Bruising, also known as a contusion, occurs when small blood vessels under the skin break, allowing blood to pool beneath the surface. It can range in severity from mild discoloration to significant swelling and tenderness. This page explores the causes, diagnostic process, and treatment options for bruising.

Causes of Bruising

Bruising can result from trauma, medical conditions, or other factors that affect the blood vessels, skin, or clotting ability.

Traumatic Causes

• Blunt Force Impact: Common causes include falls, bumps, or strikes during sports or accidents.
• Pinching or Compression: Squeezing of the skin can cause small bruises.
• Injections or Blood Draws: Needle punctures may lead to minor bruising around the site.

Medical and Biological Causes

• Aging: Thinner skin and fragile blood vessels in older adults make them more prone to bruising.
• Medications: Blood thinners (e.g., aspirin, warfarin), corticosteroids, or certain supplements like fish oil can increase the risk of bruising.
• Vitamin Deficiencies: Lack of vitamins C or K can weaken blood vessels and impair clotting.
• Blood Disorders: Conditions like hemophilia or thrombocytopenia can cause frequent, severe bruising.

Other Causes

• Intense Exercise: Straining muscles during physical activity can lead to small blood vessel tears, resulting in bruising.
• Allergic Reactions: Rarely, allergic responses can cause blood vessel fragility.
• Alcohol Use: Chronic alcohol consumption can weaken blood vessels and liver function, leading to increased bruising.

Symptoms of Bruising

Bruises vary in size, colour, and severity depending on the cause and the depth of the injury.

Typical Appearance

• Discolouration: Changes from red to purple, blue, green, yellow, or brown as the bruise heals.
• Tenderness: Soreness or mild pain around the bruised area.
• Swelling: Mild puffiness around the site of impact.

Severe Symptoms

• Hematoma: A large, raised bruise caused by more extensive bleeding under the skin.
• Painful or Hard Bruises: May indicate deeper tissue damage or bone involvement.
• Unexplained Bruising: Bruising without obvious trauma may suggest an underlying condition.

Diagnosing Bruising

Most bruises heal on their own, but unexplained or severe bruising may require medical evaluation.

Medical History
Your healthcare provider may ask about:

• Recent injuries or trauma.
• Medications or supplements you’re taking.
• History of easy bruising or bleeding disorders in the family.

Physical Examination
The doctor will evaluate:

• Size, location, and colour of the bruise.
• Presence of swelling or other symptoms, such as joint stiffness or fatigue.

Diagnostic Tests

• Blood Tests: To check for clotting disorders, low platelet levels, or vitamin deficiencies.
• Imaging: Ultrasound or X-rays may be used to assess deeper tissue damage or rule out fractures.
• Liver Function Tests: To determine if liver disease is contributing to bruising.

Treating Bruising

Treatment for bruising focuses on reducing pain, swelling, and promoting healing. Severe or recurrent bruising may require addressing the underlying cause.

Home Remedies for Minor Bruises

• R.I.C.E. Method:
  • Rest: Avoid activities that may worsen the injury.
  • Ice: Apply an ice pack for 15–20 minutes every hour during the first 48 hours.
  • Compression: Use a bandage to reduce swelling.
  • Elevation: Raise the injured area above heart level to minimize blood pooling.
• Over-the-Counter Pain Relief: Acetaminophen can help manage pain; avoid ibuprofen or aspirin if they increase bruising.

Medical Treatment for Severe Bruising

• Drainage of Hematomas: Large or painful bruises may require drainage by a healthcare provider.
• Addressing Underlying Conditions: Treating blood disorders, adjusting medications, or supplementing deficient vitamins.
• Physical Therapy: For bruises affecting mobility, such as those near joints or muscles.

Preventing Bruising

You can reduce the risk of bruising by:

• Protecting Vulnerable Areas: Use padding or protective gear during sports or activities.
• Maintaining Skin Health: Keep skin hydrated and healthy, especially in older adults.
• Balancing Diet: Include foods rich in vitamins C and K, such as citrus fruits, leafy greens, and broccoli.
• Monitoring Medications: Consult a doctor about the side effects of blood thinners or other medications.

When to Seek Medical Attention

Consult a healthcare provider if you experience:

• Frequent or unexplained bruising.
• Large or painful bruises without apparent cause.
• Bruises that don’t improve after two weeks or continue to spread.
• Signs of infection, such as redness, warmth, or pus near the bruised area.
• Accompanying symptoms like prolonged bleeding, fatigue, or jaundice.

Bruising is often a minor issue, but persistent or severe cases may signal an underlying health problem. Timely diagnosis and appropriate care can help prevent complications and ensure optimal recovery. Always consult a healthcare provider for personalized advice and treatment.