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Bruising basics: What to do when you're black & blue

From a bump against a coffee table to a slip on the ice, we all know the resulting tenderness and kaleidoscope of colors that come with a bad bruise. And while those black-and-blue badges are part of everyday life, their cause, treatment and healing process are a bit of a mystery. 

What causes a bruise?

A bruise is an injury to the small blood vessels under the skin. If the skin above the vessels isn't broken, blood pools under the skin and begins to clot, appearing as a colorful mark on the skin’s surface.

It’s also possible to bruise soft tissues, muscles and bones. The more serious the injury, the bigger the bruise, also known as a contusion. Contusions are usually more tender and painful to the touch than minor bruises to the skin.

While a bruise is usually the result of outside force, like bumping into something, there are other causes, including certain medical conditions, such as kidney or liver disease; medical treatments or medications, including the anticoagulant Warfarin; and thinning skin that comes with aging.

What do the colors mean?

Most bruises are minor and will heal within two weeks. Don’t be alarmed by the myriad of colors your bruise might display along the way. It’s part of the healing process as the body breaks down blood and other fluids under the skin. Here’s what you can expect:

  • After an injury occurs, a bruise will usually be red or purple in color.
  • Within a few days, the area may become black, blue or purple.
  • Within 5-10 days, the area will likely become yellowish or greenish.
  • Within 10-14 days, you’re in your final stage of healing. The area will usually turn brown and become lighter until the bruise eventually fades away.

How do you treat a bruise?

There are some steps you can take to help speed healing and minimize swelling, discoloration and pain:

  • Immediately following an injury, place a cold pack wrapped in a towel over the injured area for no longer than 15 to 20 minutes. (A cold pack left on the skin for too long may cause frostbite.) Remove the pack for 30 minutes. Repeat the process as often as you can for two days.
  • After two days, apply a heating pad or warm compress to the area. For leg or arm injuries, elevate the limb above your heart to keep blood and fluids from pooling in the injured area.
  • Use over-the-counter pain relievers, such as ibuprofen.
  • Gently massage the affected area to encourage blood flow.

Types of bruises

Not all bruises look the same or come with the same symptoms. For instance, an ecchymosis forms when broken blood vessels leak into the upper layers of the skin. A black eye is a common example.

Hematomas develop when the blood clots and forms a lump under the skin’s surface. (Think a “goose egg” bump on the forehead.) The affected area might be swollen, raised and painful. Head injuries often cause hematomas, because the scalp contains a lot of blood vessels prone to breakage.

Any injury to the head or near the eye can be serious, and requires treatment as soon as possible.

When you should see a doctor

You may want to visit your doctor if you bruise more easily or more often than other people around the same age and gender.

Excessive bruising could be a symptom of anemia, a medical condition caused by a lack of iron in the blood. If this is the case, you can up your iron levels by adding more animal protein to your diet along with green, leafy vegetables.

In some cases, a bruise can be a sign of something more serious. Visit your nearby Indigo Health clinic right away if you notice any of the following:

  • A bruise on your arm or leg is causing tightness or swelling.
  • Your bruise has gotten larger since the injury.
  • An injury near your eye interferes with your vision or makes it difficult to see in different directions.
  • Your bruise lasts longer than two weeks or reappears for an unknown reason.
  • The bruised area is associated with a minor fracture.
  • You have bruising on your abdomen or head.

An Indigo medical provider will examine the bruised area and provide treatment recommendations. If the bruising is severe or there are indications of a more serious issue, you may be advised to go to the emergency room.

Indigo Urgent Care clinics are open from 8 am to 8 pm, 7 days a week. Walk in or reserve an appointment time online.


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