How Can You Tell If a Bruise Is Serious?

Reviewed on 9/10/2021

Bruises are a common injury and are not usually serious. See a doctor, however, when you experience other symptoms with bruising such as fever, extreme pain, joint swelling, inability to walk or move, it occurs for no reason, you bruise easily, the bruising is excessive, unusual bleeding elsewhere, you're taking blood thinners, or you think you may have broken a bone.
Bruises are a common injury and are not usually serious. See a doctor, however, when you experience other symptoms with bruising such as fever, extreme pain, joint swelling, inability to walk or move, it occurs for no reason, you bruise easily, the bruising is excessive, unusual bleeding elsewhere, you're taking blood thinners, or you think you may have broken a bone.

Bruises occur because blood vessels under the skin break and blood leaks into the tissues under the skin. Bruises tend to begin with a reddish color to the skin that may then turn blue or purple, followed by green and yellow as they heal.

Most of the time, bruises are not serious. See a doctor if you have a bruise and:

  • It is accompanied by a fever
  • It is accompanied by extreme pain
  • There is joint swelling 
  • The bruise inhibits your ability to walk or move
  • Bruising occurs for no reason 
  • You bruise easily
  • Bruising is excessive 
  • Bruising is accompanied by unusual bleeding, such as from the gums or in the urine
  • You are taking blood thinners for a medical condition
  • The bruise is painful and under a fingernail or toenail
  • If a bruise does not improve within two weeks or doesn’t heal completely after three to four weeks
  • Numbness or weakness in an injured limb
  • You think you may have broken a bone 
  • The bruising is near the eye and you cannot move the eye, have vision changes, or a headache
  • A head or neck injury, especially if you have dizziness, nausea, vomiting, or cannot remember what happened

What Are Symptoms of a Bruise?

Symptoms of a bruise can vary depending on their severity and where on the body they occur, and may include: 

  • A reddish color to the skin that may then turn blue or purple, followed by green and yellow as they heal
  • Swelling
  • Pain
  • A lump over the injured area
  • Limited range of motion of joints
  • Itching as it heals

Bruises usually take one to two weeks to heal, but in some cases it may take longer.


 

What Causes a Bruise?

There are numerous causes of bruising. 

Bruises commonly develop when people bump into things or fall, or other direct trauma such as from contact sports or accidents. 

Risk factors for developing bruises include:

  • Aging 
  • Use of certain medications 
    • Anticoagulants 
    • Antiplatelet medications
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Steroids
    • Some cancer medicines
  • Some genetic conditions
  • Blood vessel defects
  • Platelet disorders
  • Sun damaged/thinning skin
  • Vitamin C or vitamin K deficiencies 
  • Alcohol abuse
  • Certain medical conditions
  • Child abuse/domestic abuse 

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How Is a Bruise Diagnosed?

A simple bruise can be easily diagnosed with a visual examination. 

Tests may be used to help determine the extent of an injury or the underlying cause for more serious cases of bruising, such as: 

How Should I Treat a Bruise?

Most of the time, a bruise will heal on its own in one to two weeks. Home treatment and first aid for bruises includes: 

  • The RICE method
    • Rest 
      • Stop the activity that caused the bruising
    • Ice the affected area
      • Use a cold pack, a bag of ice, or a bag of frozen vegetables ice wrapped in a towel
      • Ice 15 minutes at a time, every one to two hours
    • Compress the area with a compression bandage or stocking
    • Elevate the area above the level of the heart, if possible, to help reduce swelling
  • Use over-the-counter (OTC) pain relievers and anti-inflammatories such as:
  • Topical vitamin K may help reduce bruising 
  • Bromelain, which is a group of enzymes found in pineapples, may help reduce bruising and speed healing time
  • Arnica is often touted as an herbal remedy that can help reduce bruising
    • Studies on its effectiveness are mixed
    • Tell your doctor before using any herbal product 

What to Avoid

Do not:

  • Use a warm pack or heating pad on the bruise right after injury 
  • Stick a needle or other object in a bruise to drain it
  • Massage the injured area within the first 48 hours

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Reviewed on 9/10/2021
References
https://www.uptodate.com/contents/taking-care-of-bruises-the-basics?search=bruises&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://orthoinfo.aaos.org/en/diseases--conditions/muscle-contusion-bruise/

http://www.aafp.org/afp/2008/0415/p1117.html

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/arnica

https://pubmed.ncbi.nlm.nih.gov/12140470/

https://www.mountsinai.org/health-library/supplement/bromelain