Knocking the blues
Summer is on its way at last and most of us will become more active in the warmer weather. More gardening, more outside activities - and likely as not more bruising! It is always easy to knock yourself and the more active we are, the more likely we are likely to hit something and cause a bruise. It is doubtful there is anyone in the world that hasn’t experienced that purply blue patch as a result of a knock or a bump.
The medical name for a bruise is a contusion. It is caused when a knock is hard enough on the skin to damage the tiny blood vessels that flow near to the surface. The injured blood vessels can then leak, releasing blood into the surrounding tissue. This can cause a purplish flat patch that shows on the top layers of the skin. The actually medical name for this type of bruise is an ecchymosis.
In more severe bumps, the body may release fluid into the tissue as well as a natural defence against the injury. This together with the blood can cause a bruised area to expand with the extra fluid, and lift up into a raised area, or a more severe bruise.
One annoying aspect of growing older is that bruising sometimes becomes more common. This is because the skin is thinning, losing some of its fatty layers that cushion and protect the blood vessels against any damage. Also, the capillary walls of the blood vessels can become more fragile and so bumps that may not have caused a bruise when we were younger can now result in an unsightly blue patch. This is especially common on the legs and arms.
The blue purple look of a bruise will begin to change after a few days and eventually become a yellowish brown as the body repairs the damage and the skin returns to normal. Sometimes a bruise, instead of disappearing, can actually become worse and also more painful. This could be because the bruising was so severe that the body sealed off the area instead of cleaning it up. This leaves a small pool of blood behind in the skin and this may need to be drained by the doctor. This situation is called a hematoma. Occasionally the body may deposit calcium in the injured area making it very tender and quite firm. Again this condition needs medical treatment.
Sometimes medication can have an effect on a bruise. In some instances it can actually cause bruising. Warfarin has been associated with problems of this kind; cortisone medications can increase the fragility of the blood vessels in the skin leading to bruising.
But for most of us, a bruise will disappear of its own accord. However, there are things you can do to minimise the damage once it has occurred. A cold compress can help minimise bruising. Ice wrapped in a tea towel or plastic bag or a bag of frozen peas can be applied to the damaged area. This will reduce the blood flow the limit any bleeding into the skin. However, just be aware of over cooling the skin as this has been known to lead to frostbite.
If it is convenience, especially in an arm for instance, then lift the area with the damage above the level of the heart for a while to reduce blood flow to the region.
Other recommendations include applying gentle heat after two days to bring more circulation to the area and help clear away the excess blood; after the same time lapse, gently massaging the bruise can also have the same effect. Sunlight is good because the ultraviolet light breaks down bilirubin which is involved in the yellowing of a bruise.
Sometimes bruising may be a symptom of more severe problems. This is especially the case if there is no obvious explanation for the bruising. Certain cancers such as Hodgkin’s disease and multiple myeloma can be involved in bruising. Liver disease also has an association. As with all medical conditions that have no clear cause, if unexpected or prolonged bruising occurs, then it is essential to see professional advice.
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