Bruises
What are bruises?
Bruises happen all the time. They have long medical names like ecchymoses or contusions. They happen when we have small bleeds under the skin but the skin doesn’t break, so the blood is trapped under the skin.
A bruise starts as a red-purple patch that can turn blue-black over the first day. Over the next several days, the color fades to yellow-green as your body breaks down the blood under the skin. In older or thinner skin, you can see a rust-brown color there for months where the body didn’t fully break down the blood and left iron deposits in the skin.
Why do I have bruises?
Bruises are usually caused by injuries. You have three layers of skin - epidermis, dermis, and fat. Most of your small blood vessels are in the dermis. The dermis acts like a shock absorber for little bumps and injuries. As you get older and especially as your skin gets damaged from the sun, the dermis thins out, and your shock absorber doesn’t protect the blood vessels from bumps and bruising happens.
Lots of things can make you easier to bruise - genetics, sun damage, age, chronic diseases, medicines (especially blood thinners and aspirin), not enough Vitamin C or Vitamin K, and use of steroid creams.
How do I treat a bruise?
There is no specific treatment for bruises. However, there are ways to decrease bruising and speed up healing:
DECREASE BRUISING (after an injury):
Put ice on the bruise as soon as possible. This will constrict the blood vessels and minimize the bleeding under the skin.
Try to keep the bruise elevated after the injury. Gravity can make the blood pool under the skin and make a bruise worse. For example, sleep with a pillow under your leg for a bruise on the leg.
For pain, use only Tylenol (acetaminophen). Both ibuprofen and aspirin can make bruises worse.
SPEED UP BRUISE HEALING:
Apply arnica gel (or cream) three or more times a day to the bruise.
Some of my patients report that vitamin K cream helps as well.
After the bruise is fully formed, apply heat to increase blood flow to the bruise to help the body clear it quicker. Use a heating pad for 10-15 minutes a few times a day.
Eat a whole food, plant-based diet rich in vitamins. For a quick summary and basic recipes, visit the Lifestyle Medicine site.
How do I prevent bruises?
The best way to prevent bruises is to keep your skin healthy and your dermis as thick as possible:
Wear sunscreen or a daily moisturizer with SPF every day.
OR wear sun-protective clothing. I wear a hooded sun shirt most days.
Eat a whole food, plant-based diet rich in vitamins. For a quick summary and basic recipes, visit the Lifestyle Medicine site.
What if my bruises aren’t getting better?
If you bruise easily, it would be good to check with your primary care doctor to discuss reasons for the bruising. If you have a lot of sun damage and are bruising, look for a board-certified dermatologist in your area to check them. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
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