How to remove dried blood from under the skin

Bruise (hematoma)

The medical term for bruise is hematoma. It comes from the Greek "haima" for blood and "tome" for cut or cut. A bruise occurs when a blood vessel ruptures and blood leaks into the surrounding tissue. Most often this happens through external force. If a vessel under the surface of the skin is affected, the bruise appears as a bruise. Due to the various stages of blood breakdown, this first turns brownish, then yellowish. If deeper vessels are also injured, this is visible as swelling. When blood leaks into the tissue, this triggers a feeling of pressure which is sometimes painful.

Bruises rarely indicate more serious illnesses. As a rule, they are harmless and go away on their own after a few days to weeks. However, very large bruises can limit the mobility of muscles and joints. Depending on the location, some bruises can be dangerous:

  • close to the eyes
  • in anatomical structures (subdural hematoma, epidural hematoma).
  • in boxes (compartment syndrome)


A bruise occurs when a blood vessel bursts, blood leaks out and spreads through tissue (usually under the skin). The vascular injury can be due to the following causes:

  • Blunt violence from outside such as falls, kicks, blows or bruises can lead to the bursting of vessels.
  • As a rule, bruises are harmless, but they can indicate diseases that are associated with an increased tendency to bleed, such as hemophilia (Hemophilia) or von Willebrand factor deficiency; if you have haemophilia, bruises develop quickly and for no apparent reason.
  • Women tend by one weaker connective tissue and thus less protection of the blood vessels to bruises faster than men, even with minor injuries.
  • Older people have less subcutaneous fat and often more porous blood vessels than young people, so they are at greater risk of bruising.
  • The taking of Medicines to thin the blood such as acetylsalicylic acid or phenprocoumon (for example Marcumar®, Falithrom®) can increase the tendency to bleed and bruise even after minor injuries.
  • By taking cortisone-containing drugs the skin becomes thinner, which increases the risk of vascular damage and bruising.
  • A bruise can occur after an operation because blood vessels are injured. Larger bruises that do not resolve on their own must be surgically removed by removing the hematoma.


Immediately after the injury, the force of violence initially leads to varying degrees of pain in the area of ​​the injured area. Often it is pain from pressure. The skin is usually uninjured. Vessels located under the skin burst, blood escapes and is distributed in the tissue. At the beginning, the blood pigment hemoglobin shimmers reddish through the uninjured skin, which is visible as a bruise. As a rule, it is broken down by the body in about two to three weeks, changing its color several times:

  • There is a no later than four days after the injury The bruise turns bluebecause the blood coagulates in the tissue (separation of oxygen from hemoglobin)
  • further degradation to the bile pigment verdoglobin with brownish-black color
  • after a further four to five days breakdown to biliverdin, the The spot becomes greenish
  • now the bruise is slowly fading and becoming yellowish through the breakdown product bilirubin until it is no longer visible

Deep bruises are the first to appear Swelling noticeable and may only lead to a bruise later. It can be dangerous, especially in the arms or legs Compartment syndrome come, in which a high pressure builds up in the area of ​​muscles and damages the tissue. The signs are pain and hardened areas that develop within a short period of time.


The diagnosis of bruising is usually based on the description of the accident and the typical symptoms. If an underlying disease with a tendency to bleed is suspected, further examinations such as blood tests are necessary. If bone injuries, organ damage or joint injuries cannot be ruled out as a result of an accident, further examinations such as x-rays or ultrasound images follow.

When to the doctor

Bruises are usually harmless and go away on their own in two to three weeks. Reasons to see a doctor are:

  • often bruises even with minor injuries
  • Bruising that occurs for no apparent reason
  • if the bruise is not under the skin, but deep in the muscles
  • painful bruises that harden
  • Bruising around the eyes or genitals, or near joints
  • Bruising that has not resolved after two months
  • suspected joint injury or broken bone, restricted mobility of the affected part of the body
  • If signs of shock such as clouding of consciousness, weak pulse, or shallow, rapid breathing occur, an emergency doctor should be called. Signs of shock can indicate a larger bruise.


The following measures will help relieve the symptoms and discomfort caused by the bruised injury:

  • Elevating the injured part of the body: This makes the blood flow easier and the swelling goes down faster.
  • Cooling the injury: causes blood vessels to contract and less blood to leak out. This will reduce the extent of the bruise. When using cooling pads from the freezer, make sure that you place a kitchen towel or something similar underneath to prevent the skin from freezing.
  • Applying a compression bandage: this puts pressure on the injury, which can reduce swelling and bleeding.
  • Resting the affected part of the body: Exercise increases blood flow, which makes the bruise worse.
  • Rest for a few days: Too early stress on the affected part of the body can lead to renewed vascular damage with bleeding.
  • Treatment with ointments: Ointments with the active ingredients Heparin or hirudin can speed up the dissolution of the bruise. Ointments with anti-inflammatory agents such as arnica can reduce swelling and relieve pain.

Bruises that are very large and spreading quickly should be treated immediately in the hospital. With a large amount of blood loss, there is a risk of patients collapsing, and the high pressure can cause a Compartment syndrome with consequential damage to the tissue arise. The blood must be removed from the tissue (hematoma evacuation), if necessary bleeding must be stopped by closing a blood vessel.

In some cases, if bruises form near the joint, they may need to be surgically removed. A build-up of blood in the joint will appear Hemarthrosis called. This can trigger an inflammatory process and permanent joint damage.


Bruising that is normal in size and under the skin has a good prognosis. They are harmless and resolve in a few weeks. If there are large bruises deep in the tissue, especially within a muscle shell on the arm or leg, strong pressure can occur (compartment syndrome). Blood vessels and nerves can be damaged and tissue can die.

In relation to "normal" bruises, diseases of the blood are rare; those affected tend to bruise even with minor injuries. Here the prognosis depends on the severity of the underlying disease and the response to the therapy. Congenital blood diseases are incurable and patients depend on lifelong treatment.


After an injury, a immediate cooling Reduce the pain and spread of the bruise. Cold causes blood vessels to contract and less blood to leak out. Elevation, protection and a pressure bandage also help to reduce the leakage of blood into the tissue (PECH rule with break, ice, compression and elevation).