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Bruises develop when small blood vessels under the skin tear or rupture, most often from a bump or fall. Blood leaks into tissues under the skin and causes the black-and-blue color. As bruises (contusions) heal, usually within 2 to 4 weeks, they often turn colors, including purplish black, reddish blue, or yellowish green. Sometimes the area of the bruise spreads down the body in the direction of gravity. A bruise on a leg usually will take longer to heal than a bruise on the face or arms.
Most bruises are not a cause for concern and will go away on their own. Home treatment may speed healing and relieve the swelling and soreness that often accompany bruises that are caused by injury. But severe bruising, swelling, and pain that begin within 30 minutes of an injury may mean a more serious problem, such as a severe sprain or fracture.
If you bruise easily, you may not even remember what caused a bruise. Bruising easily does not mean you have a serious health problem, especially if bruising is minimal or only shows up once in a while.
Occasionally after an injury, blood collects and pools under the skin (hematoma), giving the skin a spongy, rubbery, lumpy feel. A regular bruise is more spread out and may not feel like a firm lump. A hematoma usually is not a cause for concern. It is not the same thing as a blood clot in a vein, and it does not cause blood clots.
Bruises that do not appear to be caused by an accidental injury may be caused by abuse. It is important to consider this possibility, especially if the bruises can't be explained or if the explanations change or do not match the injury. Report this type of bruising and seek help to prevent further abuse.
Blood spots under the skin may be either purpura or petechiae. Purpura might look like bruises, but they are not caused by an injury as most regular bruises are. Petechiae don't look like bruises. They are tiny, flat, red or purple spots in the skin, but they are different than the tiny, flat, red spots or birthmarks (hemangiomas) that are present all the time.
Sudden unexplained bruising or blood spots under the skin or a sudden increase in the frequency of bruising may be caused by:
Medical treatment for abnormal bruising or blood spots focuses on preventing or stopping bleeding, changing or adjusting a medicine that may be causing the bruising, or treating the medical problem that is causing the bruising.
If the skin is injured over a bruise, be sure to watch for signs of a skin infection.
Check your symptoms to decide if and when you should see a doctor.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Symptoms of shock in a child may include:
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Based on your answers, the problem may not improve without medical care.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, you need emergency care.
Call911or other emergency services now.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
Symptoms of serious illness in a baby may include the following:
Symptoms of serious illness may include:
Symptoms of infection may include:
Many prescription and nonprescription medicines may reduce your blood's ability to clot and cause bruising or bleeding under the skin. A few examples are:
Abnormal bleeding means any heavy or frequent bleeding or any bleeding that is not normal for you. Examples of abnormal bleeding include:
When you have abnormal bleeding in one area of your body, it's important to think about whether you have been bleeding anywhere else. This can be a symptom of a more serious health problem.
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
If your bruise does not require an evaluation by a doctor, you may be able to use home treatment to help relieve pain, swelling, and stiffness.
Call your doctor if any of the following occur during home treatment:
You can't always prevent bruises, but most of the time bruises are not a cause for concern.
Bruises are often the first sign of abuse. You may be able to prevent further abuse by reporting it and seeking help.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
Current as of: June 4, 2014
Author: Healthwise Staff
Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
To learn more, visit Healthwise.org
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