Diagnosis

For the diagnosis of long-standing bruises, various means are used. In the beginning it is important to find out whether a corresponding injury has occurred or not. Spontaneous bleeding is an indication of a bleeding tendency.

It is also important to ask about any medication taken, as some agents weaken the blood clotting and can thus lead to long visible bruising. The bruise can be examined more closely with an ultrasound machine if a large haematoma, tumour or internal bleeding is suspected. However, blood tests are particularly important: they can determine whether blood clotting takes longer than in healthy people and whether or which blood proteins are missing. This is the only way to find out which disease is present.

Associated symptoms

A completely normal phenomenon with bruises is the pressure pain. It usually gets better within a few days. If the bruise is aggravated or caused by another disease, further symptoms may occur.

For example, if there is an increased tendency to bleed, joint bleeding with pain and restricted movement in the affected joint can occur. Bruises can occur without corresponding injury. Large bruises can be caused by small injuries.

Gum or nose bleeding can also occur. It is typical for small bruises to occur all over the skin due to a low platelet count. Tumours can grow within weeks or months.

Sometimes the bruises are interspersed with small vessels or grow slowly above the skin level. If circulation problems or loss of consciousness occur after injuries to the abdomen, chest or head, a doctor should be consulted urgently, as these may be indications of internal bleeding. Bruises develop somewhat differently from person to person.

They usually disappear within 1 to 3 weeks depending on their size. The smaller they are and the deeper they are, the sooner they are no longer visible. Especially large bruises can be visible for up to 2 months.

Occasionally a part of the blood pigment under the skin cannot be broken down and remains visible as a brownish-red stain even for years. Bruises in a joint can also be felt or visible for a very long time if they are not treated properly. The colour shows how far the removal of a bruise has progressed.

This makes it possible to estimate how long it will remain visible. If they are reddish-dark bluish, they are relatively fresh. Then they become brown-blackish.

Then they take on a green-dark green colour, which means that they will heal soon. Shortly before they are completely decomposed, the spots are yellow-brownish. In the case of blood coagulation disorders, the stains may be visible for longer, but do not have to be. Usually many or large bruises occur, but they are reduced within a few weeks. If post-operative bleeding occurs days or weeks after an operation, the bruise will last correspondingly longer.