How Do You Know When a Bruise is Serious?


Everyone knows what a bruise looks like, but may not understand exactly what’s happening under the skin. When the soft tissues of the body experience mild trauma, the small veins and capillaries (the smallest blood vessels in your body) under the skin sometimes break, and red blood cells leak out. When this happens, the red blood cells collect under your skin, and your skin turns a shade of red, blue, purple or black. The size and severity of a bruise depend on how much force was applied during the injury.

What do the colors of a bruise mean?

You can often tell the age of a bruise from the color. As the body breaks down the red blood cells, the bruise changes color and is a natural part of the healing process. Here are the colors a typical bruise goes through and what it means:

  • Red
    Bruises often begin as a red mark on the skin because fresh, oxygen-rich blood has pooled under the skin.
  • Blue, purple or black
    After 1-2 days the blood that has leaked out begins to lose oxygen and change color. Depending on the size, location and severity of your bruise, it could appear shades of blue, purple or black.
  • Yellow or green
    Between 5-10 days after the initial trauma your bruise will begin to turn a yellow or green shade. These colors are the result of the compounds biliverdin and bilirubin, which are produced when the body needs to break down hemoglobin (blood).
  • Yellowish-brown or light brown
    This is the final stage of bruising and typically occurs between 10-14 days after the initial trauma.

What is the difference between a bruise, contusion and hematoma

Bruises are also called contusions. Hematomas are similar to bruises, except they are more serious and symptoms develop much more rapidly. They are also larger, deeper and tend to have more significant swelling than a typical bruise. Hematomas in the head, face and abdomen can cause severe symptoms. If you experience any of the following symptoms after a head, face or abdomen trauma, visit State Urgent Care as soon as possible to avoid further complications:

  • Head
    Intracranial hematomas may cause headaches, vomiting, nausea, slurred speech and confusion.
  • Face
    Septal hematomas make the nose and area under the eyes swell and bruise. You may also experience nosebleeds or clear fluid draining from the nose.
  • Abdomen
    Abdominal hematomas may not initially cause any symptoms but can lead to swelling, tenderness and pain.

When to get a bruise checked out

Bruises are typically surface injuries that heal on their own without medical attention, and people can treat them safely at home. However, if you suffer a more significant trauma or injury and have bruising that does not heal and disappear after 2 weeks, then it’s time to get medical attention.

See your doctor or visit State Urgent Care right away if you notice any of the following symptoms:

  • Abnormal bleeding in the gums, frequent nose bleeds or blood in the urine or stool
  • Frequent very large, very painful bruises
  • Numbness or weakness anywhere in the injured limb
  • Swelling around the bruised skin
  • Loss of function in the affected area (joint, limb or muscle)
  • Increased size or density
  • Lump under the bruise
  • Pain that lasts longer than 2-3 days
  • Persistent bruising for more than 2 weeks
  • Potential broken bone
  • Trauma in the head or neck
  • Vision impairment
  • Unexplained or random bruising, especially in the abdomen, head, or trunk, as this may signal a problem with an internal organ

Conditions that increase your risk of bruising

People taking prescription blood thinners should also talk to their doctor if they suffer a fall or significant injury, as they have a higher risk of bruising and complications from bruising. Here are additional conditions that increase your risk of significant bruising and complications:

  • Aged 50 years or older
  • Bleeding disorders (e.g., liver disease, vitamin K deficiency or a genetic disorder)
  • Blood vessel defects
  • Platelet disorder
  • Kidney disease
  • Leukemia
  • Malnutrition
  • Hemophilia A or B
  • Cushing’s syndrome

While the occasional bruise is not normally a cause for concern, easy bruising could be. If you notice more frequent or more serious bruising, talk to a medical professional, as they can help you diagnose and treat the root cause of your bruising.

How to help a bruise heal faster at home

Mild to moderate bruises typically heal after 2 weeks, though some may heal more quickly. If you have mild to moderate bruising and would like to speed the healing process or lessen any pain associated with it, here are a few things you can try at home:

  • Cold compress
    One of the first steps to helping a bruise heal more quickly is icing the affected area. Wrap the ice pack with a clean, dry cloth and press it on the bruise. The compress should never be applied directly to the skin as it could lead to further injury. Ice slows the bleeding because it shrinks the blood vessels and reduces inflammation, which can help reduce the overall size of the bruise as well.
  • Topical creams
    Over-the-counter topical healing creams like arnica, quercetin, vitamin B3, or vitamin K offer anti-inflammatory benefits to help speed up healing times. Talk to your doctor to find out which cream is right for you. *Arnica should never be used on broken skin and on those who suffer from eczema or other skin conditions.
  • Compression
    A soft elastic wrap for the first 1-2 days, during waking hours, can help decrease pain and bruising. The wrap should be firm, but not too tight. If you notice any numbness, tingling or increased discomfort, it means the wrap needs to be loosened or removed.
  • Elevation
    Elevating the bruised area comfortably over the heart, if possible, offers similar healing benefits to applying a cold compress. It helps slow the bleeding and may reduce the size of the bruising.

If you need medical attention for your bruise, visit State Urgent Care. We welcome walk-in appointments 7 days a week from 8 a.m. – 7 p.m. for non-life-threatening illnesses and injuries.