Introduction
Everybody knows it, whether with themselves or with the child: after a push, a blow or after falling down it hurts and a bruise develops. Such a bruise is nothing more than blood in the tissue under the skin. Blood leaks through the tearing of small vessels and presses on the surrounding area – that is why a bruise often hurts.
In technical terminology, bruises are called “haematomas”. Normally they disappear within 1-3 weeks and change colour several times until then. If the stain is present for much longer than 6 weeks, this is usually harmless, but can also be an indication of several diseases.
Causes why the bruise does not go away
Why a bruise does not disappear within about 3 weeks can have several causes. Some of them are completely harmless and are only a cosmetic problem, others are serious and require medical attention. It should be emphasized that the harmless causes are much more common.
A doctor should be consulted if a bruise does not go away within about 2 months. If there is a lot of blood under the skin due to an injury, it may take longer for it to heal. Particularly after operations or severe injuries such as a car accident, it should therefore be expected that the bruises are visible for a little longer.
Occasionally, parts of the blood pigment in the skin cannot be broken down and remain visible for years. However, if the bruise grows and remains painful for a long time, this can also indicate secondary bleeding in the injured area. If bruises occur unusually frequently and remain visible for a long time, an increased tendency to bleed can be the cause.
This is usually triggered by taking medication such as aspirin and Marcumar, but can also be caused by blood clotting disorders that change the composition of the blood. Typical here are liver diseases, a vitamin K deficiency, the “von Willebrand- syndrome” and “haemophilia A or B”. It should also be remembered that some tumours can look like a bruise. These are for example the hemangioma or the black skin cancer on hand or toenails. If the bruise looks untypical and has been growing for weeks or months, a doctor should be consulted.
What can I do about bruises?
In principle, the breakdown of blood under the skin can rarely be accelerated. It is therefore important to apply the so-called PECH rule immediately after an injury: Pause, ice, compression and elevation. This means: pause the sport, because a greater blood flow through the movement can increase the bruise and aggravate other injuries.
Then the injury should be covered with ice wrapped in a cloth to reduce blood flow and pain. Pressure on the injured area, if not too painful, can also reduce the bruise. If an arm or leg has been injured, it should be elevated.
Bruises that have very large bruises behind them need to be surgically removed occasionally. This is important because bruises can form a permanent swelling under the skin or become infected. If taking medication is the cause of the bruise, it should be checked whether the medication is necessary and the dose is correctly adjusted.
If this is the case, long visible bruising can only be prevented by preventing injury. Heparin ointment is often used to accelerate the removal of bruises – however, its effectiveness is controversial. Home remedies such as arnica and calendula ointment or homeopathic remedies can also be tried, but are rarely effective. If the bruise is very painful, pain-relieving ointments, for example with Diclofenac, can help.
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