A bruise is a common skin injury that results in a discoloration of the skin. Blood from damaged blood cells deep beneath the skin collects near the surface of the skin, resulting in what we think of as a black and blue mark.
Causes of a Bruise
People typically get bruises when they bump into something or when something bumps into them.
- Bruises can occur in some people who exercise vigorously, such as athletes and weight lifters. These bruises result from microscopic tears in blood vessels under the skin.
- Unexplained bruises that occur easily or for no apparent reason may indicate a bleeding disorder, especially if the bruising is accompanied by frequent nosebleeds or bleeding gums.
- Often, what are thought to be unexplained bruises on the shin or the thigh, for example, actually result from bumps into a bedpost or other object and failing to recall the injury.
- Bruises in elderly people frequently occur because their skin has become thinner with age. The tissues that support the underlying blood vessels have become more fragile.
- Bruises are also more common in those taking medicine to thin the blood.
Symptoms of a Bruise
- Initially, a fresh bruise may actually be reddish. It will then turn blue or dark purple within a few hours, then yellow or green after a few days as it heals.
- A bruise is commonly tender, and sometimes even painful for the first few days, but the pain usually goes away as the color fades.
- Because the skin is not broken in a bruise, there is no risk of infection.
When to Seek Medical Care
- Call the doctor if the bruise is accompanied by swelling and extreme pain, especially if you take a blood-thinning medication for a medical condition.
- Call the doctor if bruising occurs easily or for no apparent reason.
- Call the doctor if the bruise is painful and under a toenail or fingernail.
- Call the doctor if a bruise does not improve within two weeks or fails to completely clear after three or four weeks.
- Go to an emergency room if you think you have a broken bone along with the bruise.
- Some bruises, such as those on the head or the eye, can cause a lot of anxiety.
- If a bruise (sometimes called a "goose egg") occurs on the head, but the person did not black out and is able to remember the accident, it is unlikely that a serious head injury has resulted. On the other hand, if the person cannot remember what happened and you suspect the person may have a concussion, he or she should be taken to the nearest emergency room.
- If a bruise occurs just above the eye, you can expect the bruise to travel to the area just under the eye, possibly causing a black eye, because of the effects of gravity. As long as you are able to move the affected eye in all directions and do not have changes in your vision, it is unlikely to be a serious injury that requires a visit to the hospital.
Exams and Tests
If an injury is obviously a bruise and the doctor does not suspect any broken bones, the doctor will probably not perform any tests.
- If there is swelling or severe pain, the doctor may want to get an X-ray of the area to make sure there are no broken bones.
- If bruising occurs frequently and for no apparent reason, the doctor may have your blood tested to look for a bleeding disorder.
- Certain bruises, a pattern of bruises over time and in various stages of healing may alert a doctor to the possibility of physical abuse.
Bruises Treatment -- Home Remedies
The treatment for a bruise is most effective right after the injury, while the bruise is still reddish.
- A cold compress such as an ice pack or a bag of frozen vegetables should be applied to the affected area for 20-30 minutes in order to speed healing and reduce swelling. Do not apply ice directly to the skin. Wrap the ice pack in a towel.
- If the bruise takes up a large area of the leg or foot, the leg should be kept elevated as much as possible during the first 24 hours after the injury.
- Acetaminophen may be taken for pain as instructed on the bottle. Avoid aspirin or ibuprofen because they slow the blood from clotting and may, in fact, prolong the bleeding.
- After about 48 hours, heat in the form of a warm washcloth applied to the bruise for 10 minutes or so two to three times a day may increase blood flow to the bruised area, allowing the skin to reabsorb the blood more quickly. Ultimately, the bruise will fade in color.
Medical Treatment for a Bruise
Doctors have no special treatment for bruises other than the techniques described above: ice packs and later heat, over-the-counter medications for pain, and elevation of the bruised area, if possible.
A suspected victim of domestic abuse may be referred to a social worker.
To prevent a bruise:
- Wear protective gear (like shin guards) while playing contact sports such as soccer.
- Place furniture away from doorways and common walking paths within your home.
- Keep phone and electrical cords away from open areas where you may trip and fall.
- Be sure floors are kept dry and that rugs are slip resistant.
- Keep floors free of clutter.
- Plug in a small night light or use a flashlight if you need to walk to the bathroom during the night.
- If your doctor has prescribed blood-thinning drugs, be sure to have regular monitoring and adjust medications as necessary.
Bruises typically take about two weeks to disappear.