It is likely that
every person had a bruise at one point or another. We often get bruised as kids
while running around and falling down. When we are younger, we can usually
shrug these bruises off and carry on with our day. However, as we get older,
bruising can become more problematic. They can appear seemingly without cause
and come in different colors, which may be concerning. More often than not,
these bruises are not of great concern, but understanding the
potential causes
and types of bruising can help one recognize if a bruise is of particular
concern.
اضافة اعلان
What is a bruise?
A bruise, also referred to as a contusion, occurs when the small blood
vessels known as capillaries, located under the
skin, get damaged and begin to
leak blood. Since the skin is not broken, the blood begins to pool underneath
the skin. Bruising may occur spontaneously or due to physical trauma.
Types of bruises
Bruises come in many shapes, sizes, and colors. Typically, after an
injury, the skin of the affected area becomes red and within a day or two it
may turn into the classic blue, black, purple bruising. The bruise may show for
roughly 5–10 days, at the end of which the outer edges of the bruise become
green or yellow. People may become concerned by the change in color, but it is
a natural process which means that the body is healing and absorbing the pooled
blood. Bruising may be accompanied by swelling. Bruises can be classified based
on cause and appearance.
Ecchymosis, the
true medical term for bruising, typically appears as purple patches that do not
become white or pale when pressure is applied to the skin. They are generally
bigger than 1cm and take 1-3 weeks to completely heal.
Hematoma, a more
severe form of bruising, is usually the direct result of physical trauma, such
as a fall, and can cover more areas of the body. Hematomas are often
accompanied by swelling, and are painful.
Petechiae is a
unique form of bruising that appears as tiny red dots on the surface of the
skin. Generally, they are less than 4mm in size and, like ecchymosis, fail to
become white when pressure is applied. Petechiae may appear in a particular
area, such as arms, legs, or abdomen, and give the appearance of a rash.
Purpura is similar
to ecchymosis and can be red, purple, or brown in color. They are generally
4–10mm in diameter, which makes them larger than petechiae but smaller than
ecchymosis.
As we age, our
skin becomes thinner, dryer, and more prone to damage. As a result, we bruise
more easily. This is often referred to as senile purpura.
Symptoms that are
cause for concern
It is normal for bruises to appear as a direct result of physical injury.
However, certain types of bruises, particularly their origin, can be of greater
concern.
If you have
bruising associated with other symptoms, then you may need to seek medical
attention. Bruising in conjunction with a suspected bone fracture from a hard
blow or fall should be evaluated. Bruising with intense swelling and pain may
be indicative of internal injury. Bruising that is associated with other forms
of bleeding may also be of concern. This can include bruising under the
fingernails or after taking aspirin or blood thinners, bleeding from the gums,
nose, or mouth, or blood in urine, stool, or eyes. These symptoms may be
indicative of a more serious underlying condition.
Causes of bruising
Physical injury is the most common cause of bruising. It is normal and
often no need for alarm unless the bruising is severe and potentially
associated with a broken bone. Unexplained and spontaneous bleeding is far more
concerning. Certain supplements and medications, such as blood thinners,
corticosteroids, certain painkillers, and even fish oil can make it more
difficult for your body to make the blood clot, which increases the risk of
bruising.
If you are taking
medication that produces bruising, it is often a warning sign that your
medication may need adjustment. There is also a whole host of inherited
conditions that can make it difficult for the blood to clot and therefore make
you more prone to bruising. These can include deficiencies of factor VII, X, V,
or II, as well as Von Willebrand disease, hemophilia A, and
Christmas disease.
Lastly, bruising of the legs may be caused by an underlying condition.
Typically, blue bruising on the legs may be the result of varicose veins, but
black bruises without any known cause can be more severe, indicating a
condition known as deep vein thrombosis (DVT), whic is characterized by a clot
in the vein. DVT has the potential to be life threatening and require immediate
medical attention
Who is at risk?
Bruising is most common in the older population. This is due to multiple
factors, including the natural decline in the body’s ability to heal quickly,
as well as thinner and weaker skin. Ultimately, this causes the capillaries to
be more vulnerable and fragile, thus increasing the risk of bruising.
Women tend to bruise
more easily than men. It is believed that this is due to women having more fat
and less collagen (an important compound in skin that provides structure).
Those who
regularly take certain medications are at higher risk. Certain painkillers
known as
NSAIDs and blood thinners such as anticoagulants and antiplatelets
make it difficult for the body to produce clots. Similarly, corticosteroids,
both applied to the skin and ingested, make the skin thinner and the individual
more prone to bruising. Much like medications, certain supplements such as
ginkgo, ginger, and vitamin E can have a blood thinning effect.
Treating bruising
Most important in case of bruises is to resolve any underlying condition
that may exist. Once that is properly managed, preventing is also important.
This means exercising caution when participating in activities that increase
the likelihood of physical injury. Protective equipment such as paddings can
help.
If you already
have a bruise, there are a few home remedies that may help. Placing an ice pack
can help reduce swelling, whereas a warm compress can help improve blood flow
and expedite healing. Icing the area can start as soon as the bruising appears,
but warm compresses should wait until 48 hours after appearance. Avoid placing
the ice pack directly on the bruise and instead wrap it in a towel. Both ice
and warm compression can be applied several times a day, but ice packs should
only be applied for 10 minutes at a time.
Rest and elevation are
also important for a speedy recovery. When elevating, ensure that the affected
area is above the level of the heart. Lastly, in order to manage pain,
over-the-counter medication can be used. Paracetamol (Panadol) is preferred and
NSAIDs such as aspirin, ibuprofen, and naproxen should be avoided.
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