Internal Medicine

Bruise

definition

A bruise is also known in medical jargon as a hematoma, bruise, or violet. This is the leakage of blood from an injured blood vessel into the surrounding tissue or into an existing body cavity. Blue spots can appear on different parts of the body and for a variety of reasons. A distinction is made between a subcutaneous hematoma that lies directly under the skin, an intramuscular hematoma that occurs within the muscle fibers, and a periosteal hematoma that occurs within the periosteum. Most hematomas are usually harmless and will heal on their own. On the other hand, there are also bruises in the brain that should definitely be treated and surgically removed.

Read more here: How do you treat a bruise?

Causes bruise

Most bruises occur as part of minor, minor injuries. External acts of violence such as a fall, an accident or a blow can damage blood vessels and cause blood to flow into the tissue. A classic hematoma develops, which in most cases is not dangerous and no complications are to be expected. In the course of sports injuries or accidents, bruises of various sizes and dimensions can occur. In traffic accidents, bruises in body cavities can be dangerous and must be treated urgently. Furthermore, hematomas can also occur during injections, blood draws or after operations. In these interventions, the tissue is fundamentally injured and thus also smaller blood vessels, from which the blood ultimately emerges. People who regularly have to take blood-thinning medication such as marcumar, acetylsalicylic acid (ASA) or phenprocoumonum have an increased risk of bruising more quickly.

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Bruises for no reason

Occur in one person more often without a clear cause one or multiple bruises (bruises) on, this should be examined more closely become. Sometimes there is one behind it serious illness like for example the hemophilia. It refers to a blood clotting disorder, which are also called hemophilia referred to as. Hemophilia is one of the most common hereditary diseases. With this disease lack of certain coagulation factors, which is why even the smallest injuries can lead to profuse bleeding.
There is also an increased risk that bleeding occurs spontaneously within the body and to a considerable extent Blood loss being able to lead.
With age kick blue too more often on since the skin always thinner will and often also that cushioning subcutaneous fatty tissue decreases. The skin is more unprotected and therefore more prone to bruises from bumps and injuries.

Symptoms

How the hematomas express themselves depends largely on the Severity of injury.

Bruising that direct under the skin lying mostly show up in one dark dead to bluish hue. Depending on the size and location of the hematoma, they can also swelling and painful especially versus touch be. After some time discolored the hematoma and will paler. Because of the Degradation process in the tissue of blood cells eventually arises a greenish-yellowish spotwho is getting increasingly pale.

Blue spots die deeper in the tissue are often outwardly only faintly visible. Hematomas in the abdominal cavity or other body cavities can also be with Blood loss go hand in hand, so that sometimes that too on the circulation of the patient noticeable power.

A hematoma spreads in Muscle tissue off, it can too Pain when moving to lead. The symptoms come from sore muscles after physical activity similar. Also within joints bruises can occur, which then lead to pain on movement or even to a Function restriction to lead.

Localized bruises

In the following, bruises in certain areas of the body will be discussed in more detail.

Blue spot on the face

Since the face is rarely affected by bumps and falls, bruises are usually less likely to be found here. Especially when falling, it is the body's own reflexes that (timely) support with the arms should protect the head as best as possible. Most often, bruises on the face arise as a result of sudden accidents or as a result of scuffle and violence against the head area.

Here, too, bruises are particularly easy to develop in the areas of the face where the skin is thin over the facial bones: for example over the cheekbones, the eye sockets and the chin or forehead. A good example of bleeding in the facial area is the eyeglass hematoma. These are ring-shaped bruises around both eyes (a bruise around only one eye is called a monocular hematoma). Also known is the "violet", a bruise in the area of the eyelid, which can be caused by a blow or bump on the eye.

Blue spot on the lip

Bruises on the lip are easily caused not only by falls, accidents or the like, but also by accidental bites on the lip tissue. The reason for this is the very sensitive mucous membrane of the lip and mouth area. As a result, bruises on the lip, depending on the size, can be very painful and interfere with chewing or speaking.

As sensitive as the mucous membrane of the lip is, bruises also heal quickly there. To support the healing process, the affected area can be cooled, arnica and heparin ointments can be applied and St. John's wort oil can be applied. Other ointments / gels that contain camphor or menthol should not be used in the area of the lip, as they are not suitable for contact with the mucous membrane.

