Bruises: From Simple to Serious

No one gets through life unbruised. From childhood through old age, everyone is subject to the black and blue marks that symbolize life's hard knocks. Most of the time, a bruise (known medically as a contusion) is the harmless and temporary result of a bang, bump or blow to the body.

What is a bruise?
A bruise occurs when blood vessels are broken or damaged and blood leaks out of them into the tissue under the skin. This pooled blood, as well as the body's reaction to injury, causes the skin discoloration of a bruise. The discoloration may start out looking black, blue, red or purple. As the blood cells break down over time, the color of the bruise may change to green, yellow or brown before the bruise disappears.

What causes a bruise?
Most bruises result from a blow to the body. This can occur in many ways: playing sports, falling down, banging into a hard object and so on. You may have a tendency to bruise more easily if you:

• Are older (as you age, blood vessels become more fragile and there is less fat under the skin)
• Are female (women bruise more easily than men)
• Take certain medications, including:
  • Blood-thinners, such as aspirin or warfarin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
  • Corticosteroids
  • Certain dietary supplements
• Have a nutritional deficiency, such as of vitamins C, K, B12 or folic acid

Less commonly, bruising can be a result of:

• Bleeding disorders, such as hemophilia, that prevent your blood from clotting properly. You may also have frequent nosebleeds and bleeding gums.
• Liver disease, such as cirrhosis of the liver.
• A bloodstream infection (sepsis).
• Auto-immune diseases (in which the body attacks the blood vessels).
• Blood-related diseases, such as leukemia and lymphoma.

What can you do to treat symptoms of a bruise?
Most of the time, you don't have to do anything to take care of a bruise caused by an injury. It will go away by itself in time. But if you have swelling or pain, you may want to help reduce these symptoms by using the tried-and-true "R.I.C.E." method:

• Rest the bruised part of your body. Don't massage the bruised area.
• Ice the bruised area with an ice pack or ice cubes wrapped in a towel. Do this for 15 to 20 minutes, four times a day. If you have diabetes, poor circulation or blood vessel disorders (such as vasculitis or Raynaud's disease), talk with your doctor before using an ice pack.
• Compress (wrap up or brace) the bruised area.
• Elevate the bruised part of your body to a level above your heart.

In two to three weeks, the bruise should fade away and your skin will return to normal.

A note about NSAIDs

NSAIDs (nonsteroidal anti-inflammatory drugs) are commonly taken to reduce pain and swelling, although they are not for everyone. Ibuprofen, naproxen and aspirin are all NSAIDs. Talk to your doctor about whether taking NSAIDs is safe for you, especially if you:

• Have stomach bleeding or peptic ulcers.
• Have liver or kidney disease or a bleeding disorder.
• Drink more than three alcoholic drinks each day.
• Have high blood pressure or kidney, liver or heart disease.
• Take medicine for high blood pressure, aspirin to protect your heart or any sort of blood thinning drugs.
• Do not give aspirin to anyone younger than 20. It has been linked to Reye's syndrome, a serious illness. Do not give ibuprofen or naproxen to children without first talking to your health care provider.
• Always read instruction labels carefully to understand all precautions.