A bruise is a common skin injury that results in a discoloration of the skin caused by the accumulation of blood released from damaged blood vessels.
A fresh bruise may be red in color. It then turns blue or dark purple within a few hours, then yellow or green after a few days as it heals, and blood breaks down. It ultimately becomes yellowish-brown or light brown.
However, skin color affects the appearance of a bruise; those with medium skin tones had more red and yellow to their bruises, while darker skin tones displayed darker bruises.
Commonly, a bruise is tender and painful for the first few days. However, most bruises will disappear without treatment within about 2 weeks and they may also itch as they heal.
Causes of bruising:
1. Bumping into something
2. Vigorous exercise
3. Thin skin and fragile tissues in elderly
4. Blood anticoagulants and anti-platelets and some other medications/ supplements such as NSAIDs ,ginkgo biloba and some chemotherapies
5. Sun-damaged skin : bruising on the back of the hands and arms (called actinic purpura or solar purpura)
6. Vitamin C deficiency
7. Certain medical conditions including bleeding disorders, leukemia, hemophilia, liver disease, Cushing's disease, connective tissue diseases, iron-deficiency anemia, or aplastic anemia.
When to refer the case to a doctor:
1. If bruising occurs easily or for no apparent reason
2. If the bruise is accompanied by swelling and extreme pain, especially if the patient is taking an anticoagulant or suffers from a medical condition
3. If the bruise is painful and under a toenail or fingernail
4. If a bruise does not improve within two weeks , does not completely clear after three or four weeks, recurs in the same spot, or keeps growing in size
5. If a broken bone is suspected
6. If the patient with a bruise on his head and cannot remember what happened
7. If the affected eye cannot be moved or vision is affected.
8. The bruise causes numbness or is accompanied with loss of function of a joint, limb or muscle
9. If bruising is behind the ear (Battle's sign). It may indicate that there is a skull fracture.
10. Petechiae: multiple tiny red dots on any part of the body (most commonly the legs). It can suggest that there is a serious health problem present such as endocarditis.
Treatment:
Treatment is most effective right after the injury, while the bruise is still reddish
1. A cold compress such as an ice pack should be applied to the affected area for 20-30 minutes to speed healing and reduce swelling. Ice should not be applied directly to the skin and should be wrapped in a towel to prevent further damage
2. If the bruise takes up a large area of the leg or foot, the leg should be kept elevated as much as possible during the first 24 hours after the injury
3. Acetaminophen may be taken for pain. NSAIDs may be avoided because they may prolong bleeding
4. After about 48 hours, heat in the form of a warm washcloth applied to the bruise for 10 minutes or so 2-3 times a day may increase blood flow to the bruised area, allowing the skin to reabsorb the blood more quickly
· There are some herbal remedies that claim to help relieve the pain, swelling, or discoloration of bruises.
· Examples on such treatments: arnica creams, apple cider vinegar compresses, epsom salt baths, bromelain, tea bags and aloe vera gel.