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Red-blue hematomas When do bruises indicate serious diseases?
In most cases, bruising (hematomas) is completely harmless. They show when blood vessels under the skin and deeper tissue layers have been damaged by thrusting or falling. The popularly designated "bruises" are reddish blue. In addition, slight swelling may show. If skin discoloration appears to occur by itself, pain and other discomfort are added, serious illnesses may be behind it. Then it is advisable to involve a doctor for further assessment.
Some people experience bruising even in the case of minor bumps, others are naturally more resistant and only show corresponding hematomas in the event of severe bumps, blows or bruises. "A bruise is a hemorrhage in the body, without blood to the outside," says the chief physician for internal intensive care medicine and infectious disease at the Johanniter-Kliniken in Bonn, dr. Peter Walger. This bruise is caused by a squeezing of tissue, in which microvessels tear under the skin, adds the Munich sports physician Professor Martin Halle.
Blue spots are usually harmless, but can also point to serious illnesses. (Image: thongsee / fotolia.com) After three weeks, bruising should have subsided
In particular, children often have bruises as a result of their falls and collisions in the playground or kindergarten, but older people also increasingly notice these due to the decreasing vascular elasticity. If blood vessels are damaged inside the body, for example, the blood can run into the subcutaneous tissue or accumulate in body cavities.
When the blood clots, the color of the hematoma changes to dark blue, later the hematoma becomes darker and then yellow-green. After about two weeks, minor bruising has usually subsided. "Generally, it takes two to three weeks for the blood cells to be broken down," says Professor Reiner Hartenstein of the German Medical Internists' Association. The color changes make the stages of the degradation process clear, explains the expert.
Check the causes of sudden hematomas
People who need to take blood-thinning or anticoagulant medicines are particularly susceptible to the formation of hematomas. Even patients with diseases that cause a disturbed blood coagulation, show more spontaneous bleeding.
For both groups, the bruising is quite a risk, which is why a timely medical review is required and appropriate medical treatment must be initiated if necessary. In general, sudden bruising, the causes of which are unclear to those affected, should be clarified by a physician, says Professor Walger. Trigger could be a harmless tendency to bruise, but possible causes are also side effects of a drug, a disturbed blood clotting by a hitherto unknown disease or even a tumor.
In case of disturbed blood coagulation increased bruising
After severe falls or bumps, hematomas can occur as a result of bone fractures (fractures) or torn ligaments (ruptures). In both cases sufferers usually have severe pain and show restricted mobility and a significant swelling of the corresponding body part. If a fracture or rupture is suspected, medical advice should always be sought and medical treatment should be provided. Otherwise, the risk of complications and injuries increases. If bruises occur again and again for no apparent reason, check whether serious illnesses are the cause of the hematoma.
For example, in hemophilia a disturbed blood coagulation, which comes as a cause of bruises into consideration. Even in the most common congenital disorder with increased bleeding tendency, the Willebrand-Jürgens syndrome, sufferers suffer from a disorder of blood clotting. In addition, there are numerous other diseases such as the liver or the hematopoietic system in which increased hematomas may occur.
Medication as a trigger of the hematoma?
Medicines whose active ingredients promote the appearance of bruises are, for example, acetylsalicylic acid (ASA) or coumarin derivatives, since they act on blood coagulation. Many people are unaware that they are also interfering with the function of platelets over several days with ASA-containing painkillers, thereby inhibiting their blood clotting.
Hematomas due to cortisone's income are also possible because it affects the skin's structure. In the case of sudden, seemingly groundless, bruising, any connection with the revenue of medicines should therefore be urgently reviewed.
When to the doctor?
Medical attention should also be sought when hematomas are associated with symptoms such as severe swelling and pain, circulatory failure, dizziness, impaired body function or fever. Increased caution is also required for complaints to the abdomen, chest or head. Hematomas are not always visible here, as it can lead to hemorrhages inside the body, which are sometimes life-threatening. Hemorrhages in the abdomen can cause, for example, abdominal pain and circulatory problems. The particularly menacing cerebral hemorrhages are often associated with headaches and neurological disorders such as paralysis or consciousness.
Cool and raise
In common hematomas, the so-called PECH rule is a good approach for first aid: break, ice, compression, high camps. Timely cooling can reduce blood leakage into the tissue and reduce swelling. Ice should never be placed directly on the skin, but always a thin cloth between the skin and cooling be placed, since otherwise threatening cold and skin damage. The high-altitude storage relieves the damaged tissue. However, later cooling of the blue spot is pointless, emphasizes Professor Halle. This must happen immediately after the fall or impact. In the further course, however, ointments which counteract the swelling and inflammation, which should promote the healing of the hematomas, can be used as supportive substances. (Sb, fp)