Bruising (Contusions)

What Is a Bruise (Contusion)?

A bruise, also known as a contusion, happens when tiny blood vessels called capillaries which are located under the skin, are damaged. This allows blood to leak into the surrounding tissue, causing the skin to change color – often appearing red, purple, blue or yellow as the bruise heals.

Bruises can appear anywhere on the body and are common after an accidental bump, fall or injury. While most are harmless and fade within one to two weeks, some bruises may take longer to heal or occur more easily than expected, which could be a sign of an underlying health condition or medication effect.

What Causes Bruising?

Most bruises result from an injury that breaks small blood vessels near the skin’s surface. The leaked blood becomes trapped under the skin, leading to visible discoloration.

Common Causes Include:

• Minor injuries or impact: Falls, bumps or accidents that don’t break the skin.
• Sports or physical activity: Contact sports or exercise that strains muscles.
• Aging: As we age, skin becomes thinner and blood vessels more fragile.
• Medications: Blood thinners, aspirin or corticosteroids can increase the likelihood of bruising.
• Vitamin deficiencies: Low levels of vitamins C, K or B12 can weaken blood vessel walls.
• Medical conditions: Disorders affecting blood clotting or platelet function, such as anemia or hemophilia.

Signs and Appearance of a Bruise

Bruises typically develop quickly after an injury and change color as they heal.

Common Symptoms Include:

• Discoloration: Skin appears red or purple at first, then darkens before fading to yellow or green.
• Tenderness: The area may feel sore to the touch.
• Swelling: Mild swelling can occur around the bruise.
• Stiffness or limited movement: Particularly if the bruise affects a joint or muscle.

Bruises under the nails (subungual hematomas) or deep in the muscle tissue may cause more intense pain or swelling.

How Are Bruises Diagnosed?

Most bruises are easy to recognize based on appearance and history of injury. However, if bruising occurs frequently, without clear cause or is accompanied by other symptoms (like fatigue or bleeding), a health care provider may perform further evaluation.

Possible Diagnostic Tests Include:

• Medical history review: To identify medications, injuries or conditions contributing to bruising.
  
• Blood tests: To assess clotting function, platelet count or vitamin deficiencies.
  
• Imaging: X-rays or MRIs for deep bruises to rule out bone or muscle injury.

Early evaluation helps ensure that easy or unexplained bruising isn’t a sign of a more serious condition.

How to Treat a Bruise

Most bruises heal naturally over one to two weeks. However, treatment can help reduce pain, swelling and discoloration.

At-Home Care

• Rest: Limit activity that could worsen the bruise.
• Ice: Apply an ice pack for 10–20 minutes at a time during the first 24 hours to reduce swelling.
• Compression: Use a soft bandage to minimize swelling if the bruise is on a limb.
• Elevation: Keep the bruised area raised above heart level to help drain excess fluid.
• Pain relief: Over-the-counter acetaminophen can help ease discomfort (avoid aspirin or NSAIDs if they increase bruising).
  

Medical Treatment

See a health care provider if bruising is severe, large or associated with swelling, pain or limited movement. Treatment may include:

• Evaluating for blood disorders or vitamin deficiencies.
• Adjusting medications that increase bruising risk.
• In rare cases, draining large hematomas or providing physical therapy for muscle contusions.

How to Reduce the Risk of Bruising

While some bruising is unavoidable, certain steps can help protect your skin and blood vessels.

Helpful Prevention Tips:

• Protect your skin: Wear padding or protective gear during sports or physical work.
• Stay active safely: Strengthen muscles to prevent falls or injuries.
• Eat a balanced diet: Include foods rich in vitamins C and K for healthy skin and blood vessels.
• Manage medications: Talk to your provider about alternatives if your medicine increases bruising risk.
• Take care as you age: Use assistive devices or improve lighting at home to reduce the chance of bumps or falls.

If you notice frequent bruising, large painful contusions or unexplained skin discoloration, contact your health care provider for evaluation. Early assessment can help rule out underlying causes and guide appropriate treatment.

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If you’re wondering where the best place is to get care, please see our guide below:

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