Bruises Under the Skin: When to See a Dermatologist

There are bruises under the skin that resemble blood clots?

Last week, I noticed a small patch on the skin of my lower back.
I initially thought it would go away on its own, so I didn't pay much attention to it.
However, when I checked it today, I found that it still feels a bit fluid-filled inside, and pressing on it causes slight pain.
Is this a natural phenomenon that will resolve over time, or should I see a doctor? Which department should I visit? Since it is on my skin, I am inquiring with a dermatologist.
Thank you for your response.

Hong, 10~19 year old female. Ask Date: 2016/12/14

Dr. Wu Yuxin reply Dermatology

First, schedule an appointment with a dermