Bruise (Hematoma) Symptoms and Causes

Symptoms

Possible symptoms of a bruise (technical term: hematoma) include swelling, pain, inflammation, and discoloration of the skin that changes (red, blue, purple, green, yellow, brown) during the healing process. This text refers to simple and small-surface complaints that can be considered for self-medication.

Causes

The cause of a hematoma is blood leaking from injured vessels into surrounding tissues, where it is slowly broken down, resulting in the familiar color change. Typical triggers are blunt traumas such as falls, blows, bruises or contusions, which can occur during sports, physical activity, an accident or after exposure to violence. A bruise can also occur spontaneously and non-traumatically. This is often observed on the legs in cases of chronic venous insufficiency (weakness of the venous valves). Bruising is more common in children, the elderly, and women. Taking anticoagulant drugs is another known cause. These include, for example, acetylsalicylic acid (aspirin, generics), clopidogrel (Plavix, generics), phenprocoumon (Marcoumar), low-molecular-weight heparins, or factor Xa inhibitors such as rivaroxaban (Xarelto). Finally, bruising also occurs with injections, infusions, vaccinations, and blood draws.

Diagnosis

If spontaneous bruising is frequently seen with no explainable cause, medical evaluation is required. This is because there may be underlying blood clotting disorders or other systemic diseases. In the case of hematomas, the use of force and abuse must also be considered. A visit to the doctor is also necessary in case of a critical localization (e.g. face, by the eye, in the genital area, under the nail) and in case of a suspected internal injury, internal bleeding or fracture.

Non-drug treatment

  • Acute elevation, to reduce blood flow.
  • Cooling as an immediate measure, e.g. cold hot pack, water, cooling pads, plasters or bandages, cold sprays.
  • Compression with an elastic bandage
  • Subsequent sparing, possibly immobilization

Bruises can be covered with cosmetics for aesthetic reasons.

Drug treatment

Drug treatment is not mandatory for a simple bruise. The following medications are available to relieve discomfort and promote healing (selection): heparins:

  • Heparins and heparinoids are often used in the form of a gel for local treatment. They have antithrombotic, anti-inflammatory, analgesic, and resorptive properties.

Topical NSAIDs:

  • Non-steroidal anti-inflammatory drugs such as diclofenac, the flufenamic acid, etofenamate or salicylates are effective against the pain as well as inflammation. Local application is better tolerated than taking painkillers.

Herbal medicines:

  • Comfrey gel
  • Arnica ointment or gel
  • Calendula ointment
  • Preparations with essential oils
  • Acetic-tartaric alumina solution, usually as a gel (Euceta successor).
  • Menthol gel
  • Aescin, horse chestnut gel or ointment

Painkillers:

  • Such as acetaminophen or ibuprofen can be taken to treat the accompanying pain, if there are no contraindications. If the pain is severe, internal injuries must be considered (see above).

Disinfectants:

  • Like octenidine for the treatment of superficial injuries.