A “goose egg” is the common term for a localized hematoma on the scalp, caused by blunt force trauma to the head. This prominent swelling occurs because the scalp is highly vascularized, containing a dense network of small blood vessels just beneath the skin surface. When these vessels are ruptured by a blow, the blood pools quickly between the bone and the outer layer of the scalp, creating the characteristic dome-shaped lump. While the appearance can be alarming, the swelling itself is often a positive sign that the bleeding is contained within the scalp tissue, protecting the underlying skull.
Immediate First Aid (The First 24 Hours)
The immediate goal following a head bump is to reduce the amount of blood pooling beneath the scalp, minimizing the size and duration of the hematoma. Act quickly to constrict the blood vessels and limit internal bleeding. Immediately stop any strenuous activity or exercise and rest quietly, which helps keep the heart rate and blood pressure low.
Applying a cold compress is the most effective intervention in the initial hours because the cold temperature causes vasoconstriction, or the narrowing of blood vessels. This restricted blood flow significantly slows the internal bleeding that forms the goose egg. Always wrap the cold source (like an ice pack or frozen peas) in a thin towel before placing it on the bump to prevent skin damage.
Apply the compress for 15 to 20 minutes, followed by a break of 30 to 40 minutes. This on/off pattern prevents the skin from getting too cold and allows normal circulation to briefly return before the next application. Repeat this cold therapy consistently for the first 24 hours, as this is when the body’s inflammatory response is at its peak. Gentle, non-painful pressure can also be applied with the cold pack to further help contain the swelling.
Managing Pain and Recovery
After the initial 24 hours, focus shifts to managing discomfort and helping the body reabsorb the trapped blood. Over-the-counter pain relievers like acetaminophen can manage headache and tenderness. It is important to avoid non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, for at least 24 to 48 hours, as these medications can interfere with blood clotting and potentially increase bleeding within the hematoma.
After the first two days, transition from cold therapy to moist heat application. Heat causes vasodilation, increasing blood flow to the area and facilitating the removal of residual fluid and clotted blood. A warm compress or a heating pad applied for 15 to 20 minutes a few times a day can help speed up the resolution process.
Monitor the size of the goose egg during recovery; it should gradually decrease over several days to a week. For comfortable sleeping, try to elevate your head slightly, which can assist in fluid drainage away from the injury site. Continued rest and avoiding activities that could result in a secondary head impact are also important until the bump has visibly diminished and symptoms have resolved.
Warning Signs and When to See a Doctor
While most goose eggs are minor injuries confined to the scalp, head trauma carries a risk of a more serious underlying issue, such as a concussion or internal bleeding. You must stop self-treatment immediately and seek emergency medical attention if the injured person exhibits severe symptoms.
A loss of consciousness, even if brief, following the impact warrants immediate professional evaluation. Watch for neurological changes, including slurred speech, confusion, or difficulty with coordination and balance. Persistent or worsening headaches that do not improve with pain medication are also a cause for concern.
Repeated or forceful vomiting, or the discharge of clear or bloody fluid from the ears or nose, require an emergency room visit. Seizure activity, disproportionate pupil sizes, or an inability to be easily roused from sleep are serious red flags. If the person seems unusually drowsy or their condition appears to worsen rather than improve within the first 48 hours, professional medical assessment is necessary.