Bruising occurs when small blood vessels under the skin break and blood collects in the surrounding tissue. The colour, location and any accompanying symptoms help suggest the cause. Below are practical explanations and guidance on when to seek medical assessment.
A bruise develops when capillaries or small veins are damaged, allowing blood to pool in the tissues under the skin. Early marks may appear red or dark purple; as the body breaks down the trapped blood, colours often shift through blue‑green to yellow. Mild tenderness, swelling or a local temperature change around the bruise can occur.
Direct trauma such as bumps or falls is the most common cause. Other contributors include thinner skin and fragile vessels with ageing, intense or repetitive physical activity, certain medications or supplements that increase bleeding tendency, bleeding or clotting disorders, and nutritional deficiencies (for example low vitamin C). Alcohol use and some chronic conditions also raise bruising risk. Recurrent or unexplained bruising warrants further evaluation.
Small bruises after a clear injury usually resolve without medical care. Seek prompt medical attention if bruising is unexplained and recurrent, if a bruise is very large or rapidly expanding, if there is severe or worsening pain, ongoing bleeding, fainting, shortness of breath, confusion, or high fever. These signs may require urgent assessment by emergency services. For non‑urgent concerns, start with your primary care clinician.
Primary care physicians handle most initial assessments and order tests if needed. Hematology specialists evaluate suspected clotting or platelet disorders. Dermatology is consulted for skin‑related causes, orthopedics or trauma services for injuries affecting deeper tissues, and infectious disease physicians if infection is suspected. Tests that may be requested include a complete blood count, platelet count and routine coagulation studies; imaging is used when deeper injury is suspected.
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