From the Guidelines
A spreading bruise is a cause for concern and requires immediate medical attention if it's rapidly enlarging, accompanied by severe pain, or occurs without injury. Signs of concern include bruises that continue to grow larger, change color from purple to red, feel warm, cause increasing pain, or are accompanied by fever, numbness, or difficulty moving the affected area. For normal bruises, treatment includes rest, ice application for 15-20 minutes several times daily during the first 48 hours, compression with an elastic bandage, and elevation of the affected area above heart level. Over-the-counter pain relievers like acetaminophen (Tylenol) at 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) at 200-400mg every 6-8 hours can help manage pain.
Key Considerations
- The presence of bruising in unusual locations, such as the ears, neck, or trunk, should raise suspicion for underlying conditions, including child abuse, as noted in a study evaluating children with fractures for child physical abuse 1.
- Spreading bruises can indicate serious conditions like bleeding disorders, liver disease, or internal bleeding, so medical evaluation is important if the bruise continues to enlarge or is accompanied by concerning symptoms.
- Topical treatments such as arnica gel or vitamin K cream may speed healing, and bruises typically resolve within 2-4 weeks as the body reabsorbs the blood, with color changes from red-purple to green-yellow as healing progresses.
Treatment Approach
- Rest, ice, compression, and elevation (RICE) are key components of initial treatment for bruises.
- Monitoring for signs of infection, such as increased redness, warmth, or swelling, is crucial.
- Medical evaluation is necessary for spreading bruises or those accompanied by severe symptoms to rule out underlying serious conditions.
From the Research
Definition of a Spreading Bruise
A spreading bruise, also known as a hematoma, is a collection of blood outside of blood cells that can occur when blood vessels are damaged 2, 3, 4, 5. This can be caused by various factors such as injury, trauma, or certain medical conditions.
Signs of a Spreading Bruise
The signs of a spreading bruise may include:
- Swelling or discoloration of the skin 6
- Pain or tenderness in the affected area 6
- Limited mobility or stiffness in the affected area 6
- Bleeding or oozing from the affected area 2, 3, 4, 5
Treatment for a Spreading Bruise
The treatment for a spreading bruise may include:
- Applying pressure to the affected area to stop the bleeding 2, 3, 4, 5
- Elevating the affected area to reduce swelling 6
- Applying ice to the affected area to reduce pain and inflammation 6
- Taking medications such as desmopressin to promote blood clotting and reduce bleeding 2, 3, 4, 5
- In severe cases, surgery may be necessary to repair damaged blood vessels or remove accumulated blood 2, 3, 4, 5
Desmopressin Treatment
Desmopressin, also known as DDAVP, is a medication that can be used to treat spreading bruises by promoting blood clotting and reducing bleeding 2, 3, 4, 5. Studies have shown that desmopressin can be effective in reducing hematoma expansion and improving outcomes in patients with traumatic brain injury 5. However, more research is needed to fully understand the effects of desmopressin on spreading bruises 2, 3, 4.