Biology

Why Bruises Change Color?

Have you ever noticed how bruises change color as they heal? Sometimes when you fall, you get a nasty bruise that changes in color or appearance with the passage of time.

A bruise is also medically referred to as a contusion. It happened when tiny blood vessels are damaged or broken, a bruise varies with age. Some people bruise easily, while others have tougher skin tissue.

A bruise is caused when tiny blood vessels or capillaries are damaged or broken near the surface of your body without breaking the skin as the result of some kind of trauma to the skin. Broken capillaries leak blood in the surrounding tissues, which causes tenderness and discoloration under your skin.

In minor injuries, the bleeding is usually cramped to your skin and the bruise becomes apparent within minutes to hours. With more forceful trauma, bleeding typically occurs in the deeper tissues and the blood gradually seeps into your skin over a period of hours to days. This is why you may not see a bruise for a day or two after you’ve had a fall or other injury.

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The size of a bruise relies on what caused your injury and the amount of force involved. The more forceful the injury, the greater the amount of bleeding and the larger your bruise will be. The closer to your skin surface the bruise is, the more intense the colors you will see.

As the bruise heals, your body absorbs that leaked blood. That’s why the appearance of a bruise changes.bruise stages

A bruise typically last between two and three weeks. Exceptionally some will take longer to heal, that depends on both the severity of the injury and where on your body you got the bruise. Some parts of the body, like the arms and legs, may be slower to heal.

During the stages of a bruise, the change from one color to the next is very gradual, and there are varying shades of these colors along the way.

  • Pink and Red.

When you first get a bruise — especially one near the surface of your skin — your bruised skin can look a little pink or red. The color comes from fresh blood leaking into your tissues. Fresh blood is bright red because it contains both iron and oxygen. You may notice that the area around the bruise is also swollen and tender to the touch.

  • Blue or Dark Purple.

Within a few hours, blood that has leaked from your injured blood vessels loses the oxygen it was carrying. As a result, hemoglobin, which is typically red, begins a gradual change to blue. As this occurs, the blood becomes darker and your bruise begins to look more bluish or dark purple. This darkening can last through the fifth day after the injury.

  • Pale Green.

Around the sixth day, your bruise will begin appearing greenish in color. The green color is due to the presence of a hemoglobin breakdown product called biliverdin. It also means the healing process has begun.

  •  Yellow and Brown.

After the seventh day from the time of injury, your green bruise will eventually turn to a pale yellow or light brown shade as it enters the final stage of healing. The yellow color is from the final breakdown product of hemoglobin in your skin, a chemical called bilirubin. This is the last stage of your body’s re-absorption process. Your bruise won’t change color again. Instead, it will gradually fade away until it’s completely gone.

Most of the bruise is multicolored. This is because the amount of blood in different areas of the bruise varies, and the stages of healing overlap.

 

In some particular situation, a bruise won’t change color or seem to be healing in any way. A bruise that is firm to the touch begins growing in size, or becomes more painful as time passes can be a sign that a hematoma has formed.

A hematoma is a lump that forms when blood begins collecting under the skin or in a muscle. Instead of the process described above in the stages of bruising, the blood in a hematoma is “walled off” in the body.

Another, more uncommon reason for a bruise that won’t go away is known as heterotopic ossification. This happens when your body builds up calcium deposits around the site of your injury. It will make your bruise tender and firm to the touch.

Bruises can be scored on a scale from 0-5 to categorize the severity and danger of the injury.

Harm score Severity level Notes
0 Light bruise No damage
1 Mild bruise Little damage
2 Moderate bruise Some damage
3 Serious bruise Dangerous
4 Extremely serious bruise Dangerous
5 Critical bruise Risk of death

 

Bruise shapes may correspond directly to the instrument of injury or be modified by additional factors. Bruises often become more prominent as time lapses, resulting in additional size and swelling, and may grow to a large size over the course of the hours after the injury that caused the bruise was inflicted.

  • Condition and type of tissue: In soft tissues, a larger area is bruised than would be in firmer tissue due to ease of blood to invade tissue.
  • Age: elderly skin and other tissues are often thinner and less elastic and thus more prone to bruising.
  • Gender: More bruising occurs in females due to increased subcutaneous fat.
  • Skin tone: Discoloration caused by bruises is more prominent in lighter complexions.
  • Diseases: Coagulationplatelet, and blood vessel diseases or deficiencies can increase bruising due to more bleeding.
  • Location: More extensive vascularity causes more bleeding. Areas such as the arms, knees, shins and the facial area are especially common bruise sites.
  • Forces: Greater striking forces cause greater bruising.
  • Genes: Despite having completely normal coagulation factors, natural redheads have been shown to bruise more, although this may just be due to greater visibility on commonly associated lighter complexion.

Bruises go through various shades and colors as they heal. Understanding what those colors mean, and what you should expect during the healing process, can help you determine whether a bruise is just a bruise or a sign of something more serious.

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