Bruise that won’t go away

A bruise, also known as a contusion, occurs when small blood vessels under the skin break due to injury, causing blood to leak into the surrounding tissues. This results in a visible skin discoloration that usually changes color over time — starting as red or purple, then fading to green, yellow, and eventually returning to normal skin tone. Most bruises heal within one to two weeks without complications.

However, a bruise that does not improve or disappear within this time frame can be a sign of an underlying issue. Persistent bruising may indicate problems with blood clotting, certain medical conditions, medication side effects, or nutrient deficiencies. Identifying the cause is important because it determines whether the bruise is harmless or requires medical evaluation.

While a single bruise that lingers longer than usual may not always be a cause for alarm, multiple unexplained bruises or bruises accompanied by other symptoms should not be ignored. Understanding the possible causes can help you decide when self-care is sufficient and when to seek professional advice.

Causes of a Bruise That Won’t Heal

When a bruise lingers longer than expected, it may be due to factors that affect healing or blood clotting. While minor trauma can cause a slow-healing bruise, other causes may be more serious and require medical attention.

1. Minor Trauma with Delayed Healing

In some cases, a bruise may simply be the result of an unnoticed bump or injury. Healing can take longer in older adults or those with reduced circulation, making the bruise appear persistent.

2. Nutritional Deficiencies

Lack of certain nutrients can slow the healing process:

• Vitamin C deficiency can weaken blood vessels, making them more prone to damage.
• Vitamin K deficiency can affect normal blood clotting, prolonging bruising.
• Iron deficiency can reduce oxygen delivery to tissues, delaying repair.

3. Medications

Some medications interfere with blood clotting and can cause bruises to last longer. Common examples include anticoagulants (such as warfarin or heparin), antiplatelet drugs (such as aspirin or clopidogrel), and corticosteroids.

4. Medical Conditions

Certain diseases can cause easy or prolonged bruising:

• Blood clotting disorders like hemophilia or von Willebrand disease.
• Platelet disorders such as thrombocytopenia.
• Liver disease which affects clotting factor production.
• Diabetes which slows wound and tissue healing.
• Blood cancers such as leukemia, which can cause spontaneous bruising.

5. Aging

With age, the skin becomes thinner and blood vessels more fragile. This makes bruising more common and healing slower, even after minor injuries.

Associated Symptoms

A bruise that does not heal on time may be accompanied by other symptoms, which can provide important clues about the underlying cause. Paying attention to these signs can help determine if medical attention is necessary.

Pain and Tenderness

Most bruises cause mild to moderate soreness that improves as healing progresses. Persistent or worsening pain could indicate an underlying injury, infection, or inflammation in the area.

Swelling

Bruises are often slightly swollen at first, but prolonged or increasing swelling may be a sign of deeper tissue injury or fluid accumulation.

Skin Color Changes

Normal bruises change color over time, fading from purple or blue to green, yellow, and finally skin tone. A bruise that remains dark or worsens in appearance without fading may need further investigation.

Firmness or Lump Formation

Some bruises can develop a firm lump called a hematoma, where blood collects under the skin. This can delay healing and sometimes requires medical drainage.

Spread of Discoloration

If the bruise spreads significantly beyond its original area, it could suggest ongoing bleeding under the skin or a clotting problem.

Systemic Symptoms

Fever, fatigue, unexplained weight loss, or frequent nosebleeds occurring alongside persistent bruising could indicate an underlying systemic condition that requires urgent evaluation.

Risk Factors

Certain factors can make a person more likely to develop bruises that heal slowly or persist for an unusually long time. Understanding these risk factors can help identify individuals who may need closer monitoring or medical evaluation.

Age

Older adults have thinner skin and more fragile blood vessels, which increases the likelihood of bruising from even minor bumps. Healing also tends to be slower with age.

Gender

Women often bruise more easily than men due to differences in skin structure and fat distribution. Hormonal changes, such as those occurring during menopause, can also contribute.

Medications

Blood thinners, antiplatelet drugs, corticosteroids, and certain herbal supplements like ginkgo biloba or fish oil can increase bleeding tendencies and prolong bruising.

