Bruise
Encyclopedia
A bruise, also called a contusion, is a type of relatively minor hematoma
of tissue
in which capillaries
and sometimes venule
s are damaged by trauma
, allowing blood
to seep into the surrounding interstitial tissues. Bruises can involve capillaries at the level of skin
, subcutaneous tissue
, muscle
, or bone
. A bruise may be named by the length of its diameter
as an petechia
(less than 3 mm), purpura
(3 mm to 1 cm) or ecchymosis
(1 to 3 cm), although these terms can also refer to internal bleeding
not caused by trauma.
As a type of hematoma, a bruise is always caused by internal bleeding into the interstitial tissues, usually initiated by blunt trauma
, which causes damage through physical compression and deceleration
forces. Trauma sufficient to cause bruising can occur from a wide variety of situations including accidents, falls, and surgeries. Disease states such as insufficient or malfunctioning platelet
s, other coagulation
deficiencies, or vascular disorders, such as venous blockage associated with severe allergies can lead to the formation of bruises in situations in which they would not normally occur and with only minimal trauma. If the trauma is sufficient to break the skin and allow blood to escape the interstitial tissues, the injury is not a bruise but instead a different variety of hemorrhage called bleeding
, although such injuries may be accompanied by bruising elsewhere.
Bruises often induce pain
, but small bruises are not normally dangerous alone. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding
. The likelihood and severity of bruising depends on many factors, including type and healthiness of affected tissues. Minor bruises may be easily recognized in people with light skin color by characteristic blue
or purple
appearance (idiomatically described as "black and blue") in the days following the injury.
endings within the affected tissue detect the increased pressure, which, depending on severity and location, may be perceived as pain or pressure or be asymptomatic
. The damaged capillary endothelium
releases endothelin
, a hormone
that causes narrowing of the blood vessel
to minimize bleeding. As the endothelium is destroyed, the underlying von Willebrand factor
is exposed and initiates coagulation
, which creates a temporary clot to plug the wound and eventually leads to restoration of normal tissue.
During this time, larger bruises may change color due to the breakdown of hemoglobin
from within escaped red blood cell
s in the extracellular space. The striking colors of a bruise are caused by the phagocytosis and sequential degradation of hemoglobin to biliverdin
to bilirubin
to hemosiderin
, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color. As these products are cleared from the area, the bruise disappears. Often the underlying tissue damage has been repaired long before this process is complete.
.
The harm score is determined by the extent and severity of the fractures to the organs and tissues causing the bruising, in turn depending on multiple factors. For example, a contracted
muscle will bruise more severely, as will tissues crushed against underlying bone. Capillaries
vary in strength, stiffness and toughness, which can also vary by age and medical conditions.
straight away. Repeated impacts worsen bruises, increasing the harm level. Normally, light bruises heal nearly completely within two weeks, although duration is affected by variation in severity and individual healing processes; generally, more severe or deeper bruises take somewhat longer.
. This has the potential to cause compartment syndrome
as the swelling cuts off blood flow to the tissues. The trauma that induced the bruise may also have caused other severe and potentially fatal harm to internal organs
. For example, impacts to the head
can cause traumatic brain injury
: bleeding, bruising and massive swelling of the brain with the potential to cause concussion, coma
and death
. Treatment for brain bruising may involve emergency surgery
to relieve the pressure on the brain.
Damage that causes bruising can also cause bones to be broken
, tendon
s or muscle
s to be strained
, ligament
s to be sprain
ed, or other tissue to be damaged. The symptoms and signs of these injuries may initially appear to be those of simple bruising. Abdominal bruising or severe injuries that cause difficulty in moving a limb or the feeling of liquid under the skin may indicate life-threatening injury and require the attention of a physician.
(rest, ice, compression, elevation), painkillers (particularly NSAIDs) and, later in recovery, light stretching exercises. Particularly, immediate application of ice while elevating the area may reduce or completely prevent swelling by restricting blood flow to the area and preventing internal bleeding. Rest and preventing re-injury is essential for rapid recovery. Applying a medicated cream containing mucopolysaccharide polysulfuric acid (e.g., Hirudoid) may also speed the healing process.
Very gentle massage of the area and application of heat may encourage blood flow and relieve pain according to the gate control theory of pain, although causing additional pain may indicate the massage is exacerbating the injury. As for most injuries, these techniques should not be applied until at least three days following the initial damage to ensure all internal bleeding has stopped, because although increasing blood flow will allow more healing factors into the area and encourage drainage, if the injury is still bleeding this will allow more blood to seep out of the wound and cause the bruise to become worse.
or coagulation
disorders. Unexplained bruising may be a warning sign of child abuse
, domestic abuse, or serious medical problems such as leukemia
or meningoccocal infection. Unexplained bruising can also indicate internal bleeding or certain types of cancer. Long term glucocorticoid therapy can cause easy bruising. Bruising present around the navel
(belly button) with severe abdominal pain suggests acute pancreatitis
.
