Table of ContentsView AllTable of ContentsKey DifferencesBruisesHematomasCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Key Differences
Bruises
Hematomas
Causes
Diagnosis
Treatment
There are differences between a hematoma vs. a bruise:
A hematoma and bruise are similar in that they both occur due to trauma to a blood vessel.
This article explains more about how to distinguish a hematoma from a bruise. It also covers why they occur and treatment options.
Key Differences: Hematoma vs. Bruise
To get an initial sense of which you might be dealing with, here’s a summary of some key differences between a hematoma and a bruise.
Verywell / Laura Porter
BruisesFlatTender to the touchGenerally has few complicationsHematomasRaised, firmPainfulSome can cause serious and even life-threatening complications
BruisesFlatTender to the touchGenerally has few complications
Flat
Tender to the touch
Generally has few complications
HematomasRaised, firmPainfulSome can cause serious and even life-threatening complications
Raised, firm
Painful
Some can cause serious and even life-threatening complications
Characteristics of a Bruise
Those that occur under the surface of your skin are usually quite visible. The initial black-and-blue skin discoloration will change to a yellow, green, or light brown color within five to 10 days.
Bruises are flat, although mild swelling may be present. They can be tender to the touch.
Bruises can also form in deeper tissues, including muscles andbones. Though you won’t see them, you will feel pain and soreness in the area of the injury.
Art_rich / Getty Images
Bruises usually heal on their own within a week or two. They rarely cause serious complications, but can if there are additional injuries. For example, a black eye from a face injury may cause vision problems.
Characteristics of a Hematoma
Hematomas are larger bleeds that often involve larger blood vessels. With a hematoma, the leaking blood will pool andclot, or form clumps of blood. This can cause a hard and tender mass.
Hematomas can develop deep within the body, like in a muscle or in or around an internalorgan.They can also form beneath the skin, on the scalp, nose, ears, orunder a toenailorfingernail.
When it is closer to the skin surface, a hematoma may look like a painful red, black, or blue lump. As it breaks down, the skin will eventually change to a yellow or brown color.
How long it takes a hematoma to heal on its own will vary. Healing time ranges from weeks to months, depending on the size and location of the hematoma.
Aliaksandr Litviniuk / Getty Images
Should You Worry About a Hematoma?Hematomas may be something to be concerned about. They can cause serious harm and if they get large enough, they may causeblood pressure to drop. They can even lead toshock, a life-threatening condition that happens when organs in the body don’t get enough blood or oxygen.Very large hematomas can cause adjacent organs to shift and affect how they function.A large hematoma is generally considered to be thicker than 10 millimeters (mm) or wider than 5 mm, though this can vary.
Should You Worry About a Hematoma?
Hematomas may be something to be concerned about. They can cause serious harm and if they get large enough, they may causeblood pressure to drop. They can even lead toshock, a life-threatening condition that happens when organs in the body don’t get enough blood or oxygen.Very large hematomas can cause adjacent organs to shift and affect how they function.A large hematoma is generally considered to be thicker than 10 millimeters (mm) or wider than 5 mm, though this can vary.
Hematomas may be something to be concerned about. They can cause serious harm and if they get large enough, they may causeblood pressure to drop. They can even lead toshock, a life-threatening condition that happens when organs in the body don’t get enough blood or oxygen.
Very large hematomas can cause adjacent organs to shift and affect how they function.
A large hematoma is generally considered to be thicker than 10 millimeters (mm) or wider than 5 mm, though this can vary.
Brain and Skull Hematomas
The most dangerous and life-threatening hematomas are in the brain and skull. With these, the blood can become trapped within the skull and put pressure on the brain.
Complications that may result include:
Because a subdural hematoma can lead to brain damage or even death, it’s important to seek immediate medical attention if one is suspected.
Causes and Risk Factors
Bruises and hematomas both occur when a force—usually a blunt force—directly impacts the body, causing blood vessels to break open.Examples includefalls, car accidents, and sports injuries.
After surgery, such as a breast augmentation procedure, as well as broken bones can also lead to bruises and hematomas.
There are certain factors that may increase a person’s risk of bruises or hematomas:
Certain drugs can also increase the risk of bruises or hematomas:
Hematoma During PregnancyCertain hematomas increase the risk of miscarriage within the first 20 weeks of pregnancy if:You are also experiencingvaginal bleedingand cramping.The hematoma is subchorionic, meaning there is bleeding between the area around the embryo and uterine wall.
Hematoma During Pregnancy
Certain hematomas increase the risk of miscarriage within the first 20 weeks of pregnancy if:You are also experiencingvaginal bleedingand cramping.The hematoma is subchorionic, meaning there is bleeding between the area around the embryo and uterine wall.
