A hematoma is a collection of blood outside of a blood vessel. Hematomas can occur almost anywhere in the body and the appearance can vary depending on the location and severity. When a hematoma first occurs, it will be reddish-blue in color from the trapped blood. As the hematoma progresses, it often changes color as it resolves. Here is an overview of what a hematoma may look like when it initially occurs and as it heals.
Appearance of New Hematoma
When a hematoma first develops, it will have a bluish-purple or reddish color from the trapped blood. The size and shape can vary greatly based on the amount of bleeding and location on the body. Here are some details on the appearance of a new hematoma in different areas:
- Scalp – A scalp hematoma may create a visible bump or swollen area on the head. There may be noticeable bruising around the swelling or bump.
- Face – Facial hematomas often cause significant bruising and swelling. The eyes and lips may appear puffy and bruised.
- Arms/legs – Hematomas on the arms or legs tend to be more diffuse, causing a larger bruised area rather than a distinct lump or bump.
- Torso – Torso hematomas can be small or large depending on the source of bleeding. They may appear as a distinct discolored lump under the skin.
- Vaginal/rectal – Vaginal or rectal hematomas generally are not visible but may cause pain and discomfort.
In general, the bluish-reddish discoloration from a new hematoma is firmer than a regular bruise. The skin over the hematoma also may be tender to the touch. The appearance can range from a barely visible reddish patch to a large raised lump depending on the severity.
Changes as Hematoma Starts Healing
As your body gradually reabsorbs the collected blood over days to weeks, the appearance of the hematoma will change. Here are some of the common color variations:
- Purple – As the hematoma starts to resolve, the color often turns more purple as the blood breaks down.
- Green – Greenish hues emerge as the hemoglobin from the trapped blood further breaks down.
- Yellow – Over time the hematoma turns yellowish as your body continues absorbing the blood components.
- Brown – Finally, the area turns brown and gradually fades back to your normal skin color.
In addition to the color changes, the size, shape, and texture of the hematoma will also evolve as it heals:
- Decreasing size – The hematoma will gradually shrink in size as the blood is reabsorbed.
- Fading borders – The edges will become less defined and fade into your normal skin.
- Softening – The firm, swollen area will soften and flatten out over time.
Time Frame for Healing
The timeline for a hematoma to fully heal can vary significantly depending on:
- Cause – Traumatic injury versus minor cause
- Location – Scalp hematomas may take longer than arm
- Bleeding amount – Larger bleeds persist longer
- Age/health – Younger, healthier people may heal faster
On average, here is the general time frame for hematoma healing:
| Phase | Time Frame |
|---|---|
| Color changes to purple/greenish | 3-7 days |
| Yellowing of hematoma | 1-2 weeks |
| Brownish fading of bruise | 2-4 weeks |
| Complete resolution | 4 weeks or longer |
However, some hematomas may persist for several months, especially if they are large or in areas with poor circulation. See your doctor if the hematoma does not continue to improve or gets worse.
Signs of Infection
While most hematomas will gradually reabsorb on their own, there is a risk of infection in some cases. Seek prompt medical care if you notice any of these signs of infected hematoma:
- Increasing pain or swelling
- Redness spreading from the area
- Pus or foul-smelling drainage
- Fever or flu-like symptoms
An infected hematoma may need to be drained and treated with antibiotics. Leaving an infection untreated can cause serious complications.
When to See Your Doctor
Most minor hematomas heal well on their own with first aid and time. However, it is important to consult your doctor if you experience:
- Very large hematoma or multiple hematomas
- Facial/eye hematoma causing difficulty seeing
- Associated numbness, tingling, or loss of function
- Bleeding disorder or use blood thinners
- Hematoma develops without known cause
More serious causes of bleeding like a ruptured blood vessel may need treatment. Your doctor can check for hidden internal bleeding and monitor large hematomas at risk of complications.
First Aid Guidelines
For a minor hematoma, you can follow these at-home first aid tips:
- Rest – Avoid activities that use the injured area to let it heal.
- Ice – Apply ice packs to help reduce swelling and ease pain.
- Compress – Wrap the area with an elastic bandage to prevent rebleeding.
- Elevate – Keep the injured limb raised above heart level to reduce swelling.
Over-the-counter pain medicine like acetaminophen or ibuprofen can also help manage discomfort. Avoid taking aspirin, which may increase bleeding risk.
Outlook and Prevention
In most cases, hematomas are not a major concern and will disappear on their own as your body reabsorbs the collected blood. However, severe or recurrent hematomas may require medical treatment. You can help prevent hematomas by:
- Treating underlying bleeding disorders
- Avoiding blood thinning medications when possible
- Wearing protective gear during sports or risky work
- Being cautious to prevent falls or trauma, especially if taking blood thinners
Seeking prompt care for even minor head injuries may also help avoid larger hematomas. If you develop unexplained bruising or hematomas, discuss it with your doctor to identify any underlying conditions that need treatment.
Conclusion
A hematoma refers to a collection of blood trapped outside of a blood vessel, usually due to injury or trauma. The appearance of a new hematoma depends on the location but often looks like a reddish-purple bump or bruise. As the body reabsorbs the blood over days to weeks, the hematoma changes color to purple, green, yellow and finally brown before resolving. Most resolve without complications, but some may require medical treatment. Seeking care for concerning symptoms or signs of infection is important. With proper first aid and follow-up, hematomas generally heal well.