The colors of a bruise can vary, depending on the person’s skin tone, and bruising may be less apparent on dark skin due to contrast. It may initially appear red or purple, then change color over time.
Bruises appear due to damaged blood vessels under the skin. The most common cause is simple traumas to the skin, such as bumping into something or falling down. Medical conditions and some medications can also cause bruising to happen more easily.
Bruises can be harder to identify on skin that contains a lot of melanin, which is the pigment in cells that gives skin its color. Although very dark pigmentation in the skin may make the visual signs of a bruise less obvious, other signs will still be there.
Most bruises heal on their own and do not require treatment, though in some very severe cases, a person may need to see a doctor.
What do bruises look like on dark skin?
On all skin tones, bruises appear as areas of skin that are darker than the surrounding skin. A bruise develops similarly in dark skin tones as it does in lighter skin tones, though it may appear more pronounced on light skin tones due to greater contrast.
When it first arises, a bruise may appear red to purple. Over time, it can turn blue, then brown, green, or yellow. A bump under the skin may accompany a bruise as well.
In very dark skin, the initial impact may not cause a noticeable reddening in the skin. Depending on the person’s skin tone, the skin may appear dark brown or black in the area as the bruise forms. They may also notice a bump.
Causes of bruising
Bruises occur when the small blood vessels beneath the skin experience trauma. This typically occurs when someone experiences a sort of blunt impact.
Examples include:
- bumping into a wall or object
- dropping something heavy onto the skin
- smashing a fingernail
- being hit with a fist or blunt object
- falling down
Other causes of bruising may include more serious issues and chronic conditions, such as:
- von Willebrand disease
- thrombocytopenia
- leukemia
- surgeries, including cosmetic surgeries
- sports injuries
- car accidents
- sprained wrists or ankles
- broken bones
- torn or strained muscles
- hemophilia
- clotting factor deficiencies
Some people may bruise more easily than others. For instance, females tend to bruise more easily than males. Additionally, older adults may bruise more easilyTrusted Source than younger adults, as skin thins with age.
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Treatment and home care
Most bruises will heal over time without treatment. There may be some ways to slightly speed up the healing process or reduce pain and swelling.
These include:
- applying an ice pack to the bruise 2-3 times a day for the first 48 hours, then switch to heat
- wrapping the affected area with an elastic sports wrap
- raising the injured area if a bruise is on the arm or leg
- taking over-the-counter (OTC) painkillers, such as acetaminophen (Tylenol), to dull any pain
When to see a doctor
Overall, bruises are usually not a cause for undue concern. They may feel tender or sore, but they are often a surface injury that will heal with time.
That said, anyone who notices a bruise that does not change color or feeling after a few days should contact a doctor to see if they need any medical treatment.
Severe bruising may also cause other issues that might require treatment. Signs that a person may need medical treatment include:
- numbness in the area
- loss of function in a nearby joint or muscle
- vision impairment
- a bruise that keeps growing
- a bruise lasting longer than 2 weeks
- a bruise near a fractured or sprained bone
- a bruise in the abdomen with no known cause
The diagnostic and treatment process for people with dark skin who have major bruises is also the same.
It’s important to note that in medical settings, bruises are typically identified using natural or white light. However, these methods can often make it difficult to detect trauma on dark skin tones, particularly the age of a bruise.
Despite these considerations, there are ways to analyze the bruise, even in very dark skin where it is not easy to see, such as noting where the skin may feel tender or painful.
For instance, as a 2020 study notes, using alternative light-source technology can help doctors assess skin issues they cannot normally see in dark skin tones.
Summary
Bruising may be more difficult to see on very dark skin, but the overall process of bruising on dark skin is very much the same as other skin types.
Even if the person cannot see the bruise, there are still some signs to look out for, such as if the area is tender to the touch. Most bruises will heal on their own, and there are ways to care for the tender skin during healing.
Anyone experiencing major bruises or signs of other issues, such as a hematoma, should speak with a doctor.