Certain hematomas increase the risk of miscarriage within the first 20 weeks of pregnancy if:
Bruise on Breast: Causes and Treatments
Diagnosing Hematomas and Bruises
In the case of an internal hematoma, including one in the skull or brain, imaging tests like acomputed tomography (CT) scanormagnetic resonance imaging (MRI)may be required.
Hematoma vs. Bruise Treatment
You may be able to treat mild bruises or hematomas at home. Larger or internal hematomas may require medical care.
Bruises and Superficial Hematomas
Bruises and superficial hematomas may go away on their own, but may benefit from treatments like theRICE method(rest,ice, compression, and elevation).
To speed up the healing of a superficial hematoma or bruise:
Hematomas on the skin may benefit from a similar approach, although a splint may be advised to keep an injured limb from moving and prevent the larger vessel from breaking open again.
What Not To Do With a HematomaDo not take an NSAID likeAdvil (ibuprofen). NSAIDs can slow blood clotting and can make the condition worse. If needed, pain can be controlled withTylenol(acetaminophen).
What Not To Do With a Hematoma
Do not take an NSAID likeAdvil (ibuprofen). NSAIDs can slow blood clotting and can make the condition worse. If needed, pain can be controlled withTylenol(acetaminophen).
Larger or Deeper Hematomas
Hematomas may need to be drained or removed in cases where the hematoma is:
The drainage of any hematoma must be done before the blood clots and forms a solid mass.
Treatment for skull hematomas includes the following:
If a procedure is needed for a severe hematoma, a drain may be left in place for a couple of days after surgery while the individual is closely monitored in the hospital.
The treatment of internal hematomas elsewhere in the body may involve a watch-and-wait approach under observation, or immediate surgical investigation may be needed.
Summary
Bruises result from an injury to smaller blood vessels, while hematomas result from injury to larger blood vessels.
While bruises rarely cause serious complications, hematomas can—particularly those in the skull or brain.
Most bruises and superficial hematomas can be diagnosed with a physical exam and treated with the RICE method. Larger or deeper hematomas may require imaging studies and surgery.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.What is a black eye?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).American Osteopathic College of Dermatology.Subungual hematoma.Hosseini M, Hosseinzadeh A, Raufian K, Hedjazi A.Nontraumatic retroperitoneal hematoma after warfarin administration: fatal case report and review of the literature.Am J Forensic Med Pathol. 2015;36(4):245-248. doi:10.1097/PAF.0000000000000190AbdelFatah MAR.Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation.Egypt J Neurosurg. 2019;34(1):9. doi:10.1186/s41984-019-0035-xMedline Plus.Subdural hematoma.Neutze D, Roque J.Clinical evaluation of bleeding and bruising in primary care.Am Fam Physician.2016;93(4):279-286.Johns Hopkins Vasculitis Center.Prednisone.Wang CZ, Moss J, Yuan CS.Commonly used dietary supplements on coagulation function during surgery.Medicines. 2015;2(3):157-185. doi:10.3390/medicines2030157Şükür YE, Göç G, Köse O, et al.The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion.J Turk Ger Gynecol Assoc. 2014;15(4):239-242. doi:10.5152/jtgga.2014.14170Radiological Society of North America.X-ray (radiography) - bone.Alberta Health Services.Hematoma: care instructions.King M.The management of bruising following nonsurgical cosmetic treatment.J Clin Aesthet Dermatol. 2017;10(2):E1–E4. PMID:28367264Palatucci V, Lombardi G, Lombardi L, Giglio F, Giordano F, Lombardi D.Spontaneous muscle haematomas: management of 10 cases.Transl Med UniSa. 2014;10:13-17.Johns Hopkins Medicine.Burr holes.Johns Hopkins Medicine.Craniotomy.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.What is a black eye?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).American Osteopathic College of Dermatology.Subungual hematoma.Hosseini M, Hosseinzadeh A, Raufian K, Hedjazi A.Nontraumatic retroperitoneal hematoma after warfarin administration: fatal case report and review of the literature.Am J Forensic Med Pathol. 2015;36(4):245-248. doi:10.1097/PAF.0000000000000190AbdelFatah MAR.Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation.Egypt J Neurosurg. 