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What is Ecchymosis?

Ecchymosis is a clinical manifestation characterized by reddish to bluish sometimes purple discoloration of the skin which results from the rupture of small capillaries beneath the integument and accumulation of blood in the surrounding tissues. It is commonly referred to as bruises or contusion and sometimes the term is interchangeably used with the word hematoma.

This condition starts with an injury; the initial response is the appearance of red patches in the injured site. Few days after, as the injury slowly heals, the color gradually changes its color from red to blue or purple skin discoloration then followed slowly changes to green, followed by yellow, which indicates full recovery from the injury. Then the spots will slowly change its color into brown or take on the skin color.

This condition may appear on the skin and mucous membranes. Patients experiencing this clinical manifestation may or may not feel pain on the affected area but about majority of those manifesting this symptom claimed to have experienced acute pain over the affected area.

Ecchymosis Symptoms

The condition does not really present a number of symptoms but in general the following are the most common symptoms observed from a person suffering from this condition:

  • Presence of reddish to bluish skin discoloration usually having the diameter of more than 1 inch in the site affected.
  • Pain may or may not be present, but in general, patients suffering from this perceive acute pain in the affected site.
  • Inflammation may be present depending upon the degree of tissue damage.
  • In patients with lung cancer, ecchymosis could be an indication of thrombocytopenia or decrease in platelet level.

Ecchymosis Causes

There are a number of medical conditions that may lead to the development of this clinical manifestation. From the simplest inflammatory response of the body to more complicated medical conditions such as cancer, this manifestation could be present. Usually this condition is caused by a blunt injury. After having an injury, there is a possibility for the capillaries behind the skin to rupture. Since it is an injury caused by a blunt object, there is no room for an incision to be created. Since there is no incision, the blood wouldn’t be able to go out from the skin thus it accumulates in the surrounding tissues. The accumulation of blood in the surrounding tissues causes the appearance of reddish skin discoloration of the affected site hours after the injury. After this event, the red blood cells will undergo phagocytosis through the macrophages. Other components of the blood, such as hemoglobin will undergo enzymatic conversion, converting it to bilirubin. This is the reason why the skin color on the affected site changes to bluish – red. The bilirubin will then be converted to hemosiderin, a golden-brown substance. This is associated to the changes of colors of the bruises.

Aside from the common inflammatory response of the body, ecchymosis could also be a result of the following:

Liver cirrhosis

This disease will lead to the formation o spots as the normal function of the liver is impaired thereby causing irregularities in the blood composition which would cause the formation of these spots.


The abnormal increase in white blood cells contributes to the formation of ecchymosis spots.

Acute renal failure

As the kidneys start to degenerate, accumulation of waste products in the blood progresses, this will cause some abnormalities which lead to the formation of ecchymosis spots.


Any malignancy found in the body are known to be causes of ecchymosis.

Multiple myeloma

This disease is characterized by abnormal growth of plasma cells in the bone marrow which progresses to blood abnormalities causing ecchymosis.


The disease may lead to anemia, thus causing ecchymosis.

Grey Turner’s Syndrome

Ecchymosis in this disease usually proceeds from acute pancreatitis which would then lead to death.

Ecchymosis Treatment

Treatment of the disease does not really require complicated medical management. It can actually be treated at home. Management of this medical condition could be easier than what you’ve expected.


Rest helps the injured area be cured fast. When you rest, you are promoting increased tissue rep[air thus repairing the tissue trauma which would also lead to the treatment of the disease.

Ice application

Using a towel, cover the ice and apply it to the affected site. This will allow vasoconstriction which will constrict the ruptured blood vessels thus preventing it from causing further hematoma.

Elevation of the affected site

Elevation of the affected site promotes proper venous return thereby inhibiting inflammation. This also improves the circulation of the affected site thus there will be increased in tissue repair.

Pain killers

For those who experiences pain during the event of manifesting this symptom, pain killers such as ibuprophen and other analgesics may be taken. This will reduce the pain felt by the patient and thus increase his or her comfort.

Heat application

This promotes vasodilatation and thus increases the circulation. Increased circulation will contribute to improved tissue perfusion which will lead to better healing mechanisms of the body.

Ecchymosis Pictures

ecchymosis picturesEcchymosis Pictures

source : beltina. org


ecchymosis picturesEcchymosis Photos

source : indianpediatrics .net


ecchymosis picturesEcchymosis Images

source : cheneyhs. org



  1. This was a very informative article. I was hospitalized for 5 days with acute pain of both lower legs due to a car accident (i.e. second air bags deployed into my legs on my mini van). The pain and burning feeling has been unbearable. The ER doctor diagnosed me with acute bilateral cellulitis. However, after three days of IV treatment with Vancomyacin, the unit doctor changed my diagnosis to traumatic ecchymosis of the lower legs. I am afraid to go off the vancomyacin, but I don’t have a choice because I was discharged today. For home, I was given Narco (for pain), and told to elevate my legs and put intermittent warm compresses on them and rest. Does this seem correct? I would appreciate all responses! Thank you in advance.

  2. thank you it helped me do much.. :*

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