Bruises (Ecchymosis): What They Are, Why They Change Color, and When to See a Doctor
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
Quick answer
A bruise (ecchymosis) is skin discoloration from a broken, leaking blood vessel that lets blood pool under the skin [1] [6]. As the blood breaks down, it shifts from red or purple to brown, green and yellow. Most bruises fade within two weeks without treatment [1]. See a doctor for frequent large bruises, unexplained bruising or unusual bleeding elsewhere [1].
What the research says
According to PubMed:
Bruise color is a rough guide, not a clock. A systematic review of studies that tried to age bruises in children screened 167 studies and included 3. Any color could appear in fresh, intermediate, and old bruises, clinicians estimated a bruise's age to within 24 hours less than 40% of the time, and they correctly sorted bruises into fresh, intermediate, or old only 55–63% of the time. The studies were in children, so treat the color sequence in this article as a general pattern. (Maguire et al., Arch Dis Child, 2005 [7]).
Low platelets can show up as bruising. A clinical review of pediatric immune thrombocytopenia (ITP), a bleeding disorder with a low platelet count, describes bruising and petechiae with mild bleeding as the typical presentation. It reports that most cases resolve on their own and can be managed with watchful waiting while the platelet count recovers. This is a narrative review, so it summarizes the evidence rather than reporting new numbers. (Gotesman et al., Adv Pediatr, 2024 [8]).
Study details are from PubMed abstracts.
What is a bruise (ecchymosis)?
“Ecchymosis” (pronounced “eh-chuh-mow-sis”) is the medical term for a bruise [1]. A bruise, also called a contusion, is skin discoloration from damaged, leaking blood vessels underneath your skin [1]. Even though blood is pooling underneath your skin, you will not have any outside bleeding unless your skin breaks open [1].
The pooled blood is what makes a bruise visible. Bruises form a mark on your skin that ranges in color from black, blue, purple, brown, or yellow. Your body's blood cells repair the damaged blood vessels to help you heal [1].
Your blood vessels are tubes that carry blood throughout your body [1]. They can break or leak like a cracked pipe. When that happens, blood seeps out of the vessel and pools underneath your skin because there is no wound opening for it to escape your body. That pooling is the visible sign — the skin discoloration we call a bruise. Interestingly, your platelets act as your body's plumbers, stopping the internal bleeding and sealing the leak to heal your bruise [1].
What are other similar types of bleeding?
Several types of bleeding also cause skin discoloration. Knowing the differences helps you describe what you see to a healthcare provider.
Type | What it looks like | How it differs from a bruise |
Hematoma | A larger collection of blood outside blood vessels | Typically raised and painful to the touch; caused by trauma like a car accident or major fall [1] |
Petechiae | Pinpoint reddish dots | Less than 2 millimeters; don't turn white when you press on them [1] |
Purpura | Small bleeding under the skin |
Who gets bruises?
Bruises are very common and affect everyone at some point in life [1]. They can result from a fall, an accident, a sports injury, or a medical procedure [1]. Some bleeding disorders and medical conditions can make you more prone to bruising.
Factor | Why it increases bruising |
Cancer or liver disease [1] | Affects how blood clots and vessels behave |
Family members who bruise easily [1] | Possible inherited tendency |
Blood thinners or aspirin | Medications that thin blood or stop clotting |
Regular NSAIDs (ibuprofen, naproxen) [1] | Nonsteroidal anti-inflammatory drugs can add to bleeding risk |
Bleeding disorders | Conditions like hemophilia, von Willebrand disease, or other clotting conditions |
Low platelet count (thrombocytopenia) | Fewer platelets to plug leaks |
Vitamin C or K deficiency [1] | Vitamins needed for vessel and clotting health |
What are the symptoms of a bruise?
Bruises range in size, shape, and color depending on the type of bruise, its cause, and its location. The main symptoms include pain or tenderness when you touch the bruise, skin discoloration ranging from red to purple, black, brown, or yellow, and sometimes swelling or a raised bump (which would suggest a hematoma) [1].
What color are bruises?
Bruises are often called “black-and-blue marks,” but they actually change color over time. They may appear red or purplish at first [1]. If you have a darker skin tone, you may notice purple, dark brown, or black bruising instead [1]. As the area heals, the bruise may turn a lighter shade of brown, green, or yellow [1].