2019;34(1):9. doi:10.1186/s41984-019-0035-xMedline Plus.Subdural hematoma.Neutze D, Roque J.Clinical evaluation of bleeding and bruising in primary care.Am Fam Physician.2016;93(4):279-286.Johns Hopkins Vasculitis Center.Prednisone.Wang CZ, Moss J, Yuan CS.Commonly used dietary supplements on coagulation function during surgery.Medicines. 2015;2(3):157-185. doi:10.3390/medicines2030157Şükür YE, Göç G, Köse O, et al.The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion.J Turk Ger Gynecol Assoc. 2014;15(4):239-242. doi:10.5152/jtgga.2014.14170Radiological Society of North America.X-ray (radiography) - bone.Alberta Health Services.Hematoma: care instructions.King M.The management of bruising following nonsurgical cosmetic treatment.J Clin Aesthet Dermatol. 2017;10(2):E1–E4. PMID:28367264Palatucci V, Lombardi G, Lombardi L, Giglio F, Giordano F, Lombardi D.Spontaneous muscle haematomas: management of 10 cases.Transl Med UniSa. 2014;10:13-17.Johns Hopkins Medicine.Burr holes.Johns Hopkins Medicine.Craniotomy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Ophthalmology.What is a black eye?American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).American Osteopathic College of Dermatology.Subungual hematoma.Hosseini M, Hosseinzadeh A, Raufian K, Hedjazi A.Nontraumatic retroperitoneal hematoma after warfarin administration: fatal case report and review of the literature.Am J Forensic Med Pathol. 2015;36(4):245-248. doi:10.1097/PAF.0000000000000190AbdelFatah MAR.Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation.Egypt J Neurosurg. 2019;34(1):9. doi:10.1186/s41984-019-0035-xMedline Plus.Subdural hematoma.Neutze D, Roque J.Clinical evaluation of bleeding and bruising in primary care.Am Fam Physician.2016;93(4):279-286.Johns Hopkins Vasculitis Center.Prednisone.Wang CZ, Moss J, Yuan CS.Commonly used dietary supplements on coagulation function during surgery.Medicines. 2015;2(3):157-185. doi:10.3390/medicines2030157Şükür YE, Göç G, Köse O, et al.The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion.J Turk Ger Gynecol Assoc. 2014;15(4):239-242. doi:10.5152/jtgga.2014.14170Radiological Society of North America.X-ray (radiography) - bone.Alberta Health Services.Hematoma: care instructions.King M.The management of bruising following nonsurgical cosmetic treatment.J Clin Aesthet Dermatol. 2017;10(2):E1–E4. PMID:28367264Palatucci V, Lombardi G, Lombardi L, Giglio F, Giordano F, Lombardi D.Spontaneous muscle haematomas: management of 10 cases.Transl Med UniSa. 2014;10:13-17.Johns Hopkins Medicine.Burr holes.Johns Hopkins Medicine.Craniotomy.
American Academy of Ophthalmology.What is a black eye?
American Academy of Orthopaedic Surgeons.Muscle contusion (bruise).
American Osteopathic College of Dermatology.Subungual hematoma.
Hosseini M, Hosseinzadeh A, Raufian K, Hedjazi A.Nontraumatic retroperitoneal hematoma after warfarin administration: fatal case report and review of the literature.Am J Forensic Med Pathol. 2015;36(4):245-248. doi:10.1097/PAF.0000000000000190
AbdelFatah MAR.Prognosis of acute subdural hematoma greater than 10 mm in thickness in head injury patients with an extension or no motor response to pain after resuscitation.Egypt J Neurosurg. 2019;34(1):9. doi:10.1186/s41984-019-0035-x
Medline Plus.Subdural hematoma.
Neutze D, Roque J.Clinical evaluation of bleeding and bruising in primary care.Am Fam Physician.2016;93(4):279-286.
Johns Hopkins Vasculitis Center.Prednisone.
Wang CZ, Moss J, Yuan CS.Commonly used dietary supplements on coagulation function during surgery.Medicines. 2015;2(3):157-185. doi:10.3390/medicines2030157
Şükür YE, Göç G, Köse O, et al.The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion.J Turk Ger Gynecol Assoc. 2014;15(4):239-242. doi:10.5152/jtgga.2014.14170
Radiological Society of North America.X-ray (radiography) - bone.
Alberta Health Services.Hematoma: care instructions.
King M.The management of bruising following nonsurgical cosmetic treatment.J Clin Aesthet Dermatol. 2017;10(2):E1–E4. PMID:28367264
Palatucci V, Lombardi G, Lombardi L, Giglio F, Giordano F, Lombardi D.Spontaneous muscle haematomas: management of 10 cases.Transl Med UniSa. 2014;10:13-17.
Johns Hopkins Medicine.Burr holes.
Johns Hopkins Medicine.Craniotomy.
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