Lifestyle Factors

Poor nutrition, lack of regular exercise, smoking, and excessive alcohol consumption can weaken blood vessels and slow tissue repair, making bruises last longer.

Chronic Health Conditions

People with liver disease, diabetes, blood clotting disorders, or cancer are at higher risk for prolonged bruising due to their effects on circulation, clotting, and tissue healing.

Treatment Options

The treatment for a bruise that won’t go away depends on its cause. While some bruises require only simple home care, others may need medical attention to address an underlying condition.

Home Care for Minor Cases

If the bruise is due to a minor injury and there are no concerning symptoms, simple measures can help speed up healing:

• Cold compress: Apply an ice pack wrapped in a cloth for 10–15 minutes at a time during the first 24–48 hours to reduce swelling and bleeding under the skin.
• Elevation: Keep the bruised area raised above heart level if possible to reduce blood flow and swelling.
• Rest: Avoid strenuous activity or pressure on the affected area until healing progresses.
• Warm compress: After 48 hours, applying gentle warmth can improve circulation and promote healing.

Diet and Supplements

Eating a nutrient-rich diet can support faster healing. Include foods high in vitamin C, vitamin K, and iron to strengthen blood vessels and aid tissue repair. In cases of confirmed deficiencies, supplements may be recommended by a healthcare professional.

Medical Treatments

If a persistent bruise is linked to an underlying medical condition, treatment will focus on the root cause:

• Medication adjustment: A doctor may review and modify blood-thinning medications if bruising is excessive.
• Treatment for clotting disorders: Special medications or clotting factor infusions may be required.
• Management of chronic conditions: Proper control of diabetes, liver disease, or other systemic illnesses can help prevent recurrent bruising.

When a Procedure May Be Needed

For large hematomas or lumps under the skin, a healthcare provider may need to drain the collected blood to relieve discomfort and speed healing.

Frequently Asked Questions

1. How long should a bruise normally last?

Most bruises heal within one to two weeks, gradually changing color from red or purple to green, yellow, and then fading back to normal skin tone. If a bruise lasts longer than two weeks without improvement, it may need medical evaluation.

2. Is it normal for a bruise to still hurt after several weeks?

Mild tenderness can persist for a short period, but if pain continues for several weeks or worsens, it could indicate deeper tissue damage, infection, or another underlying problem.

3. Can a bruise that won’t go away be cancer?

While most persistent bruises are not cancerous, certain blood cancers such as leukemia can cause unexplained or long-lasting bruising. Other symptoms like fatigue, frequent infections, or unexplained weight loss should be evaluated by a doctor immediately.

4. Which vitamin deficiency causes prolonged bruising?

Deficiencies in vitamin C, vitamin K, and sometimes iron can make bruises heal more slowly. These nutrients are important for healthy blood vessels, normal clotting, and tissue repair.

5. Can medications cause a bruise to last longer?

Yes. Blood thinners (warfarin, heparin), antiplatelet drugs (aspirin, clopidogrel), and corticosteroids can increase bleeding tendencies and make bruises last longer than normal.

6. Should I massage a bruise to help it heal?

It’s best to avoid massaging a fresh bruise, as it can cause more bleeding under the skin. After 48 hours, gentle massage around the bruise (not directly on it) may help improve circulation and healing.

7. When should I see a doctor for a bruise that won’t go away?

Seek medical advice if a bruise lasts more than two weeks, appears without injury, is unusually large, spreads quickly, or is accompanied by other symptoms such as fever, fatigue, or frequent bleeding.

8. Can ice help an old bruise heal faster?

Ice is most effective in the first 24–48 hours after an injury to reduce swelling and bleeding. For older bruises, warm compresses are generally more effective for improving blood flow and healing.

9. Is it dangerous if I bruise easily?

Occasional easy bruising is common, especially with age, but frequent or unexplained bruising may signal an underlying clotting problem or other medical condition and should be checked by a doctor.

10. Can a persistent bruise leave a permanent mark?

Most bruises heal without leaving marks, but severe or deep bruises may cause temporary skin staining due to iron deposits from the blood. In rare cases, discoloration can last for months.