What Is the Difference Between a Bruise and a Contusion?

Reviewed on 2/8/2021

What are bruises and contusions?

Bruises and contusions are skin discolorations that happen due to an injury to capillaries under the surface of your skin. Bruises and contusions are the same thing.
Bruises and contusions are skin discolorations that happen due to an injury to capillaries under the surface of your skin. Bruises and contusions are the same thing.

Many people wonder what the difference between a bruise and a contusion is. The terms bruise and contusion are synonyms. Either term refers to the same injury to the surface of your skin.

Your doctor may also refer to your bruise by another medical term, ecchymosis. This is yet another word for the same injury as a bruise or contusion.

Bruises are recognizable by the discoloration on your skin due to an injury to small blood vessels under the surface of your skin. The blood from these vessels, also known as capillaries, has nowhere to go and so it collects underneath your skin. 

Certain injuries can also cause internal bruising, which can be more difficult to detect. These types of contusions are not always visible, and can even affect your organs and bones. 

If you feel pain and tenderness in an injured area of your body or find that you have a more limited range of motion, see your doctor as soon as possible.

Symptoms and signs of a bruise

Bruises are recognized by tenderness and the discoloration of your skin. Bruises are not accompanied by external bleeding unless the skin has broken open due to injury. They generally follow a specific healing pattern. 

In those with lighter skin, bruises typically start off a reddish color, followed by a bluish-purple color as they progress through the healing process. They then turn a greenish-yellow color before healing completely. 

In darker skin tones, bruises may appear purple, dark brown, or black, and uncharacteristically darker than the skin around them.

Causes of a bruises and contusions

Contusions are typically caused by an injury to the surface of the skin due to an accident such as a fall, impact, or athletic injury. 

Some people are more prone to bruising than others, and there are a few factors that may influence how easily a person bruises. 

  • Aging: As people age, they are likely to bruise more easily due to their capillaries becoming more fragile.
  • Illness: Certain diseases, such as cancer or liver disease, may impact how easily someone bruises.
  • Medicine: Certain medications, including aspirin and blood-thinning medications, may influence bruising. People may also be more prone to bruising if they regularly take nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Vitamin deficiency: People who have a lack of vitamins K or C may experience increased bruising.
  • Hemophilia: People with blood clotting disorders are more prone to bruising.

How to diagnose a bruise

Bruises can usually be identified by the discoloration of your skin and tenderness to the touch. If your bruise is severe and you suspect a further injury, consult your healthcare provider. 

Your doctor may diagnose your bruise as one of the following types based on its location, cause, and overall appearance:

  • Hematoma: A hematoma is what may come to mind when you picture an injury-related bruise. The bursting of capillaries underneath your skin causes blood to pool, and is typically accompanied by swelling and pain and a raised bump.
  • Purpura: This term refers to small bruising underneath the skin that may or may not be accompanied by pain when pressure is applied.
  • Senile purpura: This is bruising related to the thinning of the skin due to aging
  • Petechiae: This term refers to tiny bruises, about 2 mm in length, that look like pinpricks. They are generally purple, red, or brown in color and can vary depending on skin tone
  • Black eye: Bruising that occurs due to an injury around the eye, and displays as a darkened ring around the eye with swelling underneath the eye, is often labeled a black eye. Because a black eye can be accompanied by a more serious injury, it is advised to see a doctor if bruising is severe.

Treatment for a bruise

Though some can take longer, the majority of bruises will heal naturally within approximately two weeks. To reduce bruising and speed up the healing process, a cold compress can be applied after the injury. 

Elevation of the impacted area above the level of your heart is advised for serious bruising. This helps direct your blood flow toward your heart, reducing pooling in the injured area. An over-the-counter (OTC) pain reliever, such as acetaminophen, can be taken to reduce pain.  

If you seem to bruise easily, or for no detected reason, speak to your health care provider. This could be a symptom of an underlying health issue. 

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References
SOURCES:

Cleveland Clinic: "Bruises."

Medicine, science, and the law: "Assessment of bruise age on dark-skinned individuals using tristimulus colorimetry."

National Health Service: "What are bruises?"

TeensHealth: "Bruises."

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