Chapter 1: Understanding Paper Cuts

My sister could easily use a full-body wrap of bubble wrap before starting her day. She's the kind of person who can get pricked by a single thorn from a rose. Every time she tries to scratch off a lottery ticket, she ends up with a paper cut, leaving her bloodstains on the winning $4 ticket. As an English teacher surrounded by piles of papers to grade, her struggle is all too real. This morning, I received another message: "My thumb is throbbing from a new paper cut, and I have twelve more reports to grade!"

So, what makes these thin slices feel like they’re causing us excruciating pain? As a dermatologist, I’ve treated numerous paper cuts, and here’s what I’ve found:

The outer layer of skin, known as the epidermis, is about one-eighth of an inch thick and contains the highest concentration of nerve endings in the body, the sensory fibers responsible for pain. Each square centimeter of skin has roughly 200 pain receptors, but our hands and fingers have an even greater density, around 3,000 receptors. Thus, even the tiniest cut can affect thousands of these sensitive endings, leading to significant pain, similar to that caused by a deeper cut.

What’s even more surprising is that unlike the smooth edge of a razor blade, paper has a jagged and rough edge, much like a saw. Although it’s thin, paper is quite dull. Imagine using a dull knife that tears through meat instead of slicing cleanly; the same goes for paper when it cuts your fingertip, even if the damage is microscopic.

To make matters worse, shallow cuts from paper generally don’t bleed or clot, which means that without a scab, nerves close to the skin’s surface remain exposed and easily irritated. Since we constantly use our hands and fingers, these wounds can reopen frequently, prolonging our discomfort and hindering the healing process.

Additionally, most paper products are treated with harmful chemicals and can harbor bacteria, fungi, and other irritating pathogens that linger in the wound.

An Evolutionary Perspective

Despite the unpleasantness of paper cuts, there’s an evolutionary advantage to the pain they cause. These activated pain receptors serve as a warning signal.

We engage with our environment primarily through our hands and fingertips, which are more sensitive than any other part of our body. Neurons in our fingertips respond quickly to extreme temperatures, harmful pressure, and dangerous substances, helping to protect us.

If you find yourself frequently suffering from these painful nicks, consider switching your paper. Thicker paper is less likely to cut skin compared to thinner varieties. Also, if the paper has been precisely cut by a machine, its edges will be sharper. For example, deckled paper, which has irregular edges, is less likely to cause cuts. Softer paper, too, is less harmful.

The Risks Associated with Paper Cuts

While the ancient practice of torture through numerous superficial cuts is no longer in vogue, a single paper cut can still pose serious risks. In rare instances, a paper cut can lead to a secondary infection called necrotizing fasciitis, which destroys the tissue and fat beneath the skin. This condition can result in extensive tissue damage, potentially requiring amputations, skin grafts, and an extended hospital stay.

In 2018, Ryan Taylor, a 26-year-old marketing manager, experienced a typical paper cut. He thought little of it, but by the next morning, his hand was swollen. A visit to the doctor led to his hospitalization. His skin started turning black and purple, and he was diagnosed with necrotizing fasciitis. "They rushed me into surgery and told me there was a chance I could lose my arm if it continued spreading, or even my life," he recounted in a New York Post article.

How to Treat and Prevent Paper Cuts

Although amputations from paper cuts are rare, it’s wise to keep an eye on these minor injuries. Rinse the area with soap and water, apply an antibiotic ointment like Polysporin, and cover it with a bandage. Covering cuts keeps them moist and helps them heal faster than if they were left exposed. Petroleum jelly or even Chapstick can be beneficial.

Liquid Band-Aid can be effective since it protects the exposed nerves, potentially alleviating pain. Another option is Super Glue, which many patients have found helpful, although it requires caution to avoid sticking your fingers together. Nail polish can provide similar protection with a lower risk.

Preventing paper cuts is the best strategy. Dry, chapped hands are more susceptible, so make sure to moisturize your skin before handling paper. If you expect to deal with a lot of paperwork, consider wearing lightweight, form-fitting gloves.

Unless you wrap yourself in bubble wrap or shift entirely to a digital format, you’ll likely encounter a paper cut at some point. The next time you find yourself cursing in frustration, remember to thank evolution for reminding you to protect your hands.

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In this video, we further investigate the factors that contribute to the intense pain of paper cuts and what you can do to alleviate it.