$Unique_ID{PAR00032}
$Pretitle{}
$Title{Medical Advice:  Bruises}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Bruising Bruise Bruises Discolored skin Discoloration black blue
purple red yellow green Petechia petechiae capillaries blood vessels vessel}
$Log{}

Your Child:  A Medical Guide


Bruises


     Quick Reference

     SYMPTOM
     - Discolored areas of the skin (black, blue, purple, red, yellow, or
       green)

     HOME CARE
     - Immediately after an injury, apply cold to decrease bleeding and
       bruising.
     - Twenty-four hours or more after an injury, apply warmth to help the
       body absorb the bruise.

     PRECAUTIONS
     - If bruises suddenly appear without injury, see your doctor.
     - The appearance of petechiae (small, dark red or maroon bruises)
       scattered over the body may indicate an emergency.  If there is also
       fever or collapse, got medical treatment immediately.


     Bruises are made up of blood that has escaped from capillaries (tiny
blood vessels) or larger blood vessels and can be seen through the skin.  They
vary from pinhead-size to several inches across.  Bruises usually are black
and blue in color.  If they are near the skin's surface, they appear maroon or
purple.  Bruises of the whites of the eyeballs are always blood-red.  As blood
in a bruise moves back into the bloodstream, a bruise often becomes yellow or
green.
     If the escape of blood has been deep in the tissues--as with torn
ligaments or broken bones--it may take days to reach the surface of the skin
as a visible bruise.  Escaped blood often travels to other parts of the body
(for example, the blood from a bruise on the forehead may produce a black
eye).
     Most bruises are caused by physical injuries.  Normally active children
always seem to have one or more bruises.  Children with fair complexions
bruise more easily than children with darker complexions.  The areas most
likely to bruise are the shins, knees, arms, and thighs.  Bruises may take
days or weeks to disappear, depending on their size.
     A different type of bruise, called a spontaneous bruise, may be a cause
for concern.  Spontaneous bruises suddenly appear even though no injury or
blow to the skin has occurred.  Spontaneous bruises may appear because the
capillaries are abnormally fragile (sometimes due to vitamin C deficiency),
because the capillaries have been injured by infections or by allergic
reactions, or because of a lack of proper clotting of the blood.  Bruises
often are caused by injuries that were simply not noticed at the time;
however, if bruises appear in areas not likely to be injured, or if a great
many bruises appear, it is less likely that they were caused by unnoticed
injuries--these may be spontaneous bruises.
     There is another type of bruise known as a petechia.  Petechiae are
pinhead to one-eighth inch in size.  They are dark red or maroon in color and
often appear by the hundreds.  Forceful vomiting or coughing can sometimes
cause many petechiae to appear on the head and neck.  Petechiae may also
appear in one smaller area when caused by a blow to the skin.

SIGNS AND SYMPTOMS

     Bruises are easily recognized when an area of the skin is discolored
(black, blue, purple, red, green, or yellow).  Bruises can be distinguished
from other skin marks or rashes by a simple test.  A bruise of any size does
not blanch (turn white or pale) when pressed; all other red or purple marks or
skin rashes will blanch when pressed.

HOME CARE

     Applying cold compresses soon after an injury will help decrease bleeding
and lessen bruising.  Warm applications 24 hours or more after the injury can
help the body absorb the blood in the bruise.

PRECAUTIONS

  -  Spontaneous bruising should always be examined by a doctor.  Spontaneous
     bruising may be a sign of illness.
  -  Petechiae scattered over the body can indicate an urgent situation.  If
     there is also fever or prostration (extreme exhaustion or collapse), a
     true emergency exists.  Don't waste any time--see your doctor at once.

MEDICAL TREATMENT

     For bruises caused by injuries, a doctor's treatment is the same as home
care.  If there are spontaneous bruises, including petechiae that are
scattered over the body, your doctor will perform a complete physical
examination.  The examination may include a complete blood cell count;
platelet count; blood coagulation studies; nose, throat, and blood cultures;
spinal tap; and bone marrow studies.  The patient may be hospitalized to be
given intravenous fluids and antibiotics.