What causes bruises?
Broken blood vessels cause bruises to form on your skin. Beyond direct injury, there are several ways your blood vessels could break.
Cause | Example |
Injury or physical trauma | A bump, fall, or blow |
Aging skin [1] | Thinner, more fragile skin tears more easily |
Medication side effects | Anticoagulants, antiplatelet medicine, aspirin, or steroids [1] |
Conditions affecting platelets | Autoimmune diseases, leukemia, or hemophilia — and treatments for them |
How are bruises diagnosed?
You and your healthcare provider can identify a bruise by your symptoms, especially the look and color of the mark on your skin. Your provider can also determine what type of ecchymosis you have based on those symptoms. If you experience frequent or unexplained bruising, your provider may order tests to rule out possible causes [1].
How are bruises treated?
Most bruises fade away and do not need treatment [1]. More severe bruises might. You can help your bruises heal faster with a few simple steps.
Home care step | How to do it | What it does |
Rest and elevation | Rest and elevate the injured area | Prevents swelling and relieves pain [1] |
Ice packs | First 24 to 48 hours; wrap in a towel; no more than 15 minutes at a time [1]; repeat through the day | Minimizes bruising and swelling |
Warm compress | After two days; apply heat several times through the day [1] | Supports healing circulation |
Pain medication | Over-the-counter acetaminophen; check with your provider before using NSAIDs [1] | Relieves pain |
How long do bruises last?
The length of time you have a bruise varies based on what caused it and the type of bruise. Most bruises fade away within two weeks without treatment [1]. More severe bruising and hematomas may last a month or longer [1].
When should I see my healthcare provider about a bruise?
Call a healthcare provider if you experience any of the following: a black eye with vision problems; bruising that lasts more than two weeks; frequent, large bruises; a lump in the bruised area (hematoma); painful swelling; pain that lingers days after the injury; a recurring bruise in the same location; unexplained bruising; or unusual bleeding, such as nosebleeds, blood in your pee, or blood with bowel movements [1].
Unexplained bruising can be a sign of an underlying medical condition [1], so it is worth getting checked. Certain types of bruises, such as hematomas, may require medical attention [1].
How can I prevent bruises?
Everyone experiences bruising, but you can lower your risk of injury and bruising with these steps: keep floors and rooms clear of tripping hazards; move furniture away from doorways and walkways to avoid bumping into hard surfaces; turn on a light or flashlight when walking through poorly lit areas; get enough vitamins in your diet; and wear protective gear like helmets and pads when playing contact sports, bicycling, or riding a motorcycle [1].
What questions should I ask my doctor?
Useful questions include: What's causing the bruising? Why am I prone to bruising? Should I have blood tests to see if a condition is causing the bruises? What steps can I take to lower my risk of bruising? Should I look out for signs of complications?
Conclusion
A bruise is one of the body's most honest signals: a tiny leak under intact skin that your platelets quietly repair. Most bruises follow the same story — a red or purple start, a yellow-green healing phase, and disappearance within about two weeks — and need nothing more than ice, rest, elevation, and patience. The exceptions matter, though. Frequent, large, or unexplained bruises, bruises that linger past two weeks, lumps in the bruised area, or bleeding elsewhere in your body are reasons to call a healthcare provider, because they can point to conditions that deserve treatment.
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Frequently asked questions
What is the medical term for a bruise?
Ecchymosis (pronounced “eh-chuh-mow-sis”). A bruise is also called a contusion.
Why do bruises form if the skin isn't broken?
Broken blood vessels leak blood underneath intact skin. Since there is no wound opening for the blood to escape, it pools under the skin and becomes visible as discoloration.
What colors do bruises go through as they heal?
Red or purplish at first, then lighter brown, green, or yellow as the area heals. On darker skin tones, bruising may appear purple, dark brown, or black.
How long does a typical bruise last?
Most fade within two weeks without treatment. Severe bruising and hematomas may last a month or longer.
Is a bruise the same as a hematoma?
No. A hematoma is a larger collection of blood outside blood vessels that is typically raised and painful to the touch, often caused by major trauma like a car accident or a big fall.
