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When to Seek Care for a Bruise
By Traci McBee
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Phases of Bruising

Bruises go through colorful changes as the body begins to heal itself. The color changes mean that your body is metabolizing, or breaking down, the blood cells in the skin in order to repair itself.

Red/Purplish: Bruises typically start as a tender bump that will look red or purplish. The bump may swell from the blood collecting under the tissue.

Blue/Blackish: After a couple of days the bruise will look blue or
even blackish.

Greenish/Yellow: After five to 10 days a bruise may look greenish or even yellow.

Brown: After 10 to 14 days the bruise will most likely be a light brown, then continue to get lighter and lighter as it fades away.

If your bruise doesn’t change colors over time, remains firm, and gets
bigger or more painful, a hematoma may have formed. This happens when blood collects under the skin or in the muscle and—instead of trying to fix this—your body walls the blood off. If this happens, you need to have the hematoma drained by a physician.


learn more. For more information on health topics such as bruising, visit the Health Questions section of




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Ouch! Most of us have had to deal with a bruise when we bump into something or take a spill. Although the pain might last for only a couple of minutes, the resulting bruise will remind you of your mishap for a while. What is a bruise exactly, and when does a bruise require additional medical care?

A bruise, also called a contusion, forms because soft tissue on your body has been bumped. When soft tissues are injured, small veins and capillaries (the smaller blood vessels) under the skin break. Red blood cells leak out of these blood vessels and collect under your skin, causing the discoloration known as
a bruise.

“The injury required to produce a bruise varies with age,” says Louise Convery, D.O, Mercy Capitol Internal Medicine Clinic. “While it may take more impact to cause a bruise in a young child, even minor bumps and scrapes can cause bruising in an elderly person since blood vessels become more fragile as we age.”

Although everyone is susceptible to bruises, some people are more likely than others to bruise easily. Here are some other factors that contribute to bruising:

• Medication: If you take medicine to prevent blood clotting, you might bruise more easily because the medication will cause more bleeding into your skin or surrounding tissues. Drugs such as aspirin and warfarin (Coumadin) decrease your blood’s clotting abilities. If you take these drugs, bleeding from a damaged capillary will take longer to stop, and more blood will be able to leak out to form a bruise.

• Dietary supplements: If you take supplements such as fish oil or ginkgo, you might be increasing your risk for bruising. These supplements thin your blood, so make sure your health care professional is aware you’re taking them, particularly if you’re also on a blood-thinning medication.

• Medical conditions: People with blood clotting problems, such as hemophilia and liver diseases, have an increased risk of severe bruising.

It’s common to experience easy bruising with increasing age, and most bruises go away without treatment as your body reabsorbs the blood. Women also tend to bruise more easily than men, especially from minor injuries on the thighs, buttocks, and upper arms. Still, bruising can sometimes be a sign of a more serious condition, such as a blood-clotting problem or blood disease.

Dr. Convery suggests calling your physician if you experience any of these conditions:

• Your bruises are unusually large or painful, particularly if your bruises seem to develop for no known reason.
• You’re bruising easily and you’re experiencing abnormal bleeding elsewhere, such as from your nose, gums, or intestinal tract.
• You have no history of bruising but suddenly experience bruises, particularly if you recently started a new medication.

To minimize bruising and speed up the healing process, apply a cold compress or ice pack to the area injured. The cold will reduce blood flow to the injury and limit the size of the bruise. The cold will also decrease the inflammation of the area and limit swelling. In addition, elevating the injured area to a level above the heart will decrease the blood flow and prevent blood from gathering around the injury. If the bruise is causing a lot of pain, take acetaminophen (Tylenol, Excedrin) for pain relief instead of a blood-thinning medicine like aspirin.

“Bruises take time to heal, and most patients recover with no lasting effects,” says Dr. Convery. “Your physician can best evaluate if your bruise is normal or part of a larger health issue.”





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