Ecchymosis: Definition, causes, and treatment

Ecchymosis occurs when blood leaks from a broken capillary into surrounding tissue under the skin. This causes discoloration.

As the tissue heals, the area of ecchymosis may change from purple or blackish blue to yellow or green. Ecchymosis will typically take between 1 and 3 weeks to resolve.

Areas of ecchymosis have a different appearance from bruises or hematomas, which are swollen patches that form when blood collects and clots outside of a blood vessel. Hematomas may appear raised, while patches of ecchymosis are flat.

Bruises are typically caused by an injury, such as a fall or a knock, while ecchymosis is not always a result of trauma. Diseases and other conditions can also cause ecchymosis.


A fall, knock, or bump into a hard object can rupture or damage blood vessels. Ruptured blood vessels cause blood to pool, leading to ecchymosis.

These injuries also frequently lead to bruising. Ecchymosis is different from bruising because it can result from factors other than injury. These include:

  • anticoagulants, such as aspirin and warfarin
  • varicose veins
  • surgery
  • platelet abnormalities, such as a low platelet count
  • fractures and broken bones
  • end-stage kidney disease
  • hemophilia and other bleeding disorders
  • leukemia
  • dengue fever

Most of the time, patches of ecchymosis will go away without treatment. A person can reduce any pain or swelling with a cold compress or over-the-counter anti-inflammatory drugs, such as ibuprofen.

If a person has not had an injury and the cause of ecchymosis is not obvious, a doctor may perform some diagnostic tests. Depending on the severity of the bruising, they may recommend an X-ray or MRI scan.

A doctor may also examine the area and take blood to check a person’s platelet count and clotting factors.

Determining the underlying cause of ecchymosis is essential for developing a treatment plan.

When to see a doctor

Ultimately, ecchymosis may indicate some amount of internal bleeding. If severe, it should not be ignored.

Minor bruising is often not a cause for concern. However, speak with a doctor if the cause is unclear, if discoloration persists over time, or if ecchymosis occurs frequently.

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