During an autopsy
, bruises accompanying abrasions indicate the abrasions occurred while the individual was alive, as opposed to damage incurred after death.
uses suction which causes bruising in patients. Scraping, (Gua Sha
), uses a small hand device with a rounded edge to gently scrape the scalp or the skin. Slapping, (Pai-Da Therapy), is performed using two to five fingers or the whole hand mostly against joints such as shoulders, elbows, knees, wrists and ankles. For healthy people these procedures applied to a healthy part of the skin should cause redness which disappears in minutes or hours. For patients with pain, soreness or stiffness, the same procedure will typically cause bruising or blood blisters that lasts days. Each of these methods of treatment is repeated by the health practitioner or the patient himself over a number of days or weeks.
Hematoma
A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...
of tissue
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
in which capillaries
Capillary
Capillaries are the smallest of a body's blood vessels and are parts of the microcirculation. They are only 1 cell thick. These microvessels, measuring 5-10 μm in diameter, connect arterioles and venules, and enable the exchange of water, oxygen, carbon dioxide, and many other nutrient and waste...
and sometimes venule
Venule
A venule is a very small blood vessel in the microcirculation that allows deoxygenated blood to return from the capillary beds to the larger blood vessels called veins. Venules range from 8 to 100μm in diameter and are formed when capillaries unite .Venules are blood vessels that drain blood...
s are damaged by trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
, allowing blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
to seep into the surrounding interstitial tissues. Bruises can involve capillaries at the level of skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
, subcutaneous tissue
Subcutaneous tissue
The hypodermis, also called the hypoderm, subcutaneous tissue, or superficial fascia is the lowermost layer of the integumentary system in vertebrates. Types of cells that are found in the hypodermis are fibroblasts, adipose cells, and macrophages...
, muscle
Muscle
Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...
, or bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
. A bruise may be named by the length of its diameter
Diameter
In geometry, a diameter of a circle is any straight line segment that passes through the center of the circle and whose endpoints are on the circle. The diameters are the longest chords of the circle...
as an petechia
Petechia
A petechia is a small red or purple spot on the body, caused by a minor hemorrhage ."Petechiae" refers to one of the three major classes of purpuric skin conditions. Purpuric eruptions are classified by size into three broad categories...
(less than 3 mm), purpura
Purpura
Purpura is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin...
(3 mm to 1 cm) or ecchymosis
Ecchymosis
An ecchymosis is the medical term for a subcutaneous purpura larger than 1 centimeter or a hematoma, commonly called a bruise. It can be located in the skin or in a mucous membrane.-Presentation:...
(1 to 3 cm), although these terms can also refer to internal bleeding
Internal bleeding
Internal bleeding is bleeding occurring inside the body. It can be a serious medical emergency depending on where it occurs , and can potentially cause death and cardiac arrest if proper medical treatment is not received quickly....
not caused by trauma.
As a type of hematoma, a bruise is always caused by internal bleeding into the interstitial tissues, usually initiated by blunt trauma
Blunt trauma
In medical terminology, blunt trauma, blunt injury, non-penetrating trauma or blunt force trauma refers to a type of physical trauma caused to a body part, either by impact, injury or physical attack; the latter usually being referred to as blunt force trauma...
, which causes damage through physical compression and deceleration
Acceleration
In physics, acceleration is the rate of change of velocity with time. In one dimension, acceleration is the rate at which something speeds up or slows down. However, since velocity is a vector, acceleration describes the rate of change of both the magnitude and the direction of velocity. ...
forces. Trauma sufficient to cause bruising can occur from a wide variety of situations including accidents, falls, and surgeries. Disease states such as insufficient or malfunctioning platelet
Platelet
Platelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
s, other coagulation
Coagulation
Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...
deficiencies, or vascular disorders, such as venous blockage associated with severe allergies can lead to the formation of bruises in situations in which they would not normally occur and with only minimal trauma. If the trauma is sufficient to break the skin and allow blood to escape the interstitial tissues, the injury is not a bruise but instead a different variety of hemorrhage called bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
, although such injuries may be accompanied by bruising elsewhere.
Bruises often induce pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
, but small bruises are not normally dangerous alone. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding
Internal bleeding
Internal bleeding is bleeding occurring inside the body. It can be a serious medical emergency depending on where it occurs , and can potentially cause death and cardiac arrest if proper medical treatment is not received quickly....
