BRUISES

A bruise is a common skin injury that results in a discoloration of the skin.  Medically, it is known as a contusion.  It occurs when tiny blood vessels are damaged or broken as the result of trauma to the skin.  The raised area of a bump or bruise is caused by leaking from these injured blood vessels into the tissues as well the body’s response to the injury.

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.

Bruises change in appearance over time, and it may be possible to tell by looking at a bruise how old it is. When it first appears, a bruise will be reddish looking, reflecting the color of the blood in the skin. By one to two days, the reddish iron from the blood undergoes a change and the bruise will appear blue or purple. By day six, the color changes to green and by day eight to nine, the bruise will appear yellowish-brown. In general, the bruised area will be repaired by the body in two to three weeks after which the skin will return to normal.

DIAGNOSIS

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.

 

RECOMMENDED MEDICATIONS

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.

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