Understanding Bruises (Ecchymosis)
Bruises, medically known as ecchymosis, form when blood pools under the skin due to a break in blood vessels. They appear as marks on the skin ranging in color from black and blue to red and purple. Bruises typically change color as they heal and often don't require treatment. However, unexplained bruises may indicate underlying medical conditions.
What is a Bruise (Ecchymosis)?
Ecchymosis (pronounced “eh-chuh-mow-sis”) is the medical term for a bruise. A bruise, or contusion, is a discoloration of the skin resulting from damaged blood vessels leaking blood beneath the skin. Despite the pooling of blood, there is no external bleeding unless the skin is broken.
The collection of blood under the skin makes a bruise visible. Bruises can appear in various colors such as black, blue, purple, brown, or yellow. The body's blood cells work to repair the damaged blood vessels to aid in healing.
Several types of bleeding can cause skin discoloration, including:
Hematoma: Caused by trauma like a car accident or major fall, a hematoma is a larger collection of blood outside the blood vessels that is typically raised and painful to touch.
Petechiae: These are tiny (less than 2 millimeters) reddish dots on the skin that do not turn white when gentle pressure is applied.
Purpura: This is small bleeding under the skin. Purpura are larger than petechiae but smaller than ecchymosis.
Bruises are very common and can affect anyone. They can result from falls, accidents, sports injuries, or medical procedures. Certain factors increase the likelihood of bruising, including:
Age (people over 65 years old)
Gender (women and those assigned female at birth)
Certain medical conditions (e.g., cancer, liver disease)
Family history of easy bruising
Medications that thin blood or prevent clotting (e.g., aspirin, blood thinners, NSAIDs)
Bleeding disorders (e.g., hemophilia, von Willebrand disease)
Low blood platelet count (thrombocytopenia)
Vitamin C or K deficiencies
Symptoms of a Bruise (Ecchymosis)
Bruises vary in size, shape, and color depending on the cause and location. Common symptoms include:
Pain or tenderness when touched
Skin discoloration (ranging from red to purple, black, brown, or yellow)
Swelling or a raised bump (hematoma)
Bruises are often called black-and-blue marks. They may initially appear red or purplish. On darker skin tones, bruising can appear purple, dark brown, or black. As the bruise heals, it may turn lighter shades of brown, green, or yellow.
Causes of Bruises (Ecchymosis)
Bruises form when blood vessels break, causing blood to seep out and pool under the skin. This pooling causes visible discoloration. Blood vessels can break due to:
Aging skin
Side effects of certain medications (e.g., anticoagulants, steroids)
Conditions or treatments affecting blood platelet count (e.g., autoimmune diseases, leukemia, hemophilia)
Bruises are typically diagnosed based on symptoms, particularly the appearance and color of the mark. If frequent or unexplained bruising occurs, healthcare providers may order tests to identify potential causes, such as:
X-rays to check for bone fractures
Blood tests to evaluate clotting conditions and vitamin deficiencies
Most bruises heal on their own and don't require treatment. For more severe bruises, the following measures can help:
Rest and elevate the injured area to reduce swelling and pain
Apply ice packs for the first 24 to 48 hours after injury (no more than 15 minutes at a time)
Use a heating pad or warm compress after two days
Take over-the-counter pain medication, such as acetaminophen (consult with a provider before using NSAIDs)
While bruising is common, you can reduce the risk by:
Keeping floors and rooms free of tripping hazards
Moving furniture away from walkways
Using lights or flashlights in poorly lit areas
Ensuring adequate vitamin intake
Wearing protective gear during contact sports or activities like bicycling
What to Expect with a Bruise (Ecchymosis)
Bruises, though unsightly, usually fade without treatment. Severe or unexplained bruising should prompt a visit to a healthcare provider to rule out serious issues. Some bruises, like hematomas, may require medical attention.
The healing time for bruises varies. Most fade within two weeks without treatment, but severe bruising and hematomas may last a month or longer.
When to See a Healthcare Provider
Consult a healthcare provider if you experience:
A black eye with vision problems
Bruising lasting more than two weeks
Frequent or large bruises
A lump in the bruised area (hematoma)
Painful swelling
Persistent pain days after the injury
Recurring bruises in the same area
Unexplained bruising
Unusual bleeding (e.g., nosebleeds, blood in urine or stool)
Questions to Ask Your Doctor
What is causing the bruising?
Why am I prone to bruising?
Should I have blood tests to check for underlying conditions?
How can I reduce my risk of bruising?
What signs of complications should I watch for?
ICD Code for Ecchymosis
The International Classification of Diseases (ICD) is a tool for diagnosing and classifying conditions. The ICD-10-CM code for ecchymosis is R58.
Ecchymosis (bruising) is a common condition. If you bruise easily or have unexplained bruising, see a healthcare provider to rule out underlying conditions. Applying ice after an injury can minimize bruising. Most bruises heal within a couple of weeks without treatment.
By understanding the causes, symptoms, and treatments for bruises, you can better manage and prevent them.
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