Bruises: Understanding the Colors and Causes of Contusions

Shivendra Pratap Singh


High Court Lucknow

Medico Legal

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Published on: 13 Aug, 2023

Bruises, medically known as contusions, are familiar to most of us. Whether you’ve bumped into a piece of furniture or suffered a minor fall, you’ve probably sported a colorful bruise as a reminder of the mishap. But what causes them, why do they change color, and when should you be concerned? Let’s dive in.

1. What Causes a Bruise?

A bruise appears when tiny blood vessels, called capillaries, break or rupture beneath the skin, usually due to trauma or impact. This causes blood to leak into the surrounding tissues, which results in the familiar discolored mark of a bruise.

2. The Colorful Evolution of a Bruise:

The changing hues of a bruise can offer clues about its age:

  • Red: Initially, a fresh bruise may appear reddish due to the color of the fresh blood that leaked from the capillaries.
  • Blue-Purple: Within a day or so, hemoglobin in the blood can make a bruise look blue or purple.
  • Green: As the bruise heals, it may turn green due to the breakdown of hemoglobin.
  • Yellow-Brown: In its final stages of healing, a bruise might appear yellow or brown. This coloration results from the body processing the biliverdin and bilirubin, the byproducts of hemoglobin breakdown.

3. Factors Influencing Bruising:

  • Age: As we age, our skin becomes thinner and loses some of its protective fatty layers. This can make elderly individuals more susceptible to bruising from minor trauma.
  • Sex: Women might bruise more easily than men, particularly on the thighs, buttocks, and upper arms.
  • Medications: Some medicines or supplements, like aspirin, anticoagulants, or corticosteroids, can increase the likelihood of bruising.
  • Medical Conditions: Certain conditions, such as hemophilia or certain types of anemia, can result in increased bruising or prolonged healing.

4. When to be Concerned:

While most bruises are harmless and fade on their own, there are times when a bruise might warrant medical attention:

  • Location: A bruise near the eye or on the forehead can be a sign of a more serious head injury.
  • Size and Pain: Large bruises or those that are exceptionally painful should be evaluated.
  • Duration: Bruises that don’t show signs of improvement after two weeks, or those that persist beyond a month, should be examined.
  • Unknown Causes: If you find yourself bruising frequently without any known cause, it may be a sign of an underlying medical condition and should be discussed with a healthcare professional.

5. Treatment and Care:

For the majority of bruises:

  • Cold Compress: Applying a cold pack immediately after the injury can reduce blood flow to the area, minimizing the size of the bruise.
  • Elevation: Raising the bruised area, when possible, can reduce blood flow, which might limit the size of the bruise.
  • Rest and Protection: Protecting the bruised area from further trauma will help speed up the healing process.


Bruises are a natural response to trauma and, for the most part, are not a cause for concern. Understanding their progression can provide peace of mind during the healing process. However, always be attentive to your body, and if a bruise seems out of the ordinary or you’re concerned about the frequency or cause of your bruises, it’s essential to seek medical advice.


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