Bruises: From Simple to Serious

Bruises From Simple to Serious

What causes bruising? Should you worry if you bruise too often? Learn more about bruises and what they may mean.

No one gets through life unbruised. From childhood through old age, everyone is subject to the black and blue marks that reveal life’s hard knocks. Most of the time, a bruise (known medically as a contusion) is the harmless and temporary result of a bang, bump, or blow to the body.

What is a bruise?

A bruise occurs when blood vessels are broken or damaged and blood leaks out of them into the tissue under the skin. This pooled blood, as well as the body’s reaction to injury, causes the skin discoloration of a bruise. The discoloration may start out looking black, blue, red, or purple. As the blood cells break down over time, the color of the bruise may change to green, yellow, or brown before the bruise disappears.

What causes a bruise?

Most bruises result from a blow to the body. This can occur in many ways: playing sports, falling down, banging into a hard object, and so on. You may have a tendency to bruise more easily if you:

  • Are older (as you age, blood vessels become more fragile and there is less fat under the skin)
  • Take certain medications, including:
    • Blood-thinners, such as aspirin or warfarin
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
    • Corticosteroids
    • Certain dietary supplements
  • Have a nutritional deficiency, such as of vitamins C, K, B12, or folic acid

Less commonly, bruising can be a result of:

  • Bleeding disorders, such as hemophilia, that prevent your blood from clotting properly. You may also have frequent nosebleeds and bleeding gums.
  • Liver disease, such as cirrhosis of the liver.
  • A bloodstream infection (sepsis).
  • Auto-immune diseases (in which the body attacks the blood vessels), such as lupus.
  • Blood-related diseases, such as leukemia and lymphoma.

What to watch out for:

See a doctor right away if you have bruising that:

  • Occurs near your eyes
  • Occurs behind your ears, which could be the sign of a skull injury.
  • Doesn’t heal within a few weeks.
  • Seems to occur for no reason.
  • Occurs all over your body.
  • Is unexplained and is painful, and you have a chronic medical condition

You may need emergency evaluation if any of these symptoms are severe or if they are accompanied by other symptoms, such as a fever, or if they occur after surgery or a blood transfusion. You should also seek emergency care if you have widespread bruising that is accompanied by bleeding from your nose or gums, or in your eyes, stool, or urine

What can you do to treat symptoms of a bruise?

Most of the time, you don’t have to do anything to take care of a bruise caused by an injury. It will go away by itself in time. But if you have swelling or pain, you may want to help reduce these symptoms by using the tried-and-true “R.I.C.E.” method:

  • Rest the bruised part of your body. Don’t massage the bruised area.
  • Ice the bruised area with an ice pack or ice cubes wrapped in a towel. Do this for 15 to 20 minutes, 4 times a day. If you have diabetes, poor circulation, or blood vessel disorders (such as vasculitis or Raynaud’s disease), talk with your doctor before using ice or an ice pack.
  • Compress (wrap up or brace) the bruised area. Be sure not to wrap it too tightly. And don’t keep it wrapped overnight.
  • Elevate the bruised part of your body to a level above your heart.

In 2 to 3 weeks, the bruise should fade away and your skin will return to normal.

A note about NSAIDs

NSAIDs (nonsteroidal anti-inflammatory drugs) are commonly taken to reduce pain and swelling, although they are not for everyone. Ibuprofen, naproxen, and aspirin are all NSAIDs. Talk to your doctor about whether taking NSAIDs is safe for you, especially if you:

  • Have stomach bleeding or peptic ulcer.
  • Have liver or kidney disease or a bleeding disorder
  • Drink more than 3 alcoholic drinks each day
  • Have high blood pressure or heart disease
  • Take aspirin to protect your heart or take any sort of blood-thinning drugs

Do not give aspirin to anyone younger than 20. It has been linked to Reye’s syndrome, a serious illness affecting children. Do not give ibuprofen or naproxen to children without first talking to your doctor.

Always read instruction labels carefully to understand all precautions.

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