A bump to the head often results in a noticeable lump known colloquially as a “goose egg,” which can cause immediate concern. This external head injury is typically a sign of localized trauma to the scalp, but it is often less concerning than its dramatic appearance suggests. Understanding the nature of this swelling, the appropriate first steps to take, and the typical healing process provides clarity. This information explains the biology behind this common injury and details the expected timeline for its complete resolution.
Defining the Injury
The characteristic “goose egg” is a hematoma, the medical term for a localized collection of blood outside of blood vessels, essentially a severe bruise. The scalp contains a rich network of small blood vessels that easily rupture when subjected to blunt force trauma. Because the skin and underlying dense connective tissue are tightly bound to the skull, the escaping blood and fluid become trapped.
This pooling of blood has nowhere to go but outward, which is why even a minor impact can result in a large, dome-shaped protrusion. The dense, fibrous layers of the scalp prevent the blood from spreading out, concentrating the fluid in one spot. This concentration dramatically increases the visible size of the lump, which is typically confined to the soft tissues above the bone.
Immediate Care and Treatment
The most effective immediate response to a scalp hematoma is applying a cold compress to constrict the injured blood vessels. Applying ice wrapped in a thin towel helps to reduce internal bleeding and minimize the overall size of the swelling. Cold therapy should be applied for 15 to 20 minutes at a time, followed by a rest period of 30 minutes to an hour.
This cycle of cold application should continue for the first 24 to 48 hours following the injury to manage initial swelling and pain. Over-the-counter pain relievers, such as acetaminophen, can be used to manage localized discomfort and headache. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin are discouraged immediately after a head injury because they can interfere with blood clotting and potentially increase bleeding.
After the initial 48-hour period, switching from cold to warm compresses assists the body’s natural reabsorption process. Warmth helps to dilate the blood vessels, promoting increased circulation to break down the pooled blood. Rest and avoidance of strenuous activity are also recommended during the initial observation period.
Expected Recovery Timeline
The most dramatic phase of the “goose egg” is the initial rapid swelling, which typically reaches its maximum size within minutes to a few hours of the impact. The speed of the swelling is a direct result of the scalp’s abundant blood supply and the confined space for the blood to collect. The lump will feel firm and tender to the touch during this acute period.
The process of resolution begins as the body starts to naturally break down and reabsorb the collected blood cells, a process called hematoma resolution. For a mild to moderate scalp hematoma, noticeable reduction in size begins within the first two to three days. The lump will feel softer as the initial pressure subsides and the fluid dissipates.
Most “goose eggs” fully resolve within one to two weeks, though larger hematomas can take significantly longer, sometimes lasting several weeks to a few months. As the blood is broken down, the area may display the familiar color changes associated with a fading bruise. This progression moves from dark purple or blue to green, and finally to a yellowish hue before disappearing completely.
When to Seek Medical Attention
While most scalp hematomas are benign, any head injury requires careful monitoring for signs of a more serious underlying issue, such as a concussion or internal bleeding. Any loss of consciousness, even if momentary, warrants immediate medical evaluation. Persistent or worsening headaches that do not improve with pain medication are a serious warning sign.
Repeated episodes of vomiting or persistent nausea after the injury indicate that the pressure inside the skull may be increasing and require emergency care. Other immediate red flags include slurred speech, confusion, difficulty walking, or changes in vision. Unequal pupil sizes or clear fluid or blood draining from the nose or ears also require urgent medical attention.
Certain individuals should seek prompt medical advice regardless of the severity of the bump. This includes young children under the age of two, adults over 65, and anyone taking blood-thinning medications. These groups have a heightened vulnerability to complications, and a seemingly minor bump could mask a more significant problem.