Read more on the topic: Bruise on the lip

Blue spot on the chest

A bruise can also appear on the chest - as everywhere on the body. The skin and breast tissue is usually a little thicker here. Thus, there is a larger buffer to the underlying bone. As a result, bruises are usually not as easily formed here as on other parts of the body. Nevertheless: the breast tissue and the skin over the breast are also well supplied with blood. In the event of bumps, falls, blows or accidents, blood vessels can also be injured and the skin tissue bleeding. Even hickey are nothing more than bruises. Created by suction that injures the blood vessels and thus causes a small amount of bleeding.

Please also read our topic: How is a hickey made?

Depending on the severity of the bleeding and the size of the bruise, it can also feel rough and knotty. But that shouldn't immediately make you think of breast cancer: the blood that has leaked from the blood vessels and seeped into the surrounding tissue can appear encapsulated as part of the organization and healing. If, on the other hand, bruises appear on the breast without previous violence and other changes to the breast (e.g. inflammation, changes in shape, palpable lumps, etc.), then a doctor should be consulted. Because they may be signs of benign or malignant changes in the breast tissue.

Read more about the topic here: Breast cancer signs

Blue spot on the arm

Bruises tend to appear on the arm, too, as the skin over the bones is also not too thick here. As a result, the blood vessels running in it are not excessively well embedded and buffered. Especially in the area of the elbow, which is often affected in falls, accidents and bumps, bruises or bruises can easily occur. It just comes to that Bleeding in the skin tissue, this is not a problem. Depending on the size and severity of the bleeding, the bruise can be more or less severe during the healing phase painful be. But does it bleed into that Elbow joint even one, it can too severe discomfort come.

Read more about the topic here: Pain in the elbow

Same goes for that too Shoulder joint, which is often affected by falls and bumps. How easily bruises develop depends on the blood flow in the tissue, the resistance of the blood vessels and the tendency to bleed.

Bruises on the stomach and leg

Bruising on the abdomen can various causes to have. In addition to minor, uncomplicated injuries like one Push or one injection there can also be serious reasons. Especially hematomas that coincide with severe pain and Swelling such as Circulatory disorders should be examined more closely. In the context of Traffic accidents can Injuries in the abdomen occur in which larger but also smaller Vessels get hurt. Of the Blood loss then takes place inside of the body. Next Circulatory problems then also kick stomach pain on. The bleeding can seep quickly or slowly, which is why the symptoms sometimes take a few days to appear. Large area Hematomas on the abdomen and flanks should therefore always be checked by a doctor to avoid major blood loss and the associated complications.

Most bruises on the leg arise through Nudge, Injuries or as part of exercise. These hematomas are not dangerous and usually heal within two weeks. Bruising that occurs spontaneously for no explainable reason should be monitored more closely. Behind these phenomena there can be a serious illness like that hemophilia hide where the Clotting is disturbed and thus the patient increases too Bleeding tends. Another problem poses a greater one Bleeding into the muscle tissue of the lower leg These injuries can do a lot blood in the muscle flow and eventually become one Compartment syndrome to lead. The leg swells a lot swelling on. The superficial skin is also very tense. Due to the swelling there is a risk that the following but also surrounding tissue no longer supplied with blood becomes. If this symptom is not treated, there is a risk that the Tissue dies.

Blue spot on the knee

Bruises are particularly easy to develop in those parts of the body where the distance from the skin to the underlying bone is not great. The skin is very thin, especially in the knee area. The blood vessels running in the skin and the blood vessels around the knee are therefore not very good embedded. This makes them easy to handle in the event of accidents, falls and bumps burstcausing bleeding into the tissues of the knee and eventually bruising.

However, bruises in the area of the knee are sometimes uncomfortable if they occur not only in the area of the knee skin, but when it becomes too Bleeding in the Knee joint himself comes. These usually do not arise as a result of a slight bump or fall, but rather in the context of sports injuries, when there are tears in the menisci, or knee ligaments Broken bones comes.

Read more about the topic here: Pain in the kneecap

Duration of healing

In most cases it takes time one to two weeks until a bruise is gone again. But this can also individually and depending on age vary. During this period, those in the tissue free cells reduced. Characteristic of this Degradation process is the typical one Change in the color of the bruise. From an initial distinct dark red-blue spot the color changes from dark green and yellow to brown and gradually fades. The healing and the dismantling process can through ointments containing heparin or through suitable globules be promoted. It also helps to take good care of yourself immediately after an injury cool and a little pressure exercise. Often this can prevent a larger extent of a hematoma. Otherwise, it only helps to be patient until the body has broken down all of the blood cells.

What can I do if a bruise doesn't go away?

How long the bruises persist depends largely on the size and strength as well as the location of the bleeding into the skin tissue. The smaller they are and the deeper they are in the tissue, the faster they disappear again. Usually the bruises are within one to three weeks no longer visible, during this time they are broken down by the phagocytes of the immune system and even change theirs colour.

Large and severe bruises can even be up to two months be visible, as it takes much longer to break down. In some cases it can even happen that certain components of the blood cannot be broken down and transported away, so that they remain brownish-reddish under the skin for months to years later. If normal bruises persist for a very long time, you should first look for a possible cause. Possibly also through the attending physician.

The breakdown of the bruise can be supported by various measures even after a while. For example, by applying heat to better blood circulation in the tissue around the old bruises so that the phagocytes work better and faster and can remove the old blood. In addition, older bruises can still occur Heparin ointment applied even if the effect is still there controversial is. If the reason the bruise persists for a long time is the hemorrhage being encapsulated, in a few cases even a surgical, minor intervention to be necessary. This is even very advisable because long-standing, encapsulated bruises can always be prone to infection.

treatment

If you hit something or injured yourself while exercising, you can reduce the extent of a bruise if you immediately after the accident the place cools and exerts slight pressure. By placing cool packs The blood vessels under the skin contract and will compressed. This will prevent the blood into the surrounding tissue can flow. Most of the time you can't completely avoid the formation of a hematoma, but you can by cooling affect the spread a little.

If the bruise is there, it is just when it is visible on poor or leg is a small one for many people cosmetic problem and you want to get rid of it as soon as possible. Here one can Heparin ointment help a little. The heparin promotes the removal and thus the Breakdown of free blood cells. The bruise will disappear a little more quickly. Ointments that have a similar effect arnica contain. Arnica is a natural pain relieverobtained from a plant of the genus Daisy family is won. she works a swelling opposite and soothes the pain. Some home remedies like rubbing with it Rubbing alcohol or one Quark envelope, can also be used for treatment of a minor injury with a bruise. They are simple home remedies that have a cooling effect, promote blood flow and thus promote the breakdown of blood cells.

When to the doctor

A doctor should be visited when the bruise has spread very strongly and over a large area. Especially on belly, head and near joints hematomas can become problematic. For one, the injury can persist Lose blood, if the hematoma is very large, on the other hand, neighboring structures in the area can be narrowed due to the increase in the bruise and swelling. Here is one timely treatment very important as the affected person is also in a life-threatening state of shock due to the Blood loss can fall. The doctor can use a Ultrasound (Sonography) or one Computed Tomography determine the extent and location of the hematoma. In some cases it may then be necessary to have a drainage Drain the blood is placed.

Hematoma in Abdomen or even in Joints and Muscle tissue will sometimes operational away. This is done for example with a Compartment syndrome. In an operation the Lower leg opened and the Muscle fascia split so that the blood can flow outwards. A doctor should also be consulted if there is a bruise with severe pain goes hand in hand. Behind the hematoma, especially in the area of a joint, can also be long-standing inflammation hide that is causing the pain. Last but not least, an examination can also a fracture be excluded. In any case, they are in need of clarification spontaneous and frequent Hematomas that for no apparent reason occur. It must be absolutely ruled out that a hemophilia present.

Itchy bruise

A bruise is usually not itchy. Depending on the size, it can only be more or less strong Pain when moving or under pressure and may lead to restricted mobility. If an itch does occur in the area of the bruise, it usually has it other causes.

For example, consideration should be given to whether the irritated skin over the bruise might be allergic reaction acts. For example, on previously applied creams, ointments or gels. The active ingredients contained therein, such as arnica, Heparin or Diclofenac (Voltaren gel) can cause an allergic reaction on the skin. If this is the case, in addition to the bruise, there should also be reddening, pustules or blisters and / or skin wheals.