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Bruising is an area of discolored skin that develops when the lining of small blood vessels is damaged, allowing blood cells to escape into the skin and tissues. This condition most often occurs after a person knocks or otherwise injures a part of the body.
There are three types of bruises: - Subcutaneous - beneath the skin.
- Intramuscular - within the underlying muscle. It is often difficult to use the muscle that has been bruised.
- Periosteal - bone bruise. This is the most severe and painful.
Causes & Development
As a person ages, he or she will bruise more easily. The layer of protective fat just under the skin becomes thinner. The small blood vessels also become more fragile and are more easily damaged. Frequent long-term exposure to the sun can also cause the skin to be more fragile and likely to bruise. A tendency to bruise easily may run in families.
Possible causes of bruising include:- Blood disorders, including problems with blood clotting such as hemophilia A or hemophilia B
- Blood-related diseases such as leukemia
- Liver disease, such as cirrhosis
- Lymphomas
- Certain disorders in which bone marrow cells grow at an abnormal rate
- Nutritional deficiencies, such as deficiency in vitamins C, K, B12, or folic acid
- Sepsis, or severe infection in the bloodstream
- Systemic lupus erythematosus (SLE)
- Trauma, injury or physical abuse
- Prolonged coughing or vomiting
- Medications, such as blood thinners
- Surgery or other medical procedures
- Allergy-related disorders
Signs & Symptoms
Bruises can last from days to months and usually occur in several stages. A bruise generally starts out as a pinkish-red area or as tiny red dots or blotches on the skin. The bruise may be very small and may blend in with the texture of the skin, or it may be large, swollen, and painful. Within days to a week or so, the bruise becomes more purple. As it heals, it becomes brownish-yellow. Generally, bruises heal and disappear within 2 to 3 weeks.
Treatment & Prevention
The way one deals with bruising obviously depends on the cause. Some cases of bruising may be prevented or reduced if the cause is eliminated, such as replacing vitamins in someone who has vitamin deficiency.
Sometimes it may not be possible to determine or treat the underlying cause. In such cases, being careful not to bang or knock the skin against hard surfaces will decrease the likelihood of developing bruises. In general, wearing protective clothing will also prevent or lessen bruising. Avoiding excessive exposure to the sun may minimize skin damage.
Some tips:- Place ice on the bruise to help it heal faster and to reduce swelling. Place the ice in a cloth, not directly on the skin. Keep the ice on the bruise for about 15 minutes per hour for the first 24-48 hours. After that, applying a hot pack to the area will help the bruise heal more quickly.
- Keep the bruised area raised above the heart, if practical. This helps keep blood from pooling in the bruised tissue.
- Try to rest the bruised body part by not overworking the muscles in that area.
- If needed, use a pain killer such as acetaminophen (Tylenol) to help reduce the pain from the bruise.
If a person is taking a blood thinner (e.g. aspirin or warfarin), it is important that they take it exactly as prescribed in order to reduce the likelihood of bruising.
A person who has hemophilia may be given blood transfusions; a person who has nutritional deficiencies may be given special dietary recommendations; a person who has leukemia or cancer may require special medications and procedures; a person who has bacteria in the blood may need antibiotics.
Seek medical attention if
See a doctor if...- Rarely, there will be a feeling of extreme pressure in a bruised area, especially if it is large or very painful. This may be due to a condition known as compartment syndrome. Increased pressure on the soft tissues and structures beneath the skin can decrease the supply of vital blood and oxygen to the tissues. This is potentially life-threatening and you should receive emergency care promptly; surgery frequently needs to be performed to relieve the extreme buildup of pressure.
- You are bruising spontaneously without any injury, fall, or other cause.
- There are signs of infection around the bruised area such as streaks of redness, pus or other drainage, or fever.
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Signs, symptoms & indicators of Bruising Susceptibility:
Risk factors for Bruising Susceptibility:
Bruising Susceptibility suggests the following may be present:
Recommendations and treatments for Bruising Susceptibility:
KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | May do some good |  | | Likely to help |
GLOSSARY
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Bioflavonoid (Bioflavonoids, Flavonoid, Flavonoids)
Vitamin P. Any of a group of colored flavones (crystalline compounds) found next to the peel in many fruits. Essential for the stability and absorption of ascorbic acid.
Bruise (Bruised, Bruising)
Injury producing a hematoma or diffuse extravasation of blood without breaking the skin.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Folic Acid
A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Pus
White cells that the body sends to fight an infection.
Scurvy
A disease that is caused by a lack of vitamin C in the diet. It is marked by weakness, anemia, edema, spongy gums, often with open sores in the mouth and loosening of the teeth, bleeding in the mucous membranes, and hard bumps of the muscles of the legs.
Sepsis (Blood Poisoning, Septicemia)
Like septicemia, an infection that has moved deeply into the body, involving the subcutaneous or submucosal layers, connective tissue, lymph system, or blood. Septicemia: The presence of pathogenic bacteria or other microbes in the blood stream - a serious business, since most defenses are focused outside the bloodstream and the infection has bypassed them either due to its virulence, the depth and severity of the original focal infection or the weakened state of the body's immunity and life energy. Blood poisoning.
Subcutaneous (Subdermal)
Below the surface of the skin. Subdermal: Below the surface of the skin, and below subcutaneous, but definitely higher up than the muscles.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Vitamin K
Helps the blood clot when the body is injured.
Last updated: Apr 13, 2008
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