Bruising and swelling usually occurs when there is a rupture of blood vessels under the skin after surgery, a fall, or a blow to the body. The best treatments include rest, ice, compression, and elevation (RICE). People with this type of injury should rest and apply an ice pack to the affected area in order to help keep the bruise from spreading and keep swelling down. They should keep the area elevated if at all possible. After the initial day or so of ice pack treatment, heat packs should be applied to help relieve pain and facilitate healing of the bruised area.
For the first day or so after the bruising occurs, the area should be treated with an ice pack for short periods of time — no longer than 10 to 15 minutes. An ice pack wrapped in a towel makes a light compress and doesn't overly constrict the bruised skin. Patients should never apply ice packs directly to the skin. Once the bruising has stopped spreading after a day or two, a heat pack or warm compress can be applied. The heat will help carry blood cells away from the ruptured vessels and alleviate the bruising and swelling.
The black and blue color of a bruise occurs when there is swelling and the blood from the ruptured vessels gets less oxygen. The trapped blood spreads under the skin, making it look blue or black, which is the color of a freshly bruised area. As the blood under the bruised area continues to break down and heal, the bruise turns yellowish-green. A mild bruise might take several days to heal, whereas more severe or deep bruising might take several weeks to return to normal or at least significantly lighten.
Aspirin should be avoided until the bruise is starting to heal because it is an anticoagulant and prevents the blood from quickly clotting. If the blood does not clot quickly, it can cause more extensive bruising underneath the skin. Only pain relievers such as acetaminophen, which do not contain aspirin, should be used so that clotting is not affected.
There are many natural remedies to reduce swelling and bruising. Witch hazel is an herbal astringent that can be applied directly to the skin to speed healing of bruises and skin inflammation. Another herbal remedy used to reduce inflammation is Arnica, which is available in gel, cream, ointment, or liniment form and can be applied directly to the bruised and swollen area. Bruising and swelling that appears suddenly, and without a known trauma to the skin, should be checked by a medical professional who may recommend a different course of treatment.