What is bruise?
A bruise is a common skin discoloration that results from the breakage of tiny blood vessels leaking under the skin after a traumatic injury. Blood from damaged blood vessels beneath the skin collects near the surface to appear as what we recognize as a black and blue mark. This mark is from skin discoloration by red blood cells and their contents.
How common is bruise?
Bruise is extremely common. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of 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.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Bruising while taking aspirin or other blood thinners;
- Swelling and pain in the area of bruising;
- Bruising that occurs after a hard blow or fall;
- Bruising that occurs along with a suspected broken bone;
- Bruising for no reason;
- Bruising that does not improve within two weeks or fails to completely clear after three or four weeks;
- Bruising under your nails that is painful;
- Bruising accompanied by bleeding from your gums, nose, or mouth;
- Bruising accompanied by blood in your urine, stool or eyes;
- Unexplained bruising, especially in a recurring pattern;
- Bruises that aren’t painful;
- Bruises that reappear in the same area without injury;
- Any black bruises on your legs.
What causes bruise?
- 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.
- Bruising on the back of the hands and arms (called actinic purpura or solar purpura) occurs because there is often sun-damaged and thin on the skin.
What increases my risk for bruise?
There are many risk factors for bruise, such as:
- Bruises can occur in some people who exercise rigorously, such as athletes and weight lifters.
- Age: 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.
- Vitamin C deficiency (ascorbic acid deficiency or scurvy).
- Alcohol abuse.
- Certain medical conditions, including leukemia, hemophilia, liver disease, Cushing’s disease, Marfan’s syndrome, Ehlers-Danlos syndrome, connective tissue diseases, iron-deficiency anemia, or aplastic anemia, can lead to easy bruising and bleeding.
- People taking certain types of medications may bruise more easily. These medications include nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin); blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), and heparin; steroids (prednisone); and some medications used to treat cancer.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is bruise diagnosed?
- 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 the 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.
How is bruise treated?
Doctors have no special treatment for bruises other than the techniques used at home such as 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.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage bruise?
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.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: October 14, 2016 | Last Modified: January 4, 2017
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What Are Bruises? http://www.emedicinehealth.com/bruises/article_em.htm#what_are_causes_and_risk_factors_for_bruises. Accessed October 3, 2016.
Bruise. https://medlineplus.gov/ency/article/007213.htm. Accessed October 3, 2016.
What are bruises? http://www.nhs.uk/chq/Pages/1057.aspx?CategoryID=72. Accessed October 3, 2016.