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What is Ecchymosis?

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  • Written By: Niki Foster
  • Edited By: Andrew Jones
  • Last Modified Date: 24 September 2016
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Ecchymosis is the medical term for a bruise over one centimeter in diameter. Smaller bruises may be classified as purpura if they are at least three millimeters in diameter, or petechia if they are smaller. Ecchymosis can appear on the skin or on mucous membranes.

A bruise is a type of hematoma, or a collection of blood outside the blood vessels. It is relatively minor internal bleeding, usually due to blunt force trauma that causes small blood vessels to break under the surface of the skin. Ecchymosis and other bruises are visible when they occur on the skin as a dark spot. Ecchymosis has a more diffuse border than smaller bruises.

In those with light skin color, bruises typically appear purple or blue a few days after injury, then turn green, yellow, and brown as they heal. This gradual change in color is a result of enzymes present in the hematoma during healing. After capillaries or venules break due to local trauma, blood spills into the surrounding area.

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Macrophages, white blood cells responsible for cleaning up debris, ingest the red blood cells leaked into the area of the bruise. Through this process, the hemoglobin in the red blood cells is degraded into biliverdin, then bilirubin, then hemosiderin. These different byproducts of the breakdown of hemoglobin are responsible for the changing colors of the ecchymosis. The bruise will not clear until the breakdown process is complete. Often, however, the underlying tissue damage caused by the trauma has been healed well before the breakdown of hemoglobin is complete and the bruise disappears.

Ecchymosis can be treated at home by rest, the application of ice, elevation, and over the counter painkillers. Later in the healing process, light stretching exercises, heat, or light massage may be helpful as long as they do not exaccerbate any pain. If the bruise does not improve after a few days or is extremely painful, or if bruising is frequent, it is important to consult a physician.

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anon357962
Post 8

Isn't it true that it's only called a bruise if it's from trauma? So when you bump into something, or there is blunt force trauma then you have a bruise. Ecchymosis is not caused by trauma, though it looks the same. Purpura, ecchymosis, and petichiae are not bruises in that they are not caused by blunt force trauma.

anon305426
Post 7

I had a local trauma on my right foot. The ecchymosis thing has regressed, but still some remains about a year later now. It hasn't faded completely, and if I walk very fast, I will feel pain at the site of the ecchymosis.

I don't take it seriously because I know it will fade, but it has been a year and there is still pain. I'm worried!

anon288887
Post 6

A fall made my whole leg turn black, from blood gathering under the skin. The open part of the wound has almost healed, but the bruised part still remains. What can I do to speed up the process?

OeKc05
Post 5

@Oceana - Try taking vitamin K. If you have a vitamin K deficiency, your blood might be unable to clot normally, and you need to clot in order to prevent bruising.

Supplements are good, but eating actual foods that contain vitamin K is better. Vitamin K-rich foods include cabbage and leafy greens like broccoli and spinach.

It could also be possible that you do not have enough vitamin C in your diet. You could take a multivitamin, but also eat citrus fruits like oranges, papaya, and strawberries. Drinking orange juice will help you as well.

I started eating a more vitamin-rich diet just because I felt lousy most of the time. Now I feel much better, and maybe the things I learned about vitamins will help you.

Oceana
Post 4

I went to my family reunion last weekend, and I had multiple bruises on my arms and legs, just from bumping into chairs or the edges of other furniture. I got very embarrassed when my paranoid cousin asked me right in front of my husband if he had been abusing me.

I don’t ever want people to think that. Does anyone know of any vitamins I could take or foods I could eat to prevent getting bruises so easily? Iron supplements make me sick, so I can’t take those. I’d hate to have to wear long sleeves and jeans all summer to prevent suspicions of abuse.

wavy58
Post 3

@shell4life - Try applying freshly crushed parsley leaves. I have read that parsley is supposed to encourage healing and that it can help blue and black bruises fade away in a day or two.

Crush them immediately before spreading them on your bruises. Use either bandages or gauze and tape to hold the leaves on the bruise. Leave them on until you shower. After the shower, dry the bruised area off and apply freshly crushed leaves again. Hopefully, you will be clear of doggy abuse marks by the time you arrive at your destination.

shell4life
Post 2

I have two playful, rather large dogs that keep me bruised constantly. They are enthusiastic and play rather rough. Is there some type of herbal remedy that will help bruises heal more quickly?

I will be going on vacation in a few weeks. I have hired a dogsitter to come in a few days before I leave, both so the dogs can get used to her and so I can have a few days without getting any new bruises. I would love to know if there is something I could apply to my existing bruises during those two days.

FernValley
Post 1

Wow, I had no idea these had a special name. I bruise somewhat easily, and used to have big bruises all the time. When I started eating better and getting more iron, though, it became a little less frequent. I never made the connection before now, though, between the two. I guess getting more iron would make my blood cells function better. Obvious, probably, but I hadn't thought of it before this.

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