The colors of a bruise can appear different, depending on the person’s skin tone, and bruising may be less apparent on dark skin due to contrast. It may initially appear red or purple, then change color over time.
Bruises appear due to damaged blood vessels under the skin. The most common cause is simple traumas to the skin, such as bumping into something or falling down. Medical conditions and some medications can also cause bruising. Most bruises heal on their own with time.
Bruises can be harder to identify on skin that contains a lot of melanin, which is the pigment in cells that gives skin its color. Although very dark pigmentation in the skin may make the visual signs of a bruise less obvious, other signs will still be there.
Most bruises do not require treatment, though in some very severe cases a person may need to see a doctor.
On all skin tones, bruises appear as areas of skin that are darker than the surrounding skin.
The process of bruising on dark skin is the same as it is in any other skin type. Bruises arise due to broken blood vessels under the skin, causing blood to leak into the skin tissue and cause discoloration.
When it first arises, a bruise may appear red to purple. Over time, it can turn blue, then brown, green, or yellow. A bump under the skin may accompany a bruise as well.
A bruise develops similarly in skin with more melanin as it does in a very pale person, though it may show up more starkly on light skin due to greater differences in contrast.
In very dark skin, the initial impact may not cause a noticeable reddening in the skin. Depending on the person’s skin tone, the skin may appear dark brown or black in the area as the bruise forms. They may also notice a bump.
Some research has reported that skin color is a significant factor in the appearance of bruises.
The researchers used a paintball pellet to create bruises on the arms of 103 people and measured their skin color and bruise colors using a device called a colorimeter. They found that:
- people with a medium skin tone had more red and yellow in their bruises than people with a light or dark skin tone
- people with darker skin and darker hair had darker colored bruises
Bruises occur when the small blood vessels beneath the skin experience trauma. This typically occurs when someone experiences a sort of blunt impact.
- bumping into a wall or object
- dropping something heavy onto the skin
- smashing a fingernail
- being hit with a fist or blunt object
- falling down
Other causes of bruising may include more serious issues and chronic conditions, such as:
- deep vein thrombosis
- von Willebrand disease
- surgeries, including cosmetic surgeries
- sports injuries
- car accidents
- sprained wrists or ankles
- broken bones
- torn or strained muscles
- clotting factor deficiencies
Some people may bruise easier than others. For instance, females tend to bruise more easily than males. Additionally, older adults may bruise more easily than younger ones, as people’s skin gets thinner as they age.
Most bruises will heal over time without treatment. There may be some ways to slightly speed up the healing process or reduce pain and swelling.
- applying an ice pack to the bruise
- wrapping the affected area with an elastic sports wrap
- raising the injured area if a bruise is on the arm or leg
- using skin creams containing ingredients for healthy skin
- taking over-the-counter (OTC) painkillers, such as acetaminophen (Tylenol), to dull any pain
Overall, bruises are usually not a cause for undue concern. They may feel tender or sore, but they are often a surface injury that will heal with time.
With that said, more severe bruises may need medical attention. Bad bruises may put the person at risk for a hematoma.
A hematoma is a collection of blood that gets trapped within different tissues. It is much harder for the body to heal a hematoma than a bruise. Because of this, a hematoma will not fade in color as quickly as a bruise.
Anyone who notices a bruise that does not change color or feeling after a few days should contact a doctor to see if they need any medical treatment.
Severe bruising may also cause other issues that might require treatment. Signs that a person may need medical treatment include:
- numbness in the area
- loss of function in a nearby joint or muscle
- vision impairment
- a bruise that keeps growing
- a bruise lasting longer than 2 weeks
- a bruise near a fractured or sprained bone
- a bruise in the abdomen with no known cause
The diagnostic and treatment process for people with dark skin who have major bruises is also the same. The only difficulty doctors may have with very dark skin is deciding the age of a bruise, which could help them find a cause.
As a study published in
Despite these considerations, there are ways to analyze the bruise even in very dark skin where the bruise is not easy to see.
For instance, as a study posted to the Journal of Wound, Ostomy, and Continence Nursing notes, using alternative light source technology can assist doctors in assessing skin issues they cannot normally see due to very dark skin.
Bruising may be more difficult to see on very dark skin, but the overall process of bruising on dark skin is very much the same as other skin types.
Even if the person cannot see the bruise, there are still some signs to look out for, such as if the area is tender to the touch. Most bruises will heal on their own, and there are ways to care for the tender skin during healing.
Anyone experiencing major bruises or signs of other issues, such as hematoma, should see a doctor.