A bruise is a common skin injury that results in a discoloration of the skin. Blood from damaged blood vessels deep beneath the skin collects near the surface of the skin resulting in what we think of as a black and blue mark.
People typically get bruises when they bump into something or when something bumps into them.
- Bruises can occur in some people who exercise rigorously, 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.
- 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 as with a scrape or cut 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 2 weeks or fails to completely clear after 3 or 4 weeks.
- Go to the hospital's Emergency Department if you think you have a broken bone along with the bruise.
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.
Self-Care at Home
The treatment for a bruise is most effective right after the injury while the bruise is still reddish.
- A cold compress such as an icepack or a bag of frozen peas 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 icepack 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 or ibuprofen may be taken for pain as instructed on the bottle. Avoid aspirin because aspirin slows 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 2 or 3 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.
- Wear protective gear (shin guards) while playing contact sports such a 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 anticoagulant medications (blood-thinners), be sure to have regular monitoring and adjust medications as necessary.