What are petechiae and purpura?
Petechiae are pinpoint reddish dots less than 2 millimeters wide that don't turn white when pressed. Purpura is small bleeding under the skin, smaller than a bruise but larger than petechiae.
Why am I bruising so easily?
Common reasons include aging skin, blood thinners or aspirin, regular NSAIDs, cancer or liver disease, bleeding disorders like hemophilia or von Willebrand disease, low platelets (thrombocytopenia), or vitamin C or K deficiency.
Do NSAIDs increase bruising risk?
Yes. Regularly taking nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen for pain relief can make you more prone to bruising.
How do I treat a bruise at home?
Rest and elevate the area, apply ice packs (wrapped in a towel, no more than 15 minutes at a time) for the first 24 to 48 hours, switch to a warm compress after two days, and take acetaminophen for pain — checking with your provider before using NSAIDs.
Should I use ice or heat on a bruise?
Ice during the first 24 to 48 hours, then heat. Heat too early can worsen pooling; ice too late does less to help.
Can a bruise mean something serious?
Yes. Unexplained or frequent large bruising could signal an underlying medical condition, so it is worth discussing with a healthcare provider.
When should I call my doctor about a bruise?
If the bruising lasts more than two weeks, is frequent or large, includes a lump (hematoma), causes painful swelling, lingers days after injury, keeps recurring in the same spot, is unexplained, or is accompanied by unusual bleeding such as nosebleeds, blood in your urine, or blood with bowel movements. Also call for a black eye with vision problems.
Do bruises need treatment?
Most fade away without treatment. More severe bruises might benefit from care, and hematomas may require medical attention.
Can I prevent bruises?
You can lower your risk by clearing tripping hazards, moving furniture from walkways, using lights in dark areas, getting enough vitamins, and wearing protective gear during contact sports, bicycling, or motorcycle riding.
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. If you think you may have a medical emergency, call your doctor or 911 immediately.
Related Reading
Hematoma: Understanding Pooled Blood and When to Seek Emergency Care explains larger pools of blood under the skin and when they need care.
What Is a Bone Bruise (Bone Contusion)? Symptoms, Causes, and Treatment Options describes deeper bruises that affect the bone itself.
Immune Thrombocytopenia: Symptoms, Causes, and Treatment explains how low platelet counts can cause easy bruising.
Hemophilia: Symptoms, Causes, Diagnosis & Treatment Guide covers the inherited bleeding disorder behind frequent, large bruises.
References
Cleveland Clinic. Bruises (Ecchymosis): Symptoms, Causes, Treatment & Prevention. Cleveland Clinic. Last updated January 26, 2023. https://my.clevelandclinic.org/health/diseases/15235-bruises
Cleveland Clinic. Muscle Contusion: Bruised Muscle Symptoms & Causes. Cleveland Clinic. Last updated May 23, 2023. https://my.clevelandclinic.org/health/diseases/25005-muscle-contusion
Cleveland Clinic. Hematoma Definition, Types & Treatment. Cleveland Clinic. Last updated November 14, 2024. https://my.clevelandclinic.org/health/diseases/hematoma
Cleveland Clinic. Petechiae: What Are They, Causes, Treatment & Prevention. Cleveland Clinic. Last updated June 29, 2021. https://my.clevelandclinic.org/health/symptoms/21636-petechiae
Cleveland Clinic. Purpura: Blood Spots, Thrombocytopenic, Symptoms & Causes. Cleveland Clinic. Last updated April 13, 2022. https://my.clevelandclinic.org/health/symptoms/22695-purpura
MedlinePlus (National Library of Medicine). Bruises. MedlinePlus. Last updated July 24, 2025. https://medlineplus.gov/bruises.html
Maguire S, Mann MK, Sibert J, et al. Can you age bruises accurately in children? A systematic review. Arch Dis Child. 2005;90(2):187-189. PMID 15665179. https://doi.org/10.1136/adc.2003.044073
Gotesman M, Shear M, Raheel S, et al. Pediatric immune thrombocytopenia. Adv Pediatr. 2024;71(1):229-240. PMID 38944486. https://doi.org/10.1016/j.yapd.2024.02.007
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