A bruise is dark discolouration of skin caused by blood seeping under the skin after small blood vessels near the surface of the skin have been broken. As the bruise heals, the body breaks this blood down and reabsorbs it, turning the mark a typical greenish-blue.

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Bruises are usually caused by bumping into hard objects, falling off something or being hit with a blunt object. This is particularly common in younger children who are learning to walk. In young children, the skin is thinner and the bruise is more obvious.

Diagnosis/signs

• Pain
• Tenderness
• Change in colour of the skin (red, purple of black)
• Swelling

Get help immediately if:
You get a bruise as a result of an injury to the lower back, and blood is present in the urine. This could indicate injury to the kidneys or other organs.

Home treatment
Most bruises are relatively minor and will get better on their own over a period of about ten days. If the bruise is quite large and swollen, then you can apply ice packs to reduce the swelling, which will also relieve the pain. Make an ice-pack by wrapping ice or frozen peas in a damp cloth. Don’t put it directly on the skin as this could cause damage. Put the ice-pack on for 10-20 minutes every two hours for the first 24 hours and every four hours for a further 24 hours.

Elevating the area, if the bruise is on a leg or an arm, will also reduce swelling. A painkiller such as paracetamol can be used if the bruise is in a particularly painful position.

Call your doctor if:

• the bruise is the result of a serious fall from a tricycle, bicycle or any other traumatic accident (a jungle gym tumble, for example). Your doctor may want to examine you for less obvious injuries.
• you banged your head and have a bruise behind the ear; it may be a sign of a skull fracture.
• have a bruise that doesn't fade in 14 days.
• are in pain for more than 24 hours or if pain on the site of the bruise gets worse; this may be caused by a broken bone.
• have a bruise on a large joint (knee, ankle, elbow, wrist) and are reluctant to use the joint or have difficulty moving an arm or leg.
• have a cut or abrasion and show signs of infection, such as pus, unexplained fever, or increased pain and swelling.

Finally, unexplained black-and-blue spots may indicate haemophilia or leukaemia. If you develop bruises that aren't associated with injuries, make an appointment to see your doctor as soon as possible.

Prevention
Don’t purchase furniture with sharp edges. Don’t allow young children to play on hazardous equipment. Ensure that your child wears protective clothing when cycling, rollerblading or skateboarding. Don’t have loose rugs in your home or allow objects such as toys to lie around.

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