What Is Ecchymosis?

3.5 min read | Published On: 11-10-2025

Ecchymosis is the medical term for what most people call a bruise, those dark blue, purple, or green patches that appear on the skin after small blood vessels under the surface break and leak blood. The color changes happen as your body gradually reabsorbs this blood during healing.

A bruise can show up anywhere on the body, including the arms, legs or face and usually fades on its own. However, frequent or unexplained bruising can sometimes be a sign that your body needs medical attention.

Ecchymosis Definition and How It Differs from Other Skin Changes

The definition of ecchymosis is a flat area of discoloration caused by bleeding underneath the skin, usually larger than 1 centimetre. Unlike minor spots called petechiae (tiny red dots) or purpura (mid-sized patches), ecchymosis covers a larger area and may change colors as it heals.

Petechiae, purpura, and ecchymosis are often discussed together because they all involve bleeding under the skin. The difference lies mainly in their size and causes.

• Petechiae: pinpoint dots (<2 mm)
• Purpura: small patches (2–10 mm)
• Ecchymosis: larger bruises (>10 mm)

Understanding these terms helps doctors identify possible bleeding disorders or underlying conditions.

Common Causes of Ecchymosis

Ecchymosis causes vary depending on your age, health, and daily activities. Most bruises occur after a bump, fall or minor injury. However, some appear without any apparent reason, especially as we age or when certain medicines affect how blood clots.

Common causes include:

• Accidental trauma (sports injuries, minor falls, tight clothing)
• Medications such as aspirin, steroids or blood thinners
• Aging skin and fragile blood vessels
• Vitamin C or K deficiencies
• Bleeding or clotting disorders (like thrombocytopenia or hemophilia)
• Liver disease or platelet abnormalities

If you notice bruises on your legs for no reason or frequent bruises on your body that take longer to fade, it's best to discuss this with your healthcare provider.

Periorbital Ecchymosis ("Raccoon Eyes") and Ecchymosis Around the Eye

Periorbital ecchymosis, often called "raccoon eyes", refers to dark bruising around one or both eyes. It can occur after a head injury, facial trauma, or surgery, but sometimes signals a more serious condition such as a skull fracture or internal bleeding.

When bruising occurs directly on the eyelid or below the eye, commonly referred to as ecchymosis eye, it may simply result from a bump or cosmetic procedure. Still, persistent or severe discoloration should be checked by a doctor immediately.

If you notice swelling, vision changes, or pain with an eye bruise, seek prompt medical attention.

Ecchymosis vs. Hematoma: What's the Difference?

Although they may look similar, ecchymosis vs. hematoma describes two different things:

• Ecchymosis: Bleeding that spreads under the skin, creating flat discoloration.
• Hematoma: A localized collection of clotted blood under the skin or tissue that forms a firm lump or swelling.

In short, all hematomas cause bruising, but not all bruises are hematomas. Ecchymosis tends to be more superficial, while a hematoma is deeper and may take longer to resolve.

When to See a Doctor for Ecchymosis?

Most bruises heal without any special care. However, see your doctor if:

• You bruise easily or without any apparent injury
• Bruises are large, painful, or appear frequently
• You have bleeding gums, frequent nosebleeds, or red dots (petechiae)
• Bruises don't fade within two weeks
• You’re taking medications that affect blood clotting

Persistent or unexplained ecchymosis can sometimes be an early sign of a bleeding disorder or other health condition, so it’s always best to get checked if something feels unusual.

Ecchymosis Treatment and Self-Care

Ecchymosis treatment depends on its cause, but most bruises can be cared for at home with a few simple steps:

• Cold compress: Apply an ice pack wrapped in a cloth for 10-15 minutes to reduce swelling right after injury.
• Rest and elevate: Keep the bruised area raised above your heart to help prevent blood from pooling.
• Warm compress (after 48 hours): This helps improve blood flow and promotes healing.
• Avoid massaging a new bruise: It can make bleeding worse.
• Protect the area: Prevent re-injury by padding or covering the bruise.

If your doctor identifies an underlying cause, treatment may include adjusting medications, improving diet or managing related medical conditions.

How to Prevent Ecchymosis?

While not all bruises can be prevented, small changes can help protect your skin and blood vessels:

• Eat foods rich in Vitamin C (like oranges and strawberries) and Vitamin K (like spinach and kale) to keep your blood vessels strong.
• Stay active to build muscle and support healthy circulation.
• Remove home hazards that can cause trips or falls
• Wear protective gear for sports or physical work
• Check your medications with your doctor if you bruise easily

These small steps not only help prevent ecchymosis but also promote firmer, healthier skin overall.