There’s more to a bruise than meets the eye. Beneath the skin, your body is doing its best to repair injuries that can’t be seen on the surface. In this article, you’ll learn the exact process by which a bruise forms, then heals; which types of bruises are common and which are a cause for concern; why some are more prone to bruising than others; and finally, some tips for effective first aid when that bruise first appears.

What is a bruise? Bruises can happen after all sorts of injuries, large or small – from a bicycle accident or an intense soccer match to tripping over a coffee table. Also called a contusion or ecchymosis , a bruise results from an injury that tears or ruptures blood vessels beneath the skin but doesn’t break the skin. Blood then seeps out from the capillaries and collects near the area of the injury, becoming trapped just underneath the skin’s surface. This rush of blood to the injured area is part of the body’s natural healing process, but it also causes the inflammation and discoloration associated with bruising.

Types of bruises. In addition to skin bruising, bruises can occur in muscles and bones. There are three distinctive types of bruises, relating to the extent of the injury:

• Subcutaneous bruise: A skin bruise is the most common type of bruise and usually not a reason for concern.

• Intramuscular bruise: This type of bruise occurs when trauma causes blood to pool within the muscle. A muscular bruise may temporarily affect your ability to move the muscle.

• Periosteal bruise: This type of bruise is the most serious and refers to a bruise that develops on the outermost layer of a bone.

First aid. All types of bruises can be painful, so take care of the inflammation as soon as possible after the injury. Here’s how:

• First, apply a cold compress to the area and elevate if possible. Although the cold won’t help the skin discoloration, it will reduce pain, inflammation and blood flow to the area to speed healing. Ice packs like Cryopak Flexible Ice Blanket are a good choice, as they stay cold longer than ice cubes. You can also use a bag of ice wrapped in a towel or a bag of frozen vegetables. Never apply ice directly to the skin, or you could cause frostbite.

• Apply the ice directly to the injury for 15 minutes per hour. Repeat this several times throughout the day for a few days following the injury.

• Keep an eye on large injuries to the foot or leg for the first 24 hours; elevate the leg as much as possible. According to Shape magazine, because blood flows from the heart, elevating the body part will slow blood flow, minimizing blood leakage around the wound.

• To reduce pain, an over-the-counter pain medication should be sufficient; consult a doctor if your pain is more severe. But don’t take aspirin – it’ll prevent the blood from clotting properly.

• After a couple of days, eMedicine suggests using a warm washcloth to bring blood flow back to the area. Just apply for 10 minutes at a time, two to three times a day, to help fade the color.

What is normal? Every person’s body is different, and some people bruise frequently, while others rarely bruise. Bruising occurs more frequently in certain groups:

• Athletes or weight-lifters. Vigorous exercise can lead to tiny tears in the blood vessels that lie under the skin’s surface.

• The elderly. Older people bruise more easily because their blood vessels are more fragile, and their skin is thinner, with less cushioning.

• Those who take certain medications. For example, if you’re taking the prescription drug warfarin (Coumadin), which is used to prevent blood clotting, spontaneous bruising is common. Some over-the-counter drugs can also cause spontaneous bruising, including pain medications like ibuprofen, naproxen and even aspirin. Even certain herbs thin the blood and increase bruising – such as ginkgo biloba and Saint John’s Wort.

• Family matters. Sometimes, for no particular reason, certain people find that they – and other members in their family – just bruise more easily than others.

• Women. Women bruise more easily than men, especially on the thighs and upper arms.

• Blood type. People with type-O blood are most likely to bruise, while those with type-A are least likely.

Vitamin K and topical treatments. Vitamin K has a very important function in your body; it plays an essential role in the formation of blood clots. Deficiencies in this vitamin are quite rare, but if a deficiency is responsible for your frequent bruising, a supplement could help.

Chances are you’ve seen a variety of topical treatments on the market that are designed to help fade bruises a little faster – most of them utilizing vitamin K. While the jury is still out, there’s promising research that shows that these topical creams could be helpful in speeding recovery time, such as after cosmetic surgery. Arnica, an herbal extract, is also widely used in creams and oral supplements designed to relieve symptoms of bruising, as well as a variety of other herbal extracts.

Product picks:

• Hyland's Bumps 'n Bruises with Arnica Ointment.This travel-ready ointment contains Arnica Montana to help with symptoms of bruising and swelling.

• Auriderm Post Op Gel. Formulated with vitamin K oxide, this product can speed up recovery time after surgery by helping the body reabsorb blood more quickly.

• Neova Dermacirculation Formula. Apply this topical ointment to lessen the effects of bruises by improving circulation and reducing irritation.

Unexplained bruising. Sometimes a bruise seems to appear without an actual injury. The simple answer is that people can bump into things that don’t cause a lot of pain and will later forget that there was an injury at all. But certain types of bruises that occur without injury could be a cause for concern. Idiopathic bruising (or bruising without an apparent cause) can sometimes be a sign of a serious underlying bleeding condition.

Reasons to seek medical care

• If you have unexplained bruising as well as nosebleeds or bleeding gums, you could have a bleeding disorder.

• If you notice extreme discomfort, swelling and pain, especially if you’re also taking a blood-thinning medication.

• Bruises in sensitive spots such as under a toenail or fingernail.

• If you experience additional symptoms – like possible broken bones or sprains.

• Head injuries should be taken seriously, even if the bruise itself doesn’t look like a cause for concern. A bump on the head could easily be accompanied by a concussion.

• Unexplained bruising could also be a sign of domestic violence. Children with frequent bruising should be seen by a professional as soon as possible.

Most bruises, no matter how unsightly, shouldn’t be a cause for alarm; typically, they’ll heal in about two to three weeks. If your bruise doesn’t clear after a month, see a doctor to find out what’s going on.

See also:

Your Questions Answered on How to Hide and Fade Scars

5 Pesky Skincare Problems Solved

Dermatitis: Decoding Irritated Skin

Treating and Preventing Athlete’s Foot

5 Skin-Soothing Ingredients