Bruises: Causes, Symptoms and Treatment
Bruises occur when blood leaks from damaged vessels into surrounding tissue. They appear as blue, purple, or yellowish skin discolorations and usually heal on their own.
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Bruises occur when blood leaks from damaged vessels into surrounding tissue. They appear as blue, purple, or yellowish skin discolorations and usually heal on their own.
What Are Bruises?
A bruise (medically known as a hematoma or contusion) forms when small blood vessels – such as capillaries or larger veins – are damaged by an external force, causing blood to leak into the surrounding tissue. The trapped blood beneath the skin creates the characteristic discoloration, which shifts from blue-purple to green and finally yellow as the body gradually breaks down the blood.
Causes
Bruises can result from a variety of causes:
- Blunt trauma: Bumping into objects, falls, or impacts are the most common triggers.
- Medical procedures: Blood draws, injections, or surgical interventions can cause localized bruising.
- Clotting disorders: Conditions such as hemophilia or the use of blood-thinning medications (e.g., warfarin, aspirin) make bruising more likely and more extensive.
- Vitamin C or vitamin K deficiency: These nutrients are essential for blood vessel integrity and clotting function.
- Advanced age: Skin becomes thinner and blood vessels more fragile with age, making bruising more frequent.
- Intense physical activity: Muscle tears or strains can cause deep internal bruising.
Symptoms
Common signs of a bruise include:
- Blue-purple, later green-yellow skin discoloration
- Swelling and tenderness in the affected area
- A palpable lump under the skin in cases of larger hematomas
- Warmth and a feeling of tightness in the affected tissue
The color change from blue to green to yellow reflects the gradual breakdown of hemoglobin by the immune system and is a natural sign of healing.
Diagnosis
In most cases, a physical examination by a healthcare provider is sufficient to diagnose a bruise. For larger or deeper hematomas, imaging techniques such as ultrasound or MRI may be used. If bruises appear without an obvious cause or occur very frequently, blood tests to assess clotting function are recommended.
Treatment
Immediate First Aid
The standard first-aid approach follows the RICE principle:
- Rest – stop activity immediately
- Ice – apply a cold pack wrapped in a cloth for 15–20 minutes to reduce swelling
- Compression – use a light pressure bandage to limit swelling
- Elevation – raise the affected body part to encourage blood drainage
Further Treatment Options
- Heparin ointment or arnica gel: Can be applied topically to help speed up resorption of the bruise.
- Heat (after 48–72 hours): Promotes circulation and accelerates the breakdown of the hematoma.
- Pain relief: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used for pain. Aspirin should be avoided as it increases bleeding tendency.
- Surgical drainage: Very large or deep hematomas may require aspiration or surgical evacuation.
When to See a Doctor
Medical attention is strongly recommended in the following situations:
- The bruise is very large or grows rapidly.
- There is severe pain or restricted movement.
- Bruising occurs without any apparent cause.
- Bruises appear frequently and without obvious reason.
- The bruise is located on the head, abdomen, or near a joint.
- Additional symptoms such as fever or general malaise are present.
References
- Pschyrembel Clinical Dictionary. 268th edition. De Gruyter, Berlin 2020.
- Lichtman M.A. et al.: Williams Hematology. 9th edition. McGraw-Hill Education, New York 2016.
- World Health Organization (WHO): Haemophilia and other bleeding disorders. Available at: https://www.who.int (accessed 2024).
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Related search terms: Bruises + Bruise + Hematoma + Contusion + Ecchymosis