What do the colours of a bruise mean?

Bruises change colour and you can often estimate the age from the colour. The body breaks down the blood cells as part of the natural healing process, but should fade completely within 2 weeks. Typical colours are:

• Red - Bruises often begin as a red mark on the skin because fresh, oxygen-rich blood has pooled under the skin.
• Blue, purple or black - After 1-2 days the blood that has leaked out begins to lose oxygen and change color. Depending on the size, location and severity of your bruise, it could appear shades of blue, purple or black.
• Yellow or green - Between 5-10 days after the initial trauma your bruise will begin to turn a yellow or green shade as the body breaks down hemoglobin (blood).
• Yellowish-brown or light brown - This is the final stage of bruising and typically occurs between 10-14 days after the initial trauma.

What’s the difference between bruises, contusions and haematoma’s?

Bruises are also known as contusions and happen when blood leaks into the top layers of skin (Ecchymosis). A haemotoma occurs when clotted blood forms a lump under your skin which is swollen, raised and painful - an ‘egg’ on your head following a bump is a good example. Haematomas are more serious, can develop quickly, and you should be wary of haematomas on the head, face and abdomen.

• Head - hematomas may cause headaches, vomiting, nausea, and in severe cases, slurred speech and confusion. 
• Face - Septal hematomas make the nose and area under the eyes swell and bruise. They can also cause nosebleeds or clear fluid draining from the nose.
• Abdomen - Abdominal hematomas may not initially cause any symptoms but can lead to swelling, tenderness and pain. They can also be a sign of internal organ damage.

How to treat bruises

Mild to moderate bruises typically heal after 2 weeks, though some may heal more quickly. There are a few treatments that you can try to encourage the healing process and reduce pain.

• Over the counter pain relief
  Paracetamol is a ‘wonder drug’ and should be the first line of defence in tackling mild to moderate pain following an injury. It’s much underused but we recommend it, taken according to the instructions, for bruising. Anti inflammatory drugs such as ibuprofen are not recommended in the first 48 hours after an injury as evidence shows they can slow down the inflammatory process which is a vital part of healing. 
• Cold compress
  Icing the affected area can help a bruise to heal more quickly. Wrap the ice pack (frozen peas will do!) in a clean, dry cloth and place over the bruise. Cold slows the bleeding by constricting blood vessels and reducing inflammation, which can help reduce the size of the bruise too.
• Topical creams
  Over-the-counter topical healing creams like arnica, quercetin, vitamin B3, or vitamin K offer anti-inflammatory benefits to help speed up healing times providing the skin isn’t broken. Take advice on what would be best for you, or what to carry if you’re planning a longer voyage.
• Compression
  A soft elastic wrap for the first 1-2 days, during waking hours, can help decrease pain and bruising. The wrap should be firm, but not too tight. If you notice any numbness, tingling or increased discomfort, loosen or remove the wrap.
• Elevation
  Elevating the bruised area comfortably, above heart level, can offer similar healing benefits to a cold compress. It helps slow the bleeding and may reduce the size of the bruising.

When to get a bruise checked

As we’ve mentioned, bruising is normally superficial and disappears after 2 weeks, but if it’s due to a more significant trauma or injury, or lingering after 2 weeks, you’ll need to seek advice. So, ask for help if

• You think a sprain or broken bone may have caused the bruise.
• The cause was trauma to the head or neck.
• It keeps getting bigger after the first day.
• It makes your arm or leg numb, tingly, swollen or tight.
• It lasts for more than a couple of weeks or shows up again for no reason.
• It’s around your eye and you have a hard time seeing or looking in different directions.
• You got it from hitting your head, trunk, or belly. 
• A lump develops under the bruise.
• The pain lasts longer than 2-3 days.
• The bruising is unexplained or random, especially in the abdomen, chest or head as it may indicate an internal injury.

Increased risk of bruising

There are a number of factors that can increase your risk of bruising and as always we’d recommend having a list of crew medical conditions and medications they take available for emergencies. 

• People taking prescription blood thinners (anti-coagulants).
• 50 years or older - thinner skin means there’s no ‘cushion’ of fatty tissue to protect you.
• Known bleeding disorders such as liver disease, Vitamin K deficiency or a genetic disorder.
• Blood vessel defects.
• Platelet disorders.
• Kidney disease.
• Leukaemia.
• Malnutrition.
• Haemophilia A or B.
• Cushings Syndrome. 

If the bruise looks like tiny dark red/purple spots or patches (large - pupura, small - petechiae), seek medical advice straight away, especially if the casualty appears unwell. 

How to prevent bruises

Well, you could always stay wrapped up in cotton wool? 

Or, just think about the most likely situations onboard when bumps and therefore bruises might occur. Remove trip hazards, keep lines tidy, be aware of the boom and use correct tacking/jibing commands to communicate what’s happening. Use a torch or head torch (hands free!) at night. Keep two points of contact at all times when moving around in rough seas. Communicate with each other. Wear appropriate clothing and footwear. Plan your actions before moving, especially on deck. 

Of course, if you’d like to know more about staying safe at sea and how to treat minor injuries, give us a call to chat about our specialist onboard training for commercial, cruise, superyacht, leisure sailors and powerboaters. You never know when you might need medical skills and we can help to make sure you’re prepared for any eventuality.