. The likelihood and severity of bruising depends on many factors, including type and healthiness of affected tissues. Minor bruises may be easily recognized in people with light skin color by characteristic blue
Blue
Blue is a colour, the perception of which is evoked by light having a spectrum dominated by energy with a wavelength of roughly 440–490 nm. It is considered one of the additive primary colours. On the HSV Colour Wheel, the complement of blue is yellow; that is, a colour corresponding to an equal...
or purple
Purple
Purple is a range of hues of color occurring between red and blue, and is classified as a secondary color as the colors are required to create the shade....
appearance (idiomatically described as "black and blue") in the days following the injury.
Mechanism of bruise
Increased distress to tissue causes capillaries to break under the skin, allowing blood to escape and build up. As time progresses, blood seeps into the surrounding tissues, causing the bruise to darken and spread. NerveNerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
endings within the affected tissue detect the increased pressure, which, depending on severity and location, may be perceived as pain or pressure or be asymptomatic
Asymptomatic
In medicine, a disease is considered asymptomatic if a patient is a carrier for a disease or infection but experiences no symptoms. A condition might be asymptomatic if it fails to show the noticeable symptoms with which it is usually associated. Asymptomatic infections are also called subclinical...
. The damaged capillary endothelium
Endothelium
The endothelium is the thin layer of cells that lines the interior surface of blood vessels, forming an interface between circulating blood in the lumen and the rest of the vessel wall. These cells are called endothelial cells. Endothelial cells line the entire circulatory system, from the heart...
releases endothelin
Endothelin
Endothelins are proteins that constrict blood vessels and raise blood pressure. They are normally kept in balance by other mechanisms, but when they are over-expressed, they contribute to high blood pressure and heart disease....
, a hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
that causes narrowing of the blood vessel
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...
to minimize bleeding. As the endothelium is destroyed, the underlying von Willebrand factor
Von Willebrand factor
von Willebrand factor is a blood glycoprotein involved in hemostasis. It is deficient or defective in von Willebrand disease and is involved in a large number of other diseases, including thrombotic thrombocytopenic purpura, Heyde's syndrome, and possibly hemolytic-uremic syndrome...
is exposed and initiates coagulation
Coagulation
Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...
, which creates a temporary clot to plug the wound and eventually leads to restoration of normal tissue.
During this time, larger bruises may change color due to the breakdown of hemoglobin
Hemoglobin
Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates, with the exception of the fish family Channichthyidae, as well as the tissues of some invertebrates...
from within escaped red blood cell
Red blood cell
Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system...
s in the extracellular space. The striking colors of a bruise are caused by the phagocytosis and sequential degradation of hemoglobin to biliverdin
Biliverdin
Biliverdin is a green tetrapyrrolic bile pigment, and is a product of heme catabolism. It is the pigment responsible for a greenish color sometimes seen in bruises.- Metabolism :...
to bilirubin
Bilirubin
Bilirubin is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of red blood cells. Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases...
to hemosiderin
Hemosiderin
thumb|Hemosiderin image of a kidney viewed under a microscope. The brown areas represent hemosiderinHemosiderin or haemosiderin is an iron-storage complex. It is always found within cells and appears to be a complex of ferritin, denatured ferritin and other material...
, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color. As these products are cleared from the area, the bruise disappears. Often the underlying tissue damage has been repaired long before this process is complete.
Size and shape of bruises
Bruise shapes may correspond directly to the instrument of injury or be modified by additional factors. Bruises often become more prominent as time lapses, resulting in additional size and swelling. Bruising present in a different location than the site of impact is called ectopic bruising and occurs when the tissue at the site of injury is loose, allowing blood to travel under the skin to another location due to gravity or other forces, such as in a black eyeBlack eye
A black eye , or or 'shiner', is bruising around the eye commonly due to an injury to the face rather than eye injury. The name is given due to the color of bruising. The so-called black eye is caused by bleeding beneath the skin and around the eye...
.
General factors modifying size and shape of bruises
- Condition and type of tissue: In soft tissues, a larger area is bruised than would be in firmer tissue due to ease of blood to invade tissue.
- Age: elderly skin and other tissues are often thinner and less elastic and thus more prone to bruising.
- Gender: More bruising occurs in females due to increased subcutaneous fat.
- Color of skin: Although the same size, bruises are more prominent in lighter complexions.
- Diseases: CoagulationCoagulationCoagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...
, plateletPlateletPlatelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
and blood vesselBlood vesselThe blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
diseases or deficiencies can increase bruising due to more bleeding. - Location: More extensive vascularity causes more bleeding.
- Forces: Greater striking forces cause greater bruising.
- Genetics: Despite having completely normal coagulation factors, natural redheadsRed hairRed hair occurs on approximately 1–2% of the human population. It occurs more frequently in people of northern or western European ancestry, and less frequently in other populations...
have been shown to bruise more, although this may just be due to greater visibility on commonly associated lighter complexion.
Severity of bruises
Bruises can be scored on a scale from 0-5 to categorize the severity and danger of the injury.| Harm score | Severity level | Notes |
|---|---|---|
| 0 | Light bruise | No damage |
| 1 | Less than Moderate bruise | Little damage |
| 2 | Moderate bruise | Some damage |
| 3 | Serious bruise | Dangerous |
| 4 | Extremely serious bruise | Dangerous |
| 5 | Critical bruise | Risk of death |
The harm score is determined by the extent and severity of the fractures to the organs and tissues causing the bruising, in turn depending on multiple factors. For example, a contracted
Muscle contraction
Muscle fiber generates tension through the action of actin and myosin cross-bridge cycling. While under tension, the muscle may lengthen, shorten, or remain the same...
muscle will bruise more severely, as will tissues crushed against underlying bone. Capillaries
Capillary
Capillaries are the smallest of a body's blood vessels and are parts of the microcirculation. They are only 1 cell thick. These microvessels, measuring 5-10 μm in diameter, connect arterioles and venules, and enable the exchange of water, oxygen, carbon dioxide, and many other nutrient and waste...
vary in strength, stiffness and toughness, which can also vary by age and medical conditions.
Light bruises
Low levels of damaging forces produce small bruises and generally cause the individual to feel minor painPain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
straight away. Repeated impacts worsen bruises, increasing the harm level. Normally, light bruises heal nearly completely within two weeks, although duration is affected by variation in severity and individual healing processes; generally, more severe or deeper bruises take somewhat longer.
Moderate to severe bruises
Severe bruising (harm score 2-3) may be dangerous or cause serious complications. Further bleeding and excess fluid may accumulate causing a hard, fluctuating lump or swelling hematomaHematoma
A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...
. This has the potential to cause compartment syndrome
Compartment syndrome
Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...
as the swelling cuts off blood flow to the tissues. The trauma that induced the bruise may also have caused other severe and potentially fatal harm to internal organs
Organ (anatomy)
In biology, an organ is a collection of tissues joined in structural unit to serve a common function. Usually there is a main tissue and sporadic tissues . The main tissue is the one that is unique for the specific organ. For example, main tissue in the heart is the myocardium, while sporadic are...
. For example, impacts to the head
Head
In anatomy, the head of an animal is the rostral part that usually comprises the brain, eyes, ears, nose and mouth . Some very simple animals may not have a head, but many bilaterally symmetric forms do....
can cause traumatic brain injury
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
: bleeding, bruising and massive swelling of the brain with the potential to cause concussion, coma
Coma
In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
and death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
. Treatment for brain bruising may involve emergency surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
to relieve the pressure on the brain.
Damage that causes bruising can also cause bones to be broken
Bone fracture
A bone fracture is a medical condition in which there is a break in the continuity of the bone...
, tendon
Tendon
A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...
s or muscle
Muscle
Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...
s to be strained
Strain (injury)
A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is also colloquially known as a pulled muscle...
, ligament
Ligament
In anatomy, the term ligament is used to denote any of three types of structures. Most commonly, it refers to fibrous tissue that connects bones to other bones and is also known as articular ligament, articular larua, fibrous ligament, or true ligament.Ligament can also refer to:* Peritoneal...
s to be sprain
Sprain
A sprain is an injury in a joint, caused by the ligament being stretched beyond its capacity. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary...
ed, or other tissue to be damaged. The symptoms and signs of these injuries may initially appear to be those of simple bruising. Abdominal bruising or severe injuries that cause difficulty in moving a limb or the feeling of liquid under the skin may indicate life-threatening injury and require the attention of a physician.
Treatment
Treatment for light bruises is minimal and may include RICERICE (medicine)
RICE is a treatment method for soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation. When used appropriately, recovery duration is usually shortened and discomfort minimized....
(rest, ice, compression, elevation), painkillers (particularly NSAIDs) and, later in recovery, light stretching exercises. Particularly, immediate application of ice while elevating the area may reduce or completely prevent swelling by restricting blood flow to the area and preventing internal bleeding. Rest and preventing re-injury is essential for rapid recovery. Applying a medicated cream containing mucopolysaccharide polysulfuric acid (e.g., Hirudoid) may also speed the healing process.
