Ecchymosis is the medical term for a bruise, which happens when there is some bleeding under the skin. Most of the time, a bruise is nothing to be worried about. They tend to occur when there is some damage to blood vessels in an area of tissue, and this normally occurs by accidents like bumping your arm or leg, or getting hit whilst playing sports. This trauma causes your blood vessels just under your skin to burst and leak blood into the surrounding tissue. This blood then gets trapped beneath the skin, where it forms into a little pool that turns your skin purple, black, or blue.
People sometimes attend their doctor if they get bruises with no obvious cause. Most of the time, we bang our shins and lower legs on things without noticing and a surprisingly small trauma leads to a bruise.
If you feel that you have excessive bruising, or bruising that continues to occur as a result of minimal or very light trauma, then you should always discuss this with your doctor.
Some medication may also increase your chances of developing bruises. These include steroids, anticoagulants (blood thinners), and some antibiotics.
If you feel you have excessive bruising, there are a few lines of inquiry that your doctor will want to think about. Your doctor will want to know whether you have any family history of bleeding disorders, whether you take any regular medications that affect your blood, and if you take any over the counter drugs or drink excessive alcohol that could affect your bleeding and clotting.
Your doctor will then consider whether it’s necessary to do any blood tests to look at your blood clotting. If either your doctor feels it is important or you would feel reassured by having a blood test, a blood test can be arranged to check your body's clotting system.
In most instances, no treatment is needed for bruises. Providing you remain well, and as long as the trauma that caused it hasn’t caused any other damage such as broken bones, nothing else is required. It takes about 2 weeks for a bruise to fade, during which time it will change colour from red to black to brown to yellow.
If you have a particularly large bruise and become unwell, developing a temperature over 38 degrees, see your doctor for a review. In some cases bruises can become infected and cause further problems, occasionally needing antibiotics alongside other treatments.
You are fit for work if you have a bruise. However, if the nature of your work causes severe pain due to your bruise, or you are client-facing and feel very self-conscious about it, you could negotiate amended duties with your employer until you have recovered and the pain has settled or it has faded.
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