Everyone experiences bruises at some point in their life. Everyone bruises differently. “A bruise is a rupture of the blood vessels so it is like a cut underneath the skin that can happen from any kind of trauma,” said Dr. Gregory Jicha, neurologist at the University of Kentucky Alzheimer’s Center and Sanders-Brown Center on Aging. There are also some folks who bruise spontaneously and may not even recollect having been hit. “The problem gets worse as one ages, the blood vessels become more fragile and even little bumps and pushes can cause bruising,” said Jicha.

Some people are at higher risk than others. “People who take aspirin to prevent heart attacks or take Plavix increase their bruising tendencies and for folks on actual blood thinners like Coumadin, bruising can become quite dramatic,” said Jicha. Viral infections and autoimmune diseases can predispose people to bruising. But for most people, it is a balance between how strong or weak the blood vessels are and how prone to bleeding someone may be. Overall, bruising is just a cosmetic issue where people are unhappy with the look.

If you notice a bruise, take note of its features. “If you push on a bruise, it is going to hurt, which is a normal bruising response, or if the bruise is an area of our joints where we move or where the tissue is moving and every time we move the bruise hurts, that is a normal reaction,” said Jicha. When a bruise starts to become worrisome is if it hurts and you are not touching it or moving it, which is a sign there is damage to the tissue or the bleeding underneath the skin has expanded to the point that it is pushing on other parts of the body.

Sometimes bruising can be a sign of disease. “Somebody that is bruising frequently and is not sure how it is happening, and is not on blood thinners, it can be a clue that the blood is not clotting properly or that they have changed somehow,” said Jicha. It can be a sign of the bone marrow not producing enough blood clotting cells or a blood disorder. “Unexplained bruising should prompt a visit to the doctor so he can make sure all the right types of cells are there and you are not suffering from low platelets,” said Jicha.

In terms of healing, there is not much you can do. “Apply heat because it allows those blood vessels to open up and dissolve,” said Cassie Weig, nurse and school health coordinator for the Lexington-Fayette County Health Department. Remember that bruising is a normal part of having a body that can be injured. “Bruises undergo an evolution over time where when we initially get a bruise it may be bright purple, which is blood that has been released, and as it runs out of oxygen like blood in the veins, it turns more purple and less red,” said Jicha. As the bruise begins to change and the blood cells are in the tissue, they begin to break apart and release iron into the tissue which causes the bruise to turn into a greenish, light brownish or golden color.

Do not be afraid to seek medical evaluation. “If it is serious and you fear that something underneath the bruise is damaged like a bone, see a physician,” said Weig. Know what is going on in the body. “Minor bruises go away in a couple of days but a deeper bruise could mean that you have bruised deeper tissue or possibly broke a bone so you have to look at color, intensity, how fast it came up and the nature of the injury,” said Weig.

Decide the urgency of treatment for the bruise. “Think if the bruise is an acute emergency if it is exceptionally large, represents a hematoma or if it is in an area where the tissue cannot accommodate it and it would be problematic,” said Jicha. You may initially use a cold compress because the cold causes the blood vessels to constrict and limits the amount of blood that could flow through into the tissue. “We want to accelerate the removal of the blood that is leaked into the tissue so we have to increase the body’s ability to bring cells that will gobble up the stilled blood in the tissue, so we will tend to see that warmth or heat may be more beneficial for us,” said Jicha. This expands the blood vessels and increases blood flow into those areas. “We want to wait 24 hours because bleeding will stop typically in a bruise spontaneously,” said Jicha. Though people would like to think there is a magic fix for bruising, time is the key and the body will heal itself.

By Jamie Lober, Staff Writer