What is the treatment for a forehead contusion?

Treatment of Forehead Contusion

For a simple forehead contusion (bump), apply cold therapy using an ice-water mixture wrapped in a damp cloth for 10-20 minutes, limit activity that causes pain, and monitor closely for any signs of serious head injury that would require emergency evaluation. 1

Immediate First Aid Management

Cold Application

• Apply cold therapy using a plastic bag or damp cloth filled with ice and water mixture for 10-20 minutes per application to reduce hemorrhage, edema, and pain 1
• Ice-water mixture is superior to ice alone or refreezable gel packs for effective tissue cooling 1
• Place a barrier (thin towel) between the cold container and skin to prevent cold injury 1
• Limit each cold application to 20-30 minutes maximum; if uncomfortable, reduce to 10 minutes 1
• Cold application can be repeated but avoid continuous application 1

Activity Restriction

• The injured person should avoid activities that cause pain and limit use of the affected area 1
• Having the person remain still may reduce risk of worsening any underlying injury 1

Critical Red Flags Requiring Emergency Evaluation

Activate EMS immediately if any of the following develop 1:

• Loss of consciousness (even brief)
• Worsening or severe headache
• Repeated vomiting
• Altered mental status or confusion
• Seizures
• Visual changes
• Swelling or deformities of the scalp suggesting skull fracture
• Neurological deficits (weakness, numbness, tingling)

Special Considerations for Concussion Risk

When to Suspect More Than Simple Contusion

• Any person with signs or symptoms of concussion must be immediately removed from activity and not allowed to return until evaluated by a healthcare professional 1
• Signs include headache, nausea, impaired balance, difficulty concentrating, confusion, emotional lability, or fatigue 1
• Repeated concussions can lead to long-term neurological sequelae including memory problems, concentration difficulties, and persistent headaches 1

High-Risk Populations Requiring Lower Threshold for Evaluation

Consider medical evaluation for forehead contusions in patients with 1:

• Age ≥65 years
• Involvement in motor vehicle, motorcycle, or bicycle crash
• Fall from greater than standing height
• Current anticoagulant or antiplatelet medication use
• Not fully alert or intoxicated
• Other painful injuries, especially head and neck

What NOT to Do

Common pitfalls to avoid 1:

• Do not apply heat to acute contusions—cold is superior for first aid 1
• Do not apply cervical collars as a first aid provider—these require specialized training and may cause harm 1
• Do not allow return to sports or high-risk activities until cleared by healthcare professional if any concussion symptoms present 1
• Do not ignore worsening symptoms—these may indicate expanding intracranial injury requiring urgent intervention 1

Follow-Up Considerations

• If symptoms persist beyond initial treatment or worsen at any point, seek medical attention 1
• For forehead injuries with significant mechanism (high-energy trauma), tenderness over frontal bone, or visible deformity, imaging may be warranted as frontal bone fractures can be associated with intracranial injury in over one-third of cases 1
• Motor function may be impaired for up to 30 minutes following ice treatment, increasing susceptibility to further injury during this period 2