Very gentle massage of the area and application of heat may encourage blood flow and relieve pain according to the gate control theory of pain, although causing additional pain may indicate the massage is exacerbating the injury. As for most injuries, these techniques should not be applied until at least three days following the initial damage to ensure all internal bleeding has stopped, because although increasing blood flow will allow more healing factors into the area and encourage drainage, if the injury is still bleeding this will allow more blood to seep out of the wound and cause the bruise to become worse.
As a medical sign
The presence of bruises may be seen in patients with plateletPlatelet
Platelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
or coagulation
Coagulation
Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...
disorders. Unexplained bruising may be a warning sign of child abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...
, domestic abuse, or serious medical problems such as leukemia
Leukemia
Leukemia or leukaemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". Leukemia is a broad term covering a spectrum of diseases...
or meningoccocal infection. Unexplained bruising can also indicate internal bleeding or certain types of cancer. Long term glucocorticoid therapy can cause easy bruising. Bruising present around the navel
Navel
The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...
(belly button) with severe abdominal pain suggests acute pancreatitis
Pancreatitis
Pancreatitis is inflammation of the pancreas. It occurs when pancreatic enzymes that digest food are activated in the pancreas instead of the small intestine. It may be acute – beginning suddenly and lasting a few days, or chronic – occurring over many years...
.
During an autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
, bruises accompanying abrasions indicate the abrasions occurred while the individual was alive, as opposed to damage incurred after death.
As a treatment
Folk medicine, including ancient medicine of Egypt, Greek, Celts, Turks, Slavs, Mayans, Aztecs and Chinese, has used bruising as a method of treatment for some types of health problems. The methods vary widely and include cupping, scraping, and slapping. Fire cuppingFire cupping
Cupping therapy is an ancient form of alternative medicine in which a local suction is created on the skin; practitioners believe this mobilizes blood flow in order to promote healing. Suction is created using heat or mechanical devices...
uses suction which causes bruising in patients. Scraping, (Gua Sha
Gua Sha
Gua sha , literally "to scrape away fever" in Chinese , is an ancient medical treatment....
), uses a small hand device with a rounded edge to gently scrape the scalp or the skin. Slapping, (Pai-Da Therapy), is performed using two to five fingers or the whole hand mostly against joints such as shoulders, elbows, knees, wrists and ankles. For healthy people these procedures applied to a healthy part of the skin should cause redness which disappears in minutes or hours. For patients with pain, soreness or stiffness, the same procedure will typically cause bruising or blood blisters that lasts days. Each of these methods of treatment is repeated by the health practitioner or the patient himself over a number of days or weeks.
See also
- Blunt traumaBlunt traumaIn medical terminology, blunt trauma, blunt injury, non-penetrating trauma or blunt force trauma refers to a type of physical trauma caused to a body part, either by impact, injury or physical attack; the latter usually being referred to as blunt force trauma...
- Black eyeBlack eyeA black eye , or or 'shiner', is bruising around the eye commonly due to an injury to the face rather than eye injury. The name is given due to the color of bruising. The so-called black eye is caused by bleeding beneath the skin and around the eye...
- BlisterBlisterA blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...
- BurnBurn (injury)A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin . Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured...
- Cerebral contusionCerebral contusionCerebral contusion, Latin contusio cerebri, a form of traumatic brain injury, is a bruise of the brain tissue. Like bruises in other tissues, cerebral contusion can be associated with multiple microhemorrhages, small blood vessel leaks into brain tissue. Contusion occurs in 20–30% of severe head...
—a bruise of the brainBrainThe brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
tissue - Love-bite
- Myocardial contusion—a bruise of the heartHeartThe heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
muscle - Pulmonary contusionPulmonary contusionA pulmonary contusion is a contusion of the lung, caused by chest trauma. As a result of damage to capillaries, blood and other fluids accumulate in the lung tissue. The excess fluid interferes with gas exchange, potentially leading to inadequate oxygen levels...
—a bruise of the lungLungThe lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...
tissue - Ship footShip footShip Foot or Bruised Toenail is a condition where the toenail becomes bruised, usually as a result of a heavy impact such as from football or dropping something on the toe.-Etymology:...
—a bruise underneath the toenail - Subconjunctival hemorrhageSubconjunctival hemorrhagethumb|right|250px| A stress induced subconjunctival hemorrhage in the left eye one week after hemorrhaging. Same hemorrhage four weeks after hemorrhaging. Some of the blood in the [[sclera]] has turned yellow, like a bruise....