Bleeding into the skin

Considerations:
Aside from the common bruise, bleeding into the skin or mucus membranes is a very significant sign and should always be evaluated. Bleeding that consists of pinpoint dots of blood is called petechiae. Larger areas of bleeding up to approximately a centimeter in diameter are called purpura , while a very large area is called an ecchymosis.

Redness of the skin ( erythema ) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not blanch (become pale ) with pressure, while the redness of erythema decreases and then returns when pressure is applied and released.

Common Causes:

Note: There may be other causes of bleeding into the skin. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bleeding into the skin, occurring alone or in combination with other problems.

Home Care:
Bruises (or purpuric lesions) are not permanent and will fade if the underlying cause can be treated successfully.

For a hematoma, apply pressure and cold compresses initially to help reduce bleeding and swelling . After the first day, apply hot compresses to help speed the absorption of blood.

For aging skin, protection of skin is recommended. Avoid trauma (such as bumping or pulling on skin areas).

For a cut or scrape, use direct pressure to stop the bleeding.

For a drug reaction, identify and consult the health care provider about discontinuing the drug.

Otherwise, follow prescribed therapy to treat the underlying cause.

Call Your Healthcare Provider If:

  • there is sudden bleeding into the skin for no apparent reason.
  • if there is persistent, unexplained bruising.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting bleeding into the skin in detail may include:

  • quality
    • Is the area flat?
    • Is the area raised or swollen?

  • location

  • aggravating factors
    • Has there been a recent injury or accident?
    • Have you been ill lately?
    • Have you had radiation therapy ?
    • Have you had chemotherapy ?
    • What other medical treatments have you had?

  • medications
    • Do you take aspirin more than once a week?
    • Do you take Coumadin, heparin, or other "blood thinners" (anticoagulants)?

  • time pattern
    • Did it begin recently?
    • Has it occurred repeatedly (recurrent)?
    • Has a tendency to bleed into the skin been present lifelong?
      • Did it start in infancy (for example, with circumcision)?
      • Did it start with surgery or a tooth extraction?

    • Has it occurred for the past several months? How many?

  • associated conditions
    • What other symptoms are also present?

Diagnostic tests that may be performed include:

After seeing your health care provider:
You may want to add a diagnosis related to bleeding into the skin to your personal medical record.


Signs of child abuse may include multiple bruises. This child has bruises on the back and legs, a handprint, and strap marks.



This child shows signs of child abuse. There are multiple bruises, including a handprint and strap marks. Although not visible here, the child also had two black eyes.



This child has two black eyes and multiple bruises over his body following child abuse.



A black eye is caused by bleeding into the tissue around the eye. This most often follows trauma. The medical term for this type of bruising is ecchymosis.



This is a common appearance of severe bruises. The initial injury was high, but the blood pigments have migrated through the tissues down to the heel.