Responses from Erik Wert, DO, MPH, FACOI, AAHIVS and Reni Forer
Edited by Jessica Helmer
June 30th, 2023
“What if I bite my partner too hard and it bleeds?”
This is a complex issue because the two participants are facing different risks. First, we will consider the one who did the bitting. Due to the breaking of the skin, there is the possibility of exposure to blood borne pathogens. The big four would include hepatitis B or C, Syphilis, and HIV. This leads to the first recommendation: do not brush or floss your teeth for two hours before and after play. This is to prevent any micro-breaks in the gum line—micro-breaks could expose your body to these pathogens. If you want fresh breath during play, you can rinse your mouth out with mouthwash. The first step following a biting injury would be to immediately rinse out your mouth of any contaminants. This can be simple water, and do multiple rinses. If possible, rinse using an alcohol-based mouthwash. Again, avoid breaking the gum line—no brushing! Rinse, rinse and rinse.
For the bitten person, the first thing would be to consider if they are on any medications that may increase bleeding. Immediately compress the area, and if possible, apply an ice pack or similar. All bleeding will stop (if it is minor) if these steps are taken.
Secondly for the person who got bitten, the biggest issue is that the mouth has many bacteria that could increase the risk of infection or cellulitis. Signs of infection include redness, warmth, and tenderness. The seriousness can depend on the body part or area bitten. Extremities can have different risks than larger areas. Apply pressure to the area, and once the bleeding stops, you can clean the area out with water or sterile water, if available. Apply antibiotic ointment to the area, and dress with a sterile dressing.
If the bite punctures a major artery or vein, this would result in large amounts of bleeding. Immediately compress and ice the area, and seek emergency care. Another issue could be nerve injury secondary to the bite. A mild nerve issue would be a tingling sensation—the complete loss of sensation or inability to move the area needs emergency evaluation.
The arm and leg muscles have tendons. These connect to bone and allow for movement. A bite that goes through a tendon will result in an immediate muscle retraction and loss of movement of the affected area. You should seek immediate medical help.
Now for the consideration of less serious injuries. The first step is to compress and cool the area. This will help stop the blood flow. Once any bleeding is stopped, you can examine the area in detail. If the bite laceration is extremely large, it may need evaluation by medical personnel. If the area is smaller, and the bleeding has stopped, you should irrigate the area with water / or sterile water. While cleaning the area, you may cause a little bleeding—just compress the area again. Once the area is rinsed thoroughly, apply an antibiotic cream or ointment on the area, cover it with a sterile pad, and use gauze and tape to keep it in place. If none of the more serious situations are occurring, then provide standard medical care, keep the area clean, use mild soap, and apply antibiotic cream / ointment until it completely heals. The area should be monitored closely until healing has completed. If you start noticing any signs of infection, go to your doctor.
One of the most serious injuries that may not be immediately detected would be an infection of the tendon. This will be extremely red, painful, and swollen, and you may notice streaking up in the extremities where the tendon is affected. If you notice these occurring, seek IMMEDIATE medical care. This may require antibiotics, possible hospitalization, or, in severe cases, surgery.
When you are developing your dungeon / play space emergency kit, you should consider some of these items: sterile gauze, antibiotic ointment, cool pack, bandaids, something to rinse out the area like water (ideally something sterile), and tape. A lot of these items can be found in your local pharmacy.
Dr. Erik Wert is a primary care physician and an Assistant Clinical Professor of Medicine at Michigan State University.
This is a great question, because human bite wounds are some of the most likely types of wounds to become infected. Human mouths carry a large number of different bacteria, and as many as 20-25% of human bite wounds become infected, according to some studies , which put them at par with, if not higher, than dog and cat bites.
Additionally, the bite may have not only broken skin, but also caused damage to underlying structures such as tendons and/or joints (depending on the area of the bite) .
Human bites can also transmit certain infections, including HIV, syphilis, Hepatitis B and C , .
If you have bitten your partner and broke skin, I would suggest the following:
- Do not put the bitten area in your mouth or have your partner put it in their mouth, as that will increase exposure to bacteria.
- Plan to go to an urgent care, ER, appointment with your primary care provider, or call your physician’s office and talk to an RN. If the bite wound is on the neck, face, hands, fingers, or feet, you should be seen immediately.
- If the skin around the wound is broken and actively bleeding, apply pressure with a clean and dry dressing or cloth.
- If the wound is NOT actively bleeding, you can wash the wound thoroughly with soap and water or an antiseptic such as hydrogen peroxide. Do NOT wash the wound if it is still actively bleeding.
Apply an antibiotic ointment and cover the wound with a sterile bandage. Do not use tape to close the wound as that may trap harmful bacteria inside.
You may be asking yourself, why do I need to go to the doctor if it’s just a small wound? There are several reasons including, 1) they may prescribe prophylactic antibiotics to prevent infection, 2) they may need to provide vaccinations such as tetanus depending on your partner’s vaccination status, 3) they may surgically close the wound depending on its size/depth to help with healing and decrease scarring, 4) they can check for signs of damaged nerves or tendons to decrease risk of long-term effects on strength and sensation, and 5) they may determine that your partner needs post-exposure prophylaxis for infections such as HIV depending on your and your partner’s current status and risk.
Reni Forer is a medical student at Michigan State University (2025).
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