From the Research
To treat a scalp hematoma, conservative management with non-elastic bandage packing and direct compression is recommended, as most hematomas are self-limited and can be managed without surgical intervention 1.
Key Considerations
- Apply an ice pack wrapped in a cloth to the affected area for 20 minutes every 2-3 hours during the first 24-48 hours to reduce swelling and pain.
- Take over-the-counter pain relievers like acetaminophen (Tylenol) at a dose of 650-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed for pain, not exceeding the maximum daily doses (4000mg for acetaminophen, 3200mg for ibuprofen) 1.
- Rest and avoid activities that could cause further injury.
- After 48 hours, switch to warm compresses for 20 minutes several times daily to help the body absorb the collected blood.
- Most scalp hematomas resolve on their own within 1-2 weeks.
- Seek immediate medical attention if you experience severe headache, confusion, vomiting, vision changes, or if the hematoma is very large or continues to grow, as these may indicate a more serious injury 2, 3.
Important Notes
- Scalp hematomas typically heal well because the scalp has an excellent blood supply that promotes healing, but the underlying bruise may change colors (purple to green to yellow) as it resolves.
- The management of scalp wounds should consider the particular anatomy, vasculature, and microbiome of the scalp, and further research is needed for more comprehensive and effective protocols for the management of scalp injuries 4.
- In young children with scalp hematomas as an isolated finding after head trauma, the use of clinical prediction rules can aid clinicians in determining the level of risk of clinically important traumatic brain injury and deciding whether to perform a CT scan 3.