When to see the doctor?
A doctor should be consulted if the bruise has spread very strongly and over a large area. Hematomas can be particularly problematic on the stomach, head and near joints. On the one hand, the injury can continue to lose blood if the haematoma is very large, on the other hand, neighbouring structures in the vicinity can become constricted due to the increase in haematoma and swelling.
Timely treatment is very important here, as the affected person may also fall into a life-threatening state of shock due to the blood loss. The doctor can determine the extent and location of the haematoma using ultrasound (sonography) or computer tomography. In some cases it may then be necessary to place a drainage to drain the blood.
Haematomas in the abdominal cavity or even in joints and muscle tissue are sometimes removed surgically. This is done, for example, in the case of compartment syndrome. In one operation, the lower leg is opened and the muscle fascia is split so that the blood can drain away to the outside.
A doctor should also be consulted if a bruise is accompanied by severe pain. Behind the haematoma, especially in the area of a joint, there may also be an inflammation that has been present for a longer period of time and is causing the pain. Last but not least, a fracture can also be ruled out during an examination. In any case, spontaneous and frequent haematomas, which occur without any recognisable reason, are in need of clarification. Here it must be absolutely excluded that haemophilia is present.
Itchy bruise
A bruise usually does not itch. Depending on its size, it can only be painful to a greater or lesser extent when moving or under pressure, and may lead to restrictions in movement. If itching does occur in the area of the bruise, it usually has other causes.
For example, it should be considered whether the irritated skin above the bruise may be an allergic reaction. For example, to previously applied creams, ointments or gels. The active ingredients contained in them, such as arnica, heparin or diclofenac (Voltaren gel) can cause an allergic reaction on the skin. If this is the case, in addition to the bruise, redness, pustules or blisters and/or skin squashes should also occur.
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