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What is Ecchymoses (Bruising)? Print E-mail
Written by Glenn Rosenberg   
Tuesday, 13 October 2009

Bruising is an area of discolored skin. Bruising develops when the lining of small blood vessels is damaged, allowing blood cells to escape into the skin and tissues. This condition most often occurs after a person injures a particular part of the body.

What is going on in the body?

A person may notice several stages of bruising. A bruise usually starts out as a red area or as tiny red dots or splotches on the skin. Within days to a week or so, the bruise becomes more purple. As it heals, it becomes brownish-yellow. Generally, bruises heal and disappear within 2 to 3 weeks.
What are the causes and risks of the symptom?

As a person ages, he or she will bruise more easily. The layer of protective fat just under the skin becomes thinner. The small blood vessels also become more fragile and are more easily damaged. Frequent long-term exposure to the sun can also cause the skin to be more fragile and likely to bruise. The tendency to bruise easily may run in families.

Other causes of bruising may include the following:
- blood disorders, including problems with blood clotting such as hemophilia A or hemophilia B
- blood-related diseases such as leukemia, a blood cancer
- liver disease, such as cirrhosis
- lymphomas
- certain disorders in which bone marrow cells grow at an abnormal rate
- nutritional deficiencies, such as deficiency in vitamins C, K, B12, or folic acid
- sepsis, or severe infection in the bloodstream
- systemic lupus erythematosus, an autoimmune disorder in which a person's body attacks its own cells for unknown reasons
- trauma, or injury
- prolonged coughing or vomiting
- medications, such as blood thinners
- abuse, such as child abuse, spousal abuse, or elder abuse
- surgery or other medical procedures
- allergy-related disorders

What are the treatments for the symptom?

Treatment of bruising will vary depending on the underlying cause of the bruise. When an injury occurs, the application of an ice pack off and on for the first 24 hours will reduce further bruising and swelling. After 24 hours, a hot pack to the area will help the bruise heal more quickly.

Other treatments will vary greatly depending on the cause of the bruising. A person who has hemophilia may be given blood transfusions. A person who has nutritional deficiencies may be given special dietary recommendations. A person who has leukemia or cancer may require special medications and procedures. A person who has bacteria in the blood may need antibiotics.
What are the side effects of the treatments?

Side effects will depend on the treatment used. There are usually no side effects when ice or heat are used properly. There may be stomach upset or allergic reaction to antibiotics and other medications. Treatments that require surgery pose a risk of bleeding, infection, and allergic reaction to anesthesia. Medications used for leukemia may cause more side effects, including hair loss or an increased risk of infection.

What happens after treatment for the symptom?

After treatment, recommendations will vary depending on the cause of the bruising and the treatment used. In some situations, no further treatment is necessary for minor bruising. For more serious disease or injury, treatment may continue, and a person may have further instructions to follow.
How is the symptom monitored?

If bruising worsens, or if any other symptoms are present, monitoring by a healthcare provider may be necessary. Any new or worsening symptoms should be reported to the healthcare provider.

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