Bruises



A bruise is an injury that produces a blood clot and a mark on your skin, as a result of trauma to the area, resulting from impact. You get a bruise when the blood vessels under the skin are injured and damaged, making the bruises very painful. Bruises, medically known as contusions can occur in the skin, muscles and bones. A bruise normally takes a couple of weeks to fade, but some severe bruises can take up to a month to heal. A bruise changes color in different stages of healing. In the beginning the bruise is reddish in color, then turns bluish-purple (ecchymosis) and fades to a greenish-yellow before turning normal. The injury levels required to get a bruise changes with age. Children are less susceptible to bruises, while even a small bump or nudge can cause extensive bruising in an elderly person. This happens because the blood vessels become more fragile with age and an elderly person may get a bruise even without any injury.

 

Symptoms of Bruises

There are a few symptoms that you should treat as urgent if you get bruises. If there is any kind of trauma to the head that is serious enough to cause bruising, it could require medical attention. Typically, a head bruise where the person does not black out and remembers everything is unlikely to be serious, but it's best to be cautious. If any symptoms such as dizziness or nausea accompany the injury, make it a point to seek prompt medical attention. In general, any trauma to the head or eyes should be treated very seriously.

  • You should call a doctor if the bruises are accompanied by swelling and/ or extreme pain. Especially if you are on any blood thinning medication, and you get a bruise with a swelling and extreme pain, call for the doctor immediately.
  • If bruising occurs for no apparent reason, you should seek medical help. If a bruise is under a toenail or fingernail, and does not heal or clear after three to four weeks, you should call your doctor. If an injury causes bruising and is also accompanied by severe pain it could suggest more severe damage, such as from a fracture.
  • A sharp blow just above the eye, will lead to a black eye, especially with the effects of gravity. It is usually not serious if you do not have changes in your vision or if you can move the affected eye in all directions.
  • Initially, a fresh bruise is reddish, progressing to a purplish- blue or dark purple within a few hours; finally taking on a yellowish or green hue before healing. Bruises are tender and sometimes very painful for the first few days. However, it starts subsiding as the color fades, which means the blood clot normalizes and the bruised tissues start the healing process.
 

Causes of Bruises

Typically, a bruise is caused when you bump into something with a lot of force. If bruising is accompanied by bleeding gums or nosebleeds, it indicates a bleeding disorder and you should immediately seek medical attention.

  • The intensity of a blow or injury required to produce a bruise varies with age. Elderly persons bruise quickly because blood vessels become thin and fragile as we age. Bruising may also occur without any injury in old age.
  • Often athletes and weight lifters get small microscopic tears from extreme rigorous exercises or overstretching.
  • Medications that cause thinning of the blood can increase the intensity of bruising. These medications interfere with natural blood clotting, causing more bleeding of the blood vessels and tissues. Drugs that cause blood thinning, whether intentional or as a side effect, could include arthritis medications, known as non steroidal anti-inflammatory medicines like ibuprofen, naproxen and over the counter medicines like aspirin. People who have blood clots in the legs and heart are also prescribed a drug called Warfarin. This drug is known to cause severe bruising, especially if the levels of medication become high. Cortisone medicines like prednisone, increase the fragility of tiny blood vessels and promote bruising.
  • Patients with inherited clotting problems like hemophilia or acquired conditions like liver cirrhosis, run the risk of extensive bruising and life threatening bleeding.
  • An unexplained bruise on the thigh or shin area can occur from freak accidental injuries and bad sleeping disorders that go unnoticed, till you find a bruise or a purplish patch.
 

Remedies for Bruises

The changing colors of a bruise signify the stage of healing. The most effective time to start bruise treatment is at the first stage when the wound is still reddish. There are some extremely effective home remedies for bruises that have been traditionally used as cures. Keep in mind that while some of these traditional remedies may be highly effective, not all of them are, and some could in fact be counterproductive.

  • You can take a pack of frozen peas, an icepack or a cold compress and apply to the bruise for about half an hour to reduce swelling. Treating bruises and the accompanying swelling is important. The cold will reduce blood circulation to the area and limit the bleeding into the skin and reduce the size of the bruise. This will also reduce the pain and inflammation, helping speed up healing by limiting the swelling. It is advisable to avoid applying ice directly to the skin, as extreme temperatures can worsen damage to the skin.
  • You can take acetaminophen or ibuprofen for pain relief by following instructions on the bottle. You should avoid aspirin as a pain relief since this slows blood clotting and may even prolong the bleeding.
  • If possible, you should elevate the bruised area above the level of the heart. This is because the lower the bruise is to the heart, the more chances are of blood flowing into the area, thereby increasing the bleeding and swelling. If you get a big bruise on your leg, you should keep your leg high and elevated for the first 24 hours of the injury.
  • After about 48 hours, you can apply gentle heat to the bruise with a warm washcloth for about 10 minutes, three to four times a day. This will increase blood circulation to the area and facilitate healing.
  • You can gently apply pressure to the bruised area, but you need to be very careful and gentle.
  • You should also stop taking any blood thinning medications. Always consult your physician or a pharmacist before making any modifications to the dosage, as this can be quite detrimental to your health.
  • People who suffer from blood thinning abnormalities, patients who are on blood thinning drugs, elderly patients and those who have experienced severe trauma from the injury need immediate medical attention. They should be taken to an emergency ward or a health care provider immediately.
 

Diet for Bruises

It would be best to follow a healthy well balanced diet, as healing is at its optimum, when the body is well nourished.

  • Certain foods like dairy products, white flour, sugar and processed foods are best avoided as they can delay recovery.
  • Include garlic and onions in your diet. According to some naturalists garlic can help facilitate healing because of its natural anti-microbial properties.
  • Ensure that your diet is rich in vitamin C and iron. Citrus fruits and fresh vegetables like sweet potatoes, cauliflower, broccoli and all fresh fruits contain vitamin C and essential vitamins that help in tissue building and tissue recovery.
  • Drink lots of water and healthy fluids like herbal tea, soups, fresh fruit juices.

Suggestion for Bruises

If you can't quit smoking, it would be a good idea to at least cut down when you get a bruise. Smoking interferes with blood circulation and supply to the body and effects collagen metabolism; both affecting and delaying the healing process.

If you have kids in the house, or pets, or are simply accident prone, it may be prudent to keep a first aid kit handy at all times!

References

  1. Philip Buttaravoli, CHAPTER 137 - Contusion: (Bruise), Minor Emergencies (Second Edition), Mosby, Philadelphia, 2007, Pages 557-560, ISBN 9780323040266, 10.1016/B978-032304026-6.50142-3.

 
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