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A bruise is skin discoloration caused by broken blood vessels. There are three types: subcutaneous, intramuscular, and periosteal. Periosteal bruises are the most painful and may require rest and pain relief. Blood thinners increase the risk of bruising and head injuries. Consult a doctor if there is extreme pain or swelling.
A bruise is an area of skin discoloration resulting from blood vessels breaking and leaking into the skin. The bruise can also be called a contusion or a hematoma. Most are familiar with the type of bruise that occurs when you have a blunt blow to your skin, such as might occur if you slammed your shin on the dishwasher door. In fact, there are three types of bruises that can occur. These are subcutaneous, intramuscular and periosteal.
A subcutaneous bruise is usually the lightest, least painful, and shortest. In fact, some bruises under the skin don’t hurt much, and people don’t remember hurting themselves. The subcutaneous bruise affects the blood vessels directly under the skin. It can range in color from dark purple to brown. As the bruise fades, it turns yellowish or tan and eventually disappears.
An intramuscular bruise affects blood vessels in the muscle and occurs in the muscles underlying the skin. Because it’s deeper, it usually means a harder blow to the bruised area. So it can be more painful and the bruise can be much bigger as blood vessels release blood to the skin. It can also be painful to touch.
A periosteal bruise affects blood vessels and the outer layer of bone, called the cortex. If you break off enough of the bark, you have a fracture. On the other hand, when only a few fibers break, this is normally a bone bruise. It is the most painful of the bruises and often requires an X-ray to rule out a fracture. This is especially true because fractures also cause skin discoloration.
Generally the treatment for a periosteal bruise is to glaze the injury for 10 to 15 minutes every two hours for the first day. This can help with swelling and pain. The area may also need to be rested, depending on the extent of the injury. Also, taking acetaminophen can help. Doctors may recommend not taking ibuprofen or aspirin, as this can thin the blood and actually make bruising worse.
In fact, people who routinely use blood thinners like aspirin and warfarin bruise much more easily. Blood vessels are slightly more vulnerable. People taking blood thinners should be especially careful and seek treatment for any head injuries, as the risk of concussion is much higher.
Typically, however, the occasional bruise, especially of the subcutaneous type, is likely to cause little discomfort, but will dissipate without significant pain. If a person notices extreme pain or swelling around the site of an injury, a doctor should be consulted to rule out more extensive injury to the bones or muscles.
