Bruising

No matter how careful you are, there's no avoiding an occasional bruise. Also known as a contusion or ecchymosis, a bruise results when part of your body is struck hard enough to crush muscle fibers and connective tissue. As blood from ruptured small blood vessels pools up beneath the skin, you initially develop a red mark that may be painful and swollen.

As your body responds by breaking down and reabsorbing the blood, the bruise usually changes color from red to blue-purple or even black in a day or two. It then turns green or yellow in five to ten days, and then yellow-brown or light brown after ten to 14 days, before it finally fades away.

Although bruises are usually just a temporary nuisance, they can be a sign of other medical problems, and deep bruises to the muscle and bone can be severe enough to require medical treatment.

Who's Susceptible to Bruises?

Even the toughest athlete will develop a bruise if a blow is hard enough. But some people are more susceptible to easy bruising, from injuries that may be too slight to even remember. Factors associated with easy bruising include:

• Increasing age. As we get older, muscle fibers and connective tissue weaken, the walls of small blood vessels become more fragile and likely to rupture, and skin loses some of its protective fatty layer.
• Gender. Women of all ages are more likely than men to have tender, easily bruised skin.
• Medications and supplements. Medications associated with easy bruising include aspirin, warfarin (Coumadin), and clopidogrel (Plavix), which thin blood and reduce its ability to clot; and corticosteroids, which thin the skin. Blood-thinning supplements such as ginkgo biloba and fish oil may also increase the risk of bruising, especially if they're combined with blood-thinning drugs.

Home Treatment for Bruises

You can camouflage bruises with special cosmetics such as Dermablend and Covermark. You can help speed the healing process by:

• Resting the injured area.
• Elevating the injured area. If possible, raise the bruise (on your shin, for example) above the level of your heart to divert blood flow to the rest of your body.
• Icing it down. Apply anything cold — an ice pack or even a bag of frozen vegetables — to the bruise for a half hour to an hour each day for the first couple of days to decrease blood flow and inflammation.
• Taking non-steroidal anti-inflammatory medications. Over-the-counter pain relievers such as ibuprofen or acetaminophen may help reduce pain and inflammation.

Because bruises don't break the skin, they usually don't require bandages. But if you have a muscle bruise (contusion), lightly wrap the injured area in a soft bandage or ace wrap.

When to See a Doctor

You should seek medical evaluation if a bruise or bruises:

• Develop for no known reason.
• Are near your eye.
• Become more painful or swollen.
• Interfere with joint movement.
• Persist for longer than two weeks.

Unusually large, painful, or sudden bruising — especially for no known reason — or easy bruising associated with abnormal bleeding from other parts of your body such as the nose, gums, or intestinal tract may be a sign of a blood-clotting or other blood-related disorder.

These disorders include idiopathic thrombocytopenic purpura (ITP), a deficiency of clotting compounds called platelets that often occurs in older people. ITP causes red or purple blotches, most often on sun-damaged skin on the forearms or the backs of the hands, that last longer than normal bruises. Skin-thickening prescriptions for ITP may include creams containing alpha hydroxy acid or Retin-A, a vitamin A derivative.

Sometimes, bruising is associated with domestic abuse, either in the home or a health care setting. Nursing-home residents can be the victims of such abuse, which may result in unusually large bruises on the face, arms, chest, or back. All suspected cases of abuse should receive careful medical evaluation.

Although bruises aren't the kind of beauty marks that anyone wants, they're usually just a harmless consequence of you banging into something or something banging into you. With proper home care — and medical treatment if necessary — you can minimize their pain, discomfort, and Technicolor hues.