The Changing Colors of Bruises and What They Mean

By Tina M. St. John, MD. May 7th 2016

Bruises happen, temporary reminders of perhaps less-than-graceful moments you’d just as soon forget. When you have a bruise, it seems to take forever to go away — especially as you watch it progress through a rainbow of red, blue, purple, black, green and yellow shades.

Many curious folks wonder why bruises change color and what the various shades signify. The color of bruises comes from the presence of blood within your skin, which goes through specific stages of breakdown and cleanup as the area heals. Unsightly though they may be, the changing colors of bruises represent different stages in the healing process. So take heart; the changing colors in that bruise of yours indicate that it will soon be gone.

What Is a Bruise?

You develop a bruise, or black-and-blue mark, when some type of trauma causes bleeding near the surface of your body without breaking the skin. With minor injuries — like bumping your arm or pinching your finger — the bleeding is usually confined to your skin and the bruise becomes apparent within minutes to hours.

With more forceful trauma — like twisting your ankle, running into the corner of a table or getting hit with a baseball —bleeding typically occurs in the deeper tissues and the blood gradually seeps into your skin over a period of hours to days. This is why you may not see a bruise for a day or two after you’ve had a fall or other injury.

The size of a bruise depends on what caused your injury and the amount of force involved. The more forceful the injury, the greater the amount of bleeding and the larger your bruise will be. The closer to your skin surface the bruise is, the more intense the colors you will see.

Fresh to Early Bruise Colors

Fresh bruises develop within minutes to a few days, depending on how deep below your skin surface the bleeding is. You’ll typically see a new bruise progress from red to blue to purple within the first couple of days after an injury.

  • Red Bruises
    When you first get a bruise — especially one near the surface of your skin — it usually appears red. The color comes from fresh blood leaking into your tissues. Fresh blood is bright red because it contains both iron and oxygen.
  • Blue Bruises
    Within a few hours, blood that has leaked from your injured blood vessels loses the oxygen it was carrying. As this occurs, the blood becomes darker and your bruise begins to look more bluish or purple.
    Note that if you have a deep bruise, the red stage may have already passed by the time you are first able to see the bruise. So the first color you see may be a bluish purple color.
  • Purple Bruises
    Typically, over one to three days (depending in the severity of your injury), a bruise becomes more intensely purple and may even appear black. This occurs as red blood cells break down and iron is released into the injured area.

Healing Bruise Colors

When red blood cells break down, they release an iron-containing protein called hemoglobin. As your bruise begins to heal, your body converts the hemoglobin into other colored chemicals. The presence of these chemicals causes your bruise to change color as it heals.

  • Green Bruises
    You’ll know your bruise is beginning to go away when you notice it turning green. You’re likely to first notice the transition from purple to green at the edges or center of a bruise. The green color is due to the presence of a hemoglobin breakdown product called biliverdin. The last part of the word, “verdin,” comes from the Latin word for green — making it easy to remember (and impress your friends).
  • Yellow Bruises
    At long last, your green bruise will eventually turn yellow as it enters the final stage of healing. The yellow color is from the final breakdown product of hemoglobin in your skin, a chemical called bilirubin. The yellow fades as your body clears away the last of the debris from the bleed, leaving you with bruise-free skin that is none the worse for the wear.

As you’ve probably noticed with bruises you’ve had in the past, most are multicolored. This is because the amount of blood in different areas of the bruise varies, and the stages of healing overlap. So don’t worry if your bruise looks like something not even Jackson Pollock could have come up with. 

Next Steps

There are a few things you can do to limit the extent of a bruise and help it go away more quickly.

  • As soon as possible after the injury, apply an ice pack or some frozen food wrapped in clean towel. This helps stop the bleeding that leads to a bruise.
  • Elevate the area (above the heart, if possible) to also reduce bleeding and limit swelling.
  • After about 48 hours, apply heat to the bruise for 10 to 20 minutes several times daily. The heat increases circulation in the area, which may help the bruise fade more quickly.

See a doctor if:

  • There is anything more than light bruising around the eye to make sure there isn’t a fracture or damage to the eye itself;
  • The bruise continues to enlarge after 24 to 48 hours or becomes increasingly painful;
  • The injured area is not functioning normally, such as not being able to walk on a bruised ankle; and
  • Bruises are developing without an apparent cause.

Cosmetic foundation or a concealer can often mask a bruise in an obvious spot, such as the face or neck. Keeping the area out of sight with clever wardrobe choices is another option. Most bruises disappear in a week or two, but large ones may take significantly longer to heal.

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