A hematoma is a collection of blood that has escaped from blood vessels and pooled within body tissues following an injury. Understanding how long a hematoma might take to resolve can help manage expectations and guide appropriate care.
What is a Hematoma?
A hematoma is a localized collection of blood outside of blood vessels, often resulting from trauma or injury. Unlike a common bruise, which typically indicates a small leakage of blood from capillaries, a hematoma involves a larger volume of blood pooling, often forming a raised lump or swelling. This pooled blood can appear as a discoloration ranging from dark red or purple to blue or black, depending on its age and depth. The underlying cause is damage to blood vessels, allowing blood to escape into surrounding tissues.
General Healing Timelines
The healing timeline for a hematoma varies, but minor ones generally resolve within one to four weeks. Larger or deeper hematomas, however, may require several weeks to a few months to fully heal. The body naturally reabsorbs the pooled blood over time, a process that involves a series of noticeable color changes.
Initially, a hematoma might appear red or a darker shade due to the presence of fresh, oxygenated blood. Within one to two days, as the blood loses oxygen and begins to break down, the discoloration shifts to purplish, black, or blue. After about five to ten days, the hematoma may transition to green or yellow hues before fading to a yellowish-brown or light brown over ten to fourteen days. Discoloration can sometimes appear in areas distant from the injury site due to gravity.
Factors Affecting Recovery Time
Several factors influence how quickly a hematoma resolves. The size and depth of the hematoma are significant, with larger and deeper collections of blood generally requiring more time to dissipate. The location of the hematoma also plays a role; for example, hematomas within the skull can be particularly serious and have distinct healing considerations. Even smaller hematomas in confined spaces, such as under a fingernail, can cause intense pain due to pressure.
An individual’s age can influence recovery, as older individuals may have a higher risk of hematomas and potentially different healing rates. Underlying health conditions, including clotting disorders, liver disease, or hypertension, can affect the body’s ability to manage and resolve pooled blood. Certain medications, particularly blood thinners like warfarin or aspirin, can increase the risk of bleeding and extend the healing period of a hematoma. The presence of infection can further complicate the healing process and delay resolution.
When Medical Care is Needed
While many hematomas resolve without medical intervention, certain signs and symptoms indicate a need for professional evaluation. Seek medical care if you experience:
- Rapid enlargement or increasing pain not alleviated by over-the-counter pain relievers.
- Signs of infection, such as increased pain, spreading redness, warmth, pus, fever, or red streaks extending from the site.
- Neurological symptoms, including numbness, weakness, tingling sensations, or changes in speech or vision.
- Following a head injury, symptoms like a severe headache, confusion, persistent nausea or vomiting, loss of balance, seizures, or loss of consciousness.
- Interference with joint function or vision, or if bruising does not heal within two weeks.
At-Home Care and Management
For minor hematomas, several at-home care strategies can help support the healing process and alleviate discomfort. Following the R.I.C.E. principles is often recommended. This involves:
- Resting the affected area to prevent further injury and allow the body to heal.
- Applying an ice or cold pack to the site for 10 to 20 minutes at a time, several times a day during the first 24 to 48 hours, to help reduce swelling and pain. Always wrap the ice in a towel to protect the skin.
- Gentle compression with an elastic bandage to help minimize swelling, but ensure it’s not too tightly wrapped to avoid restricting circulation.
- Elevating the injured area above the level of the heart to further reduce swelling by promoting fluid drainage.
Over-the-counter pain relievers like acetaminophen can manage pain, but aspirin or ibuprofen should be avoided in the initial stages as they can thin the blood and potentially worsen bleeding. Aggressive massage or applying heat to the hematoma should be avoided for the first 48 to 72 hours.