What is Ecchymosis & How Long Does It Last?

Ecchymosis is the discoloration of the skin caused by extravasation of blood due to the rupture of the underlying vascular capillaries that leads to collection of blood outside the cells. It is a subcutaneous spot with diffused borders measuring approximately more than 10 mm in diameter and is differentiated from the hematoma and bruises by its non-raised appearance. It is also mistaken as Purpura and Petechiae discoloration that are lesser in diameter. It is also known as bleeding under the skin.

It can occur in submucosa, organs, connective tissues, bones, joints and muscles.

Ecchymosis is more seen to occur in children and elderly population as their skin are thin and blood capillaries become fragile and more prone to rupture. However, Ecchymosis can affect in any generation of people.

Also, it is seen more often in area that are prone to injuries like knees, legs and arms that quite often bump over walls or furniture. Also, it is seen in areas where the skin is thin such as eyelids, umbilical cord area, and mucus membranes of oral cavity and over lips.

• Ecchymosis may be caused by a surgical injury
• Pathophysiological function of cells
• Medical conditions like end stage kidney disorder, acute renal failure, dengue fever, endocarditis, Systemic lupus erythematosus, vasculitis, liver disorder can also cause Ecchymosis.
• Bleeding disorders like hemophilia A that presents with defect in blood clotting, aplastic anemia
• Sudden trauma causing blunt injury due to falling, bumping into furniture or any hard objects causing excessive pressure on any body parts
• Accidents leading to bone fracture can also be a cause of Ecchymosis.
• Use of anticoagulants such as Aspirin and warfarin
• Use of steroid medication Betamethasone
• Varicose veins can cause ecchymosis. In case of varicose veins, the blood flows in the wrong direction due to faulty vein valves altering the direction of the blood causing it to pool and thus leading to ecchymosis. This may be associated with swollen ankles and spider veins.
• Decreased platelet counts
• Leukemia.

• Ecchymosis presents as a flat, patchy skin discoloration which is bluish purple in appearance. As the tissue healing advances, the patch turns blackish blue to yellow or greenish color.
• Ecchymosis discoloration following a trauma or hematoma is more swollen due to collection of blood in the form of sacs in the interstitial tissue spaces.
• Occasional pain in the affected area
• Inflammation of affected area and skin tenderness
• Pus formation in severe cases associated with fever and chills.

Ecchymosis generally heals within 2-3 weeks. It does not require any treatment if ecchymosis has occurred due to bumping. However, if the injury that has caused ecchymosis is a broken bone, it might take longer to heal.

Ecchymosis can be well managed if the cause is determined to help prepare a treatment plan. The ways to help it heal include:

• Complete rest to the body is recommended.
• Cold fermentation helps in constriction of the blood vessels preventing the oozing of blood in extravascular spaces.
• Ecchymosis due to fracture is managed by using cast to immobilize the fractured bone.
• Medication such as anti-inflammatory drugs namely Ibuprofen can be used to treat Ecchymosis.
• In severe cases, diagnostic tests such as X-Ray and MRI can be performed. Blood test to check the platelets and clotting factors are also recommended by physicians depending on the underlying condition.
• Vitamins supplements are beneficial to help improve the healing of the condition. It is advised to take Vitamin C and K rich diet as well as green leafy vegetables.
• Ecchymosis Patients should report to the doctors in time if the symptoms persists more than a normal course.