Bleeding Into the Skin

What is bleeding into the skin?

Bleeding into the skin is when one of your blood vessels bursts and leaks into the surrounding tissue. Your blood vessels are the tubes that carry blood throughout your body. Although bleeding into the skin may sound serious, it usually doesn’t cause severe symptoms. It often leads to a bruise that heals within several days or weeks.

What are the types of bleeding into the skin?

Bruises are the most common type of bleeding into the skin. They usually appear as red, blue, black or purple spots and may develop after an injury. Bruises can appear a few different ways:

• Petechiae (puh-TEE-kee-uh) occur when only a few small blood vessels burst. They look like tiny red dots smaller than 2 millimeters (mm), or about the width of a crayon tip.
• Purpura happens when several small blood vessels burst. It looks like a reddish-purple patch. Purpura spots are about 4 mm to 1 inch — about the width of a pencil eraser to the size of a quarter.
• Ecchymosis (ehk-ih-MO-sis) is when multiple blood vessels very close together burst, resulting in pooled blood just under your skin’s surface. Ecchymosis looks like a bruise, but it’s not always related to an injury.
• Hematomas occur when larger blood vessels burst, resulting in pooled blood. Most hematomas are minor. But if they develop in larger organs or body cavities, they can be severe and even life-threatening.

Who might get bleeding into the skin?

Anyone can get bruises or minor bleeding into the skin. Some people may be more likely to develop bruises, including people who:

• Are over the age of 65.
• Take blood-thinning medications (anticoagulants).
• Take supplements that increase bleeding risk, such as vitamin E.
• Have lighter skin tones.
• Play contact sports.

Some people have conditions that make them bruise or bleed more easily, such as:

• Hemophilia.
• Leukemia.
• Liver disease.
• Lupus.
• Marfan syndrome.
• Meningitis.
• Platelet disorders, including thrombocytopenia.
• Vitamin K deficiency.

What is the difference between bleeding into the skin and redness of the skin?

Bleeding into the skin may look like a reddish patch of skin. But if you have bleeding into the skin, the area won’t become lighter (blanch) when you apply pressure. In contrast, erythema, a type of skin rash causing redness, becomes paler when you press on the affected area.

What causes bleeding into the skin?

Injuries are the most common cause of bleeding into the skin. You may bump into an object, fall or get hit during a sport.

Other causes of bleeding into the skin include:

• Straining from crying, coughing or vomiting.
• Using crutches or wearing a cast.
• Wearing poorly fitted shoes, clothes or glasses.

What are the symptoms of bleeding into the skin?

Sometimes, the only symptom of bleeding into the skin is discoloration. You may have a patch of skin that looks red, black, blue or purple.

Sometimes, bruises may also be:

• Painful.
• Swollen.
• Tender to the touch.

How is bleeding into the skin diagnosed?

Usually, healthcare providers diagnose bleeding into the skin by physically examining the area. They may ask you:

• When you first noticed symptoms.
• Whether you have any other symptoms.
• What medications you use.
• If you can point to or describe the injury that caused the bruise.
• If you have a family history of severe bruising or conditions that cause bruising.

If your healthcare provider thinks you may have an underlying condition that causes bruising, they may order images or tests such as:

• Blood test.
• Bone marrow biopsy.
• Urine test.
• Ultrasound, CT scan or MRI (types of imaging scans).

What is treatment for bleeding into the skin?

Often, you can treat bleeding into the skin at home. For minor bruises, you can:

• Apply an ice pack to the area for 10 to 15 minutes at a time.
• Avoid direct heat to the area for about 48 hours.
• Elevate the injured area.
• Take ibuprofen (Advil®) or acetaminophen (Tylenol®) to reduce pain.

If bleeding into the skin doesn’t go away, your healthcare provider may try other treatments. They may prescribe medications or recommend that you stop taking certain medications. You may also need treatment to manage a condition that causes bleeding into the skin.

How can I prevent bleeding into the skin?

Usually, bleeding into the skin occurs after an impact injury. Ice and elevate the area immediately after an injury to lower the chances that a bruise will develop. If you play contact sports, always wear protective gear.

If you have a condition that leads to easy bruising, seek care from your healthcare provider. Ongoing treatment of chronic conditions can lower your risk of complications such as bleeding into the skin.

What is the outlook for bleeding into the skin?

Bleeding into the skin is usually minor and heals on its own within about two weeks. Occasionally, certain medications (like blood thinners) or chronic conditions can make you more likely to develop bleeding into the skin. Treating underlying conditions can lower your risk of bruising. Your healthcare provider may also recommend stopping the medications that cause bleeding. (But don’t stop taking any medications without consulting your healthcare provider.)

Is bleeding into the skin serious?

Bleeding into the skin is usually minor. If symptoms keep developing in the same area or don’t go away within two weeks, it could indicate a more serious condition.

When should I see my healthcare provider for bleeding into the skin?

If you’ve had bleeding into the skin for longer than two weeks, see your healthcare provider. You should see your provider sooner if you have bruises along with:

• Blood in your urine or stool.
• Bleeding gums.
• Fainting (syncope) or dizziness.
• Fever.
• Nausea or vomiting.
• Severe pain or swelling.

A note from Cleveland Clinic

Bleeding into the skin happens when small blood vessels burst just below your skin’s surface. These blood vessels leak into surrounding tissues. Your skin may appear red, purple, blue or black. Bleeding into the skin may cause only discoloration, or the spot may be swollen and tender to the touch. Usually, bleeding into the skin is minor and heals in about two weeks.