A bruise or contusion is basically a traumatic injury on the skin or underlying tissues. Bruises can develop after an accident such as a fall or bumping into or struck by a blunt object. Since the exterior skin is not cut or broken, no external bleeding occurs. Nevertheless, the damage on the blood vessels below the skin can cause them to rupture and eventually leak blood. The blood that leaked gathers or pools below the skin.
Once the blood vessels are damaged, the platelets in the blood accumulate at the site of injury to form a plug. The platelets mix with certain proteins called clotting factors to develop a fibrin clot. Take note that this clot prevents blood from leaking from the blood vessels and holds the platelets together so that healing can start.
As the blood clots, the skin above the damaged area appears discolored. Initially, the skin is often reddish or purplish in color but as the bruise starts to heal, it turns brown, green or yellow. The discoloration is commonly known as the black-and-blue mark. Other symptoms that can manifest include tenderness, swelling or pain.
Types of bruises
- Ecchymosis – flat, purple-colored bruise that occurs once blood leaks out to the upper skin layers.
- Hematoma – mass of clotted blood. The affected becomes elevated, swollen or painful. This type of bruise can occur after an injury or impact on the skin, but can also develop without any cause.
Causes of bruises
- Minor injuries such as bumps on objects, falls or dropping a heavy object on the foot or hand can cause the formation of a bruise at the area of impact.
- The elderly usually bruise more easily than younger individuals. This is due to the fact that the elderly have thinner skin and have less fat deposited beneath the skin. In addition, the blood vessels are more likely to break after a minor injury.
- Women tend to bruise easier than men.
- Bleeding disorders such as hemophilia
- Certain medications such as anticoagulants increases the tendency to bruise
- Vitamin deficiency such as vitamin B12, K, C and folic acid are vital in the ability of the blood to clot
- Domestic, elder or child abuse
How to treat a bruise
The treatment depends on the underlying cause. Always bear in mind that bruises due to minor injuries often vanish after a few weeks. During the healing process, the bruise can change color from red or dark purple to yellow, green or brown before vanishing.
Apply an ice pack during the initial 24-48 hours after the bruise develops. It should be removed after 15 minutes. Cover the ice pack with a cloth or towel before it is applied on the skin.
Rest and elevate the injured limb to minimize the swelling and pain. After 2 days, apply a heat pack or a towel soaked in warm water over the damaged area several times throughout the day.
Over-the-counter pain medications such as acetaminophen can be given to reduce the discomfort or pain. If a bruise does not subside after a few weeks or recur without a known cause, it requires medical attention.