist to encourage your loved one to seek help
  • Find support for yourself by looking for medical advice, seeing a therapist, or group support meetings

It’s crucial that no matter what, they seek treatment. When someone already has visible track marks, it means their addiction has reached a chronic state and can lead to many health risks, including overdose. 

What About Needle Exchange Programs?

Needle exchange programs (NEPs), also known as syringe services programs (SSPs) or syringe exchange programs (SEPs). These are community-based services that provide sterile needles and syringes, facilitate safe disposal of used syringes, and provide a trusted link to other services and programs. Although controversial, these harm reduction programs have their pros and cons. 

Almost a decade after needle exchange programs launched, the CDC seems positive about its results. They estimate that these programs contributed to a reduction of risky behaviors by 80%. They also noticed that new cases of HIV/AIDS went down by 30 percent. 

Another study recorded the prevention of 120 injection-related HIV cases in 24 months, in Washington D.C. alone. But, SEPs aren’t solely about preventing blood-borne illnesses. The CDC estimates that users of SEPs are three times more likely to stop using drugs than those who don’t use the program. 

Even though needle exchange for drug addicts has proven extremely effective in helping reduce the spreading of blood-borne diseases, they don’t address addiction. 

Can Marks Heal?

Individuals who inject drugs into their veins on a consistent and addictive basis will always have marks until they cease use. Ointments, creams, and various wound care techniques can be used with limited success, but the only way to remove these marks is to seek addiction therapy. These unsightly blemishes will go away with time but can reappear unless the habit is discontinued permanently. Of course, it also takes time to heal, depending on the severity of the damage.

Those with damaged veins need to seek medical attention to address a potential infection. Serious bloodstream infections can lead to significant health complications. In the long run, some plastic surgeons might be able to reduce the appearance of damaged veins.

Seeking Help Today

These marks don’t just suddenly disappear. One study found that over 53 percent of former IV drug users had significantly visible scars even after five years. Whether you’re looking for help for yourself or a loved one, addiction treatment is the best way to say goodbye to track marks. And most importantly, the only way to address the underlying issue — addiction.

Starting with our medical detox programs and following up with our intensive patient programs, together, we can fight this addiction and help you or your loved one start their path towards recovery. Our evidence-based treatment options at Lighthouse Recovery Institute help those struggling with addiction find the right way to recovery. If you or someone you know struggles with intravenous (IV) drug addiction, contact us to start substance abuse treatment programs and start your journey towards sobriety. 

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