Bleeding into the skin

Alternative names:

bruising; ecchymoses; hematomas; petechiae; pinpoint red spots on the skin; skin spots - red

Home care:

Bruises (or purpuric lesions) are not permanent and will fade if the underlying cause can be treated successfully.

For a hematoma, apply pressure and cold compresses initially to help reduce bleeding and swelling. After the first day, apply hot compresses to help speed the absorption of blood.

For aging skin, protection of skin is recommended. Avoid trauma (such as bumping or pulling on skin areas).

For a cut or scrape, use direct pressure to stop the bleeding.

For a drug reaction, identify and consult the health care provider about discontinuing the drug.

Otherwise, follow prescribed therapy to treat the underlying cause.

Call your health care provider if:

• there is sudden bleeding into the skin for no apparent reason.
• if there is persistent, unexplained bruising.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting bleeding into the skin in detail may include:

• quality
  • Is the area flat?
  • Is the area raised or swollen?

• location
  • Where is the hematoma or purpura spot?

• aggravating factors
  • Has there been a recent injury or accident?
  • Have you been ill lately?
  • Have you had radiation therapy?
  • Have you had chemotherapy?
  • What other medical treatments have you had?

• medications
  • Do you take aspirin more than once a week?
  • Do you take Coumadin, heparin, or other "blood thinners" (anticoagulants)?

• time pattern
  • Did it begin recently?
  • Has it occurred repeatedly (recurrent)?
  • Has a tendency to bleed into the skin been present lifelong?
    • Did it start in infancy (for example, with circumcision)?
    • Did it start with surgery or a tooth extraction?

  • Has it occurred for the past several months? How many?

• associated conditions
  • What other symptoms are also present?

Diagnostic tests that may be performed include:

• bleeding time and coagulation test
• CBC with platelet count and blood differential
• bone marrow biopsy

After seeing your health care provider:
You may want to add a diagnosis related to bleeding into the skin to your personal medical record.