Everyone gets bruises now and then. They start black and blue, then change to shades of purple, green, and yellow as they heal. Most of the time, bruises heal on their own within a week or two.
But there are different kinds of bruises and blood spots under the skin. Sometimes you may need to get a bruise checked out to find out if there’s something more going on than just being clumsy.
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What Is a Bruise (Contusion)?
When you get a bump from falling or walking into a coffee table, blood vessels under your skin rupture. That injury causes blood to leak into the tissue under your skin, creating a bruise or, medically speaking, a contusion. Older adults and women tend to bruise more easily than men or younger people.
Other types of bruises and blood spots under the skin are:
- Hematoma: After an injury, blood pools under the skin, forming a lump. These heal on their own without the need for treatment.
- Purpura: These are severe bruises that appear without an injury. They may appear in one spot or multiple areas. A clotting disorder usually causes purpura.
- Petechiae: These look like bruises, but aren’t. You may know these as tiny red or purple spots that show up on the skin or lining of the mouth. They happen when small blood vessels break close to the skin’s surface.
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Can a Contusion Get Worse?
Bruises from everyday bumps and falls usually go away on their own. But a deep muscle bruise (such as from a sports injury or car accident) may lead to complications, such as:
- Compartment Syndrome. A severe bruise can lead to painful swelling known as compartment syndrome. You may need surgery to relieve pressure on the muscles, blood vessels, and nerves.
- Myositis Ossificans. Sometimes when an athlete has a deep muscle bruise, the body heals incorrectly. In this condition, small amounts of bone tissue form in the injured muscle — usually the thigh or upper arm. Rest and physical therapy are the recommended treatments for myositis ossificans.
“Maintaining photographic evidence of the evolution of a bruise can help your physician provide you more guidance if further care is needed,” says Gorka Murga, MD, of Lindenbaum, Perryman & Associates-UPMC.
Can a Contusion Cause a Blood Clot?
Trauma to a muscle can cause both contusions and blood clots, but a bruise itself does not lead to a blood clot.
When to Get a Bruise Checked Out
In most cases, bruises or blood spots aren’t a cause for concern. However, if a bruise appears suddenly without an injury, it can be a sign of a problem that needs immediate medical attention.
Medications or medical conditions can cause you to bruise more frequently, including:
- Blood thinners.
- Clotting or bleeding disorders.
- Infections, like sepsis.
- Certain vitamin deficiencies.
- Liver disease.
- Some cancers.
It’s normal to notice an occasional bruise and not remember bumping into anything. But if you experience unexplained bruising more often than usual, talk to your doctor.
Unexplained Bruises: Worries & Causes
It happens to everyone: You’re undressing or bathing and notice a dark, sensitive bruise on your arm or leg. Most likely, you’ve bumped your limb without paying much attention.
But bruising without injury can also happen. It may have more serious implications. You may have an underlying health condition that makes your skin likely to bruise.
What Can Cause Unexplained Bruising?
Causes of unexplained bruising can be harmless or serious. They include:
- Age. Our skin gets thinner as we get older, so older adults are more prone to getting bruises from mild bumps.
- Sex. Women tend to bruise more easily than men.
- Genetics. If people in your family bruise easily, you may as well.
- Medication. Some medicines (aspirin, ibuprofen, blood thinners) make the skin more susceptible to bruising.
- Vitamin deficiencies. People who don’t get enough vitamin B12, C, or K may bruise more easily.
- Blood disorders. Hemophilia, platelet function defects, and other clotting disorders make bruises more likely.
- Liver disease. If your liver doesn’t work well, you’re more likely to bruise.
- Alcohol abuse. Prolonged alcohol abuse can damage the liver and make the skin more likely to bruise.
Should You Worry About Unexplained Bruises?
Most bruises are harmless. But do call your doctor if your bruise:
- Doesn’t get better in a week or two.
- Appears after you start a new medication.
- Is on your torso, back, or face, where bumps and injury are uncommon.
- Keeps coming back in the same place.
- Is unusually large.
Of course, you should be mindful of frequent bruises on children or older adults. Such bruising could be a sign of physical abuse.
How Do You Treat a Bad Bruise?
You can manage most bruises with the R.I.C.E. method: rest, ice, compression, and elevation. In addition to resting and applying ice to the affected area, you can use an elastic bandage to reduce swelling. Propping up the bruised area above the level of your heart can optimize blood flow.
Most bruises only need treatment for a day or two before they start to feel better. Talk to your doctor if your bruise hasn’t healed within two weeks. Severe sprains and fractures can cause bruising, along with swelling and pain.
In most cases, a bruise is a minor problem that will heal quickly. To search for a primary care specialist near you, visit UPMC’s Find a Doctor.
Editor's Note: This article was originally published on , and was last reviewed on .
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