Bruises (Ecchymosis)
Less commonly, hematomas can also happen deep inside the body, where they are not visible in plain sight.
When Does a Hematoma Need to Be Drained?
Hematomas are common injuries that can occur anywhere in the body, often after injury or surgery.
Similar to a bruise, they often heal on their own with at-home care such as rest, icing, and time. Although most hematomas aren’t overly painful or severe, some may be too filled, leading to serious symptoms or external bleeding.
If you or a loved one is living with a hematoma, it is important to know if and when it should be drained by a medical professional.
Let’s discuss hematomas in more detail, including an answer to the question, “When do hematomas need to be drained?”
What Is a Hematoma?
A hematoma is a pool of clotted blood that forms under the skin, on an organ, tissue, or body cavity.
Hematomas can appear anywhere in the body, including the brain, where they are considered most severe and life-threatening.
Causes and Symptoms
Hematomas are often caused by a broken blood vessel sustained by injury or surgery.
They commonly appear directly below the skin’s surface or under a nail and resemble a raised bruise that appears purplish-blue.
They can range from small to large, depending on the severity of the cause.
Less commonly, hematomas can also happen deep inside the body, where they are not visible in plain sight.
Symptoms vary from person to person but often include
- Inflammation
- Redness
- Tenderness
- Warmth
- Pain
- Swelling
How to Treat a Hematoma
Hematoma treatment depends on the injury’s location, symptoms, and cause.
Some hematomas, especially those just below the skin’s surface, may require no treatment, while others may be considered a medical emergency.
The most common treatment for hematomas is the RICE method.
R — Rest the affected area.
I — Ice the hematoma in increments of 10 to 20 minutes at a time, several times a day.
C — If the area is swollen, apply compression using a bandage. Make sure that the dressing is snug but not too tight.
E — Elevate the injured area.
Symptom management throughout healing is also a vital aspect of treating a hematoma. For example, if you experience pain, over-the-counter pain relievers may be effective.
Before beginning a treatment regimen, consult your doctor for specific and personalized care instructions.
When Do Hematomas Need to Be Drained?
In most cases, hematomas do not require drainage.
While many hematomas can be successfully treated using the RICE method, others are more serious and require surgical intervention. That’s where hematoma drainage comes into play.
Drainage surgery may be recommended if the hematoma puts pressure on the spinal cord, brain, or other major organs.
In other cases, drainage may be the best route to prevent a hematoma from worsening that is at an increased risk of infection.
Complete Hematoma Care Is Available at Getwell Urgent Care
You don’t have to live with hematomas forever.
If you have a large or painful hematoma that won’t heal, we encourage you to get checked to get the diagnosis and treatment for blood that has settled in that area.
Getwell Urgent Care is open seven days a week to provide prompt and personalized care and treatment.
No appointments are ever necessary. Simply walk in to get seen today.
Bruises (Ecchymosis)
“Ecchymosis” is the medical term for bruises. These form when blood pools under your skin. They’re caused by a blood vessel break. Bruises look like a mark on your skin that’s black and blue or red to purple. Bruises change color as they heal and most don’t need treatment. Unexplained bruises could be a sign of an underlying medical condition.
Overview
What is a bruise (ecchymosis)?
“Ecchymosis” (pronounced “eh-chuh-mow-sis”) is the medical term for a bruise. A bruise, or contusion, is skin discoloration from damaged, leaking blood vessels underneath your skin. Even though there’s blood pooling underneath your skin, you won’t have any external bleeding unless your skin breaks open.
The collection of blood makes a bruise visible. Bruises form a mark on your skin that ranges in color from black, blue, purple, brown or yellow. Your body’s blood cells repair damaged blood vessels to help you heal.
What are other similar types of bleeding?
There are several types of bleeding that cause skin discoloration, including:
- Hematoma: Trauma, such as a car accident or major fall, can cause a hematoma. A hematoma is a larger collection of blood outside of blood vessels that’s typically raised and causes pain to the touch.
- Petechiae: These are pinpoint areas (less than 2 millimeters) of reddish dots on your skin that don’t turn white after applying gentle pressure.
- Purpura: This is small bleeding under your skin. Purpura are smaller than ecchymosis but larger than petechiae.
Who gets bruises?
Bruises are very common and will affect everyone at some point in their life. Bruises can occur from a fall, accident, sports injury or medical procedure. People older than 65 years are more likely to bruise, along with women and people assigned female at birth.
There are some bleeding disorders and medical conditions that may make you more prone to bruising, including:
- Having cancer or liver disease.
- Having family members who bruise easily.
- Taking medications to thin blood or stop clotting, such as aspirin or blood thinners.
- Regularly taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, including ibuprofen (Advil®) or naproxen (Aleve®).
- Having a bleeding disorder such as hemophilia, von Willebrand disease or another blood clotting condition.
- Experiencing a low blood platelet count (thrombocytopenia).
- Having a vitamin C or vitamin K deficiency.
Symptoms and Causes
What are the symptoms of a bruise (ecchymosis)?
Bruises range in size, shape and color depending on the type of bruise, cause and location. Symptoms of a bruise include:
- Pain or tenderness (sore feeling) when you touch the bruise.
- Skin discoloration (red to purple, black, brown or yellow).
- Swelling or a raised bump on your skin (hematoma).
What color are bruises?
Bruises are sometimes called black-and-blue marks. They may appear red or purplish at first. If you have a darker skin tone, you may notice purple, dark brown or black bruising. As the area heals, the bruise may turn a lighter shade of brown, green or yellow.
What causes bruises (ecchymosis)?
Broken blood vessels cause bruises to form on your skin. Blood vessels are tubes that carry blood throughout your body. Blood vessels can break or leak like a cracked pipe. This causes blood to seep out of your blood vessel and pool underneath your skin, as there isn’t an opening (wound) for your blood to get out of your body. The pooling of blood causes a visible sign of a bruise on your skin (skin discoloration). Your blood cells (platelets) are your body’s plumbers to repair the leak in your blood vessels. Platelets stop bleeding within your body to heal your bruise.
There are several ways that your blood vessels could break, including:
- An injury or physical trauma to your body.
- Aging skin.
- A symptom of taking a medication (like anticoagulants, antiplatelet medicine, aspirin or steroids).
- Having a condition or receiving treatment that affects your blood platelet count (such as autoimmune diseases, leukemia or hemophilia).
Diagnosis and Tests
How are bruises (ecchymosis) diagnosed?
You and your healthcare provider can identify a bruise by your symptoms, especially the look and color of the mark on your skin. Your provider can further identify what type of ecchymosis you have based on your symptoms.
If you experience frequent or unexplained bruising, your provider may order tests to rule out possible causes. These tests include:
- X-ray to check for bone fractures.
- Blood tests to check for clotting conditions and vitamin deficiencies.
