What is the Difference Between Ecchymosis and Hematoma

Ecchymosis and hematoma are two conditions that are caused by traumatic injuries. They are also characterized by pooling of blood in certain regions of the body. Both of these conditions occur when blood vessels break and blood leaks into the tissues around. However, ecchymosis and hematoma are not the same.

The key difference between ecchymosis and hematoma is their cause. Ecchymosis is the discoloration of the skin due to the rupture of the blood vessels below the surface of the skin, while hematoma is the pooling of blood in tissues or spaces outside the blood vessels due to a cut or torn vessel as a result of injury.

CONTENTS

1. Overview and Key Difference
2. What is Ecchymosis
3. What is Hematoma
4. Similarities – Ecchymosis and Hematoma
5. Ecchymosis vs Hematoma in Tabular Form
6. Summary – Ecchymosis vs Hematoma
7. FAQ – Ecchymosis and Hematoma

What is Ecchymosis?

Ecchymosis is a red, blue, black, or purplish color mark on the skin that develops due to a small leakage of blood from the capillaries. The possible causes of ecchymosis include minor accidents such as bumps, trips, slips, and falls; more serious injuries and physical trauma; blood draws, cupping treatments; and thinning skin due to age.  The symptoms of this condition include pain or tenderness when touching the bruise, skin discoloration, and swelling or a raised bump on the skin.

Figure 01: Ecchymosis

Ecchymosis can be diagnosed through health history, physical examination, and X-ray. Furthermore, treatment for ecchymosis includes resting and elevating the injured area, applying a heating pad or warm compress to the injured area after two days, applying ice packs for the first 24 to 48 hours after injury, and taking over-the-counter pain medications such as acetaminophen.

What is Hematoma?

A hematoma refers to the collection or pool of blood outside a blood vessel. The possible causes for hematoma include aneurysms, head injuries, orthopedic injuries, use of blood thinning medications, and certain viral infections. Moreover, the symptoms of this condition may include pain, bruising, swelling, pins and needle sensation, and numbness or nerve pain.

Figure 02: Hematoma

Hematoma can be diagnosed through health history, physical examination, MRI, angiography, and ultrasound. Furthermore, treatment options for hematoma include resting, elevation of the injured area, applying ice, compression, transfusing blood in case of severe blood loss, giving CPR in cases where the heart stops, and surgeries such as repairing damaged blood vessels and tissues.

Similarities Between Ecchymosis and Hematoma

1. Ecchymosis and hematoma are usually caused by traumatic injuries.
2. Both of these conditions occur when blood vessels break and blood leaks into the surrounding tissues.
3. Hematoma can be a symptom of ecchymosis.
4. Both conditions can be diagnosed through health history, physical examination, and imaging testing.
5. They can be treated through resting, applying ice, taking pain medications, and other therapies.

Difference Between Ecchymosis and Hematoma

Definition

1. Ecchymosis is skin discoloration from damaged, leaking blood vessels underneath the skin.
2. A hematoma is a closed wound due to blood pooling someplace inside the body.

Causes

1. Ecchymosis can be caused by physical trauma, aging, skin, taking certain medications, and having a condition or receiving treatment that affects the blood platelet count.
2. Hematoma can be caused by traumatic or penetrating injuries or internal bleeding with conditions that don’t involve an injury or external cause, such as aortic dissections, hemophilia, blood cancers, and hemorrhagic strokes.

Signs and Symptoms

1. The signs and symptoms of ecchymosis include pain or tenderness when touching the bruise, skin discoloration, swelling, or a raised bump on the skin.
2. The signs and symptoms of hematoma include pain, swelling, redness, disfiguring bruises, headache, neurologic problems such as weakness on one side, difficulty speaking, falling, confusion, and seizures.

Diagnosis

1. Ecchymosis can be diagnosed through health history, physical examination, X-ray, and blood tests.
2. Hematoma can be diagnosed through health history, physical examination, MRI, angiography, and ultrasound.

Treatment

1. Ecchymosis is treated by applying an ice pack in the first 24 to 48 hours after the initial injury, resting the affected area, raising injured limbs above the heart to prevent painful swelling, using a heat pack several times a day 48 hours after the injury and taking nonsteroidal anti-inflammatory medications, such ibuprofen.
2. Hematoma is treated through resting, applying ice, compression, elevation, taking over-the-counter (OTC) pain medications, and surgeries.

The following table summarizes the difference between ecchymosis and hematoma.

Summary – Ecchymosis vs Hematoma

Ecchymosis and hematoma occur when blood vessels break and blood leaks into the surrounding tissues due to traumatic injuries. However, ecchymosis is a red or purple patch greater than 1cm where there is bleeding under the skin, while hematoma is an area where blood has accumulated and coagulated. This summarizes the difference between ecchymosis and hematoma.

FAQ: Ecchymosis and Hematoma

1. What deficiency causes ecchymosis?

• In rare cases, vitamin and mineral deficiencies can cause skin bruising or ecchymosis. The most famous is scurvy due to vitamin C deficiency. Ecchymosis can also be a manifestation of zinc deficiency or vitamin B deficiencies.

2. What is the main cause of ecchymosis?

• The main cause of ecchymosis is traumatic injury, like being hit with an object or falling on a hard surface. It can also be caused by medicines that stop clotting.

3. How to cure ecchymosis?

• Ecchymosis can be treated by resting and elevating the injured area to prevent swelling and to relieve pain, applying a heating pad or warm compress to the injured area after two days, applying ice packs for the first 24 to 48 hours after injury, and taking pain medications such as acetaminophen.

4. What are the symptoms of the hematoma?

• The symptoms of hematoma, in general, are pain, swelling, redness, disfiguring bruises, warmth, tenderness, and inflammation. Other rare symptoms include headache, neurologic problems such as weakness on one side, difficulty speaking, falling, confusion, and seizures.

5. How to treat a hematoma?

• Asymptomatic hematomas can be treated through self-care, such as resting, applying an ice pack to the area, compression, and elevation. However, if a hematoma is symptomatic, then surgical drainage may be necessary in order to relieve pressure in the hematoma.

Reference:

1. “What Are Hematomas?” Cleveland Clinic.
2. “Bruises (Ecchymosis): Symptoms, Causes, Treatment & Prevention.” Cleveland Clinic.

Image Courtesy:

1. “Bruising and ecchymosis of the medial arch. (a) Whole foot and (b) close-up” By sportEX journals (CC BY-ND 2.0) via Flickr

2. “Hematoma development” By Whoisjohngalt – Own work (CC BY-SA 4.0) via Commons Wikimedia

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