Most people will experience occasional minor bleeding into the skin or bruising, often following an injury when the blood vessels break. If the bleeding is severe, spontaneous, or chronic, it will generally need medical attention to prevent serious complications.
Minor bleeding into the skin is a common occurrence and is often no cause for concern. A person may experience bleeding into the skin for various reasons.
This article looks at what bleeding into the skin is and what can cause it. It also covers diagnosis, treatment, and when to contact a doctor.
If a blood vessel ruptures, the blood inside can leak into nearby tissues and spaces. This is known as hemorrhaging. When hemorrhaging occurs directly below the skin, the blood can escape into the surrounding skin and cause it to discolor.
Typically, this skin discoloration is a mixed shade of red, blue, black, and purple. On dark skin, it may appear dark purple, brown, or black.
The number and type of blood vessels that rupture will affect the size and appearance of the skin discoloration and the extent of the bleeding.
Breaking only a few small blood vessels or capillaries tends to cause petechial lesions, or petechiae. These are small, red dots under 2 millimeters (mm) in width that appear on the skin’s surface.
If more than a few capillaries rupture in the same area, they can cause purpura. Purpura appears as small patches of reddish-purple discoloration. These patches are larger than 2 mm, generally ranging between 4 mm and 1 centimeter (cm) in width.
Neither petechiae nor purpura blanch if pressed. This means that the discoloration does not disappear after applying brief pressure to the area.
When many capillaries break close together, blood can pool under the skin’s surface to form an ecchymosis. This is a bluish-purple or black bruise that can vary in size. However, it is generally larger than 1 cm in width. Ecchymosis is not always the result of trauma and may not include outward swelling, unlike most bruises.
Bruises that result from trauma are usually tender to the touch and may be slightly swollen.
Bruises vary in their healing time from a few days to several weeks, depending on how severe they are. A moderate bruise typically takes around 2 weeks to fade away entirely. Bruises in the lower legs can sometimes take longer to heal.
Hematomas are pools of clotted or partially clotted blood. They are also caused by broken blood vessels. Hematomas can occur in various places in the body. Some can be minor, but some — such as a hematoma in an organ or body cavity — can be serious or life threatening events.
Most people experience some bleeding under the skin and bruising during their lifetime. However, some people are also more prone to bruising than others.
Certain activities may also increase the risk of bleeding into the skin and bruising. For example, hematomas and contusions are
Some other common causes may include:
- impact injuries
- wearing ill-fitting glasses, clothing, or shoes
- using certain medical devices, such as braces, crutches, or casts
- straining from vomiting, coughing, or crying
Several health conditions and medications can also interfere with the body’s ability to form blood clots. This can lead to excessive or spontaneous bleeding and bruising.
Conditions that are likely to increase the risk of bleeding and bruising include:
- kidney or liver disease
- aplastic anemia
- vitamin C or vitamin K deficiency
- idiopathic thrombocytopenic purpura
- strep throat
- scarlet fever
- infective endocarditis
- Marfan syndrome
Some medications can also increase the risk of bleeding and bruising. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and blood thinners such as aspirin (an antiplatelet medication) and warfarin (an anticoagulant).
A person should always consider the potential side effects before taking medication and seek professional medical help if they are unsure.
If a person seeks medical help for bruising, a doctor will carry out a physical exam to diagnose the cause. This will often involve dating the lesions and assessing their severity.
Accurately diagnosing bruising can be harder on dark skin tones. A
A doctor may also seek to establish the cause of bruising by asking a person about aspects of their medical history, including:
- the potential sources of their lesions or bruises
- any other current symptoms
- medication use, especially blood thinners and NSAIDs
- previous injuries or surgeries
- their family medical history
If a person is prone to excessive bleeding, it is important to know this as soon as possible. Otherwise, a small injury could unexpectedly become an emergency. Finding out hereditary risk factors at an early age can help prevent problems and complications later on.
A doctor may order further diagnostic procedures if they are unsure of the cause or think that there could be an underlying medical condition. These procedures can include blood and urine tests, imaging studies such as CT scans, and bone marrow biopsies.
There is no specific way to treat minor skin bleeding and bruising. However, some home remedies may
Some common home remedies for minor bleeding into the skin and bruising include:
- applying an ice pack to the area for 10–15 minutes as soon as possible and then repeating this several times
- trying to keep the injured area elevated
- applying pressure to the bleeding areas
- avoiding exposing the injury to direct heat from showers, hot tubs, or saunas for 2 days following the injury
- applying a heated compress to the area for up to 20 minutes and repeating several times daily
- eating plenty of whole fruits and vegetables rich in antioxidants, such as vitamins A, C, D, and E, as this helps promote healing
- avoiding smoking or using tobacco products, as they can delay healing
- avoiding alcohol, especially for the first 2–3 days after the injury
- avoiding vigorous exercise for 24 hours
- applying herbal gels and creams, such as arnica or vitamin K8, several times daily until the bruise heals
200–400 milligramsof bromelain up to three times per day
For more severe cases of bleeding into the skin and bruising, or those resulting from an underlying medical condition, a doctor will put together a tailored treatment plan.
Minor bleeding into the skin or bruising that happens from time to time is rarely cause for concern.
However, anyone who experiences bleeding into the skin with no apparent cause or bruising that lasts for longer than 2 weeks should speak with a doctor.
In addition, individuals taking blood thinners and who experience frequent or severe bleeding or bruising should also seek medical attention.
It is also best to contact a doctor if any of the following symptoms accompany the bruising:
- extreme pain
- blood in the urine or stool
- bleeding gums
- swollen extremities
- darkening of the skin around the bruise over time
- nausea or vomiting
- a large lump in the area of bruising
- dizziness or fainting
- joint or bone pain
- bruising in the same place over and over again
A person should seek immediate medical care if they experience any unexplainable bruising that is sudden or severe.
A person may experience bleeding into the skin and bruising for a variety of reasons. Causes can include minor injuries, trauma from surgical procedures, and certain medications.
Bleeding into the skin may also occur due to other health conditions, such as liver disease, meningitis, or Marfan syndrome.
Most small bruises will heal naturally with rest. Compression, elevation, and medications such as bromelain may assist in the healing process.
If a person experiences persistent, severe, or unexplained bleeding into the skin, they should seek immediate medical care.