Updated on February 6, 2024
3 min read

What Are Track Marks and What Do They Look Like?

Key Takeaways

What are Track Marks?

The appearance of track marks is one of the tell-tale signs of frequent, intravenous (IV) drug use. They occur at the injection site and lead to collapsed veins. 

Often, track marks are signs of long-term substance use. Injection drug users sometimes use long sleeves, pants, and make-up to hide track marks from others.

Intravenous drug use leads to an intense high far more potent than other methods. IV drug users are at an increased risk for serious health problems. 


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What Do Drug Track Marks Look Like?

The initial appearance of track marks resembles deep bruising. When the bruising subsides, the injection site scabs over.

Long-term users will have track marks on all areas of the body. Many users will have clusters of track mark scabs on the arms, legs, and between the fingers and toes. 

Track mark scabs can also resemble dark, round circles. These particular track marks result from scar tissue skin popping. This is a method in which the needle is injected under the skin instead of a vein. 

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Heroin Addiction & Track Marks

Heroin use is one of the most common reasons for track marks. Heroin users who use intravenously typically have a substantial tolerance to the drug. As such, intravenous use is the only way to satisfy cravings. 

Heroin increases dopamine, a feel-good chemical, in the brain. This exchange of injection and dopamine directly changes the brain's reward center.

This same mode of operation is used by prescription opioids such as OxyContin. Prescription opioids are frequently the cause of future heroin addiction

What are the Dangers of IV Drug Use?

Track marks pose several notable health risks. They are also an indicator of substance use disorders (SUDs).

The dangers of IV drug use include:

  • Skin infections: Caused by repeated piercing, scar tissue, and needle sharing
  • Blood clots: Occur from repeated vein punctures and general heroin use 
  • Hepatitis B: A severe liver condition that arises from sharing needles
  • Hepatitis C: A more severe version of Hepatitis B that arises from sharing needles
  • Scarring: Permanent scars due to repeated injections

IV drug use can also lead to HIV or sepsis. Bacterial infections from sharing needles can lead to these diseases.

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Other Signs of IV Drug Use

Substance use disorder (SUD) affects millions of people worldwide. Addiction-related changes affect lifestyle, appearance, and physical and mental health. Specific signs of shooting up include: 


  • Significant weight loss
  • Dirty or disheveled clothing
  • Sores
  • Collapsed veins due to restricted blood flow
  • Thinning or patchy hair 
  • Poor dental hygiene 
  • Formation of abscesses
  • Overly aged appearance 


  • Drug paraphernalia 
  • Inability to keep appointments
  • Declining bank account balances 
  • Inability to sustain a job
  • Unpaid bills 
  • Homelessness 
  • Sudden disregard for interpersonal relationships 

Mental Health

  • Onset or triggering of mental illness 
  • Mood swings
  • Chaotic or incoherent thoughts
  • Suicidal thoughts and speech 
  • Diminished logic 
  • Poor sleep 
  • Unable to focus on non-drug-related concerns

While there are other signs of shooting up, these are the most common. Snorting drugs and orally consuming drugs have their own symptoms. However, these symptoms often coincide with the aforementioned risks of intravenous use. 

Treatment Options for Addiction

Treatment programs for prescription opioids, methamphetamine, and heroin are available for those who need them. Addiction treatment options include:

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Updated on February 6, 2024
5 sources cited
Updated on February 6, 2024
  1. U.S. Department of Health and Human Services, et al. “Key Substance Use and Mental Health Indicators in the United States.” SAMHSA, 2018, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.htm.

  2. Centers for Disease Control and Prevention. “Injection Drug Use and Wound Botulism.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Oct. 2018, www.cdc.gov/botulism/wound-botulism.html. 

  3. Semel Institute for Neuroscience & Human Behavior. “Potential Complications Of IV Drug Use.” Potential Complications Of IV Drug Use | Semel Institute for Neuroscience and Human Behavior, www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/Potential_Complications_Of_IV_Drug_Use.

  4. Cornford, Charles S, et al. Deep Vein Thromboses in Users of Opioid Drugs: Incidence, Prevalence, and Risk Factors. Dec. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3223775/. 

  5. World Health Organization. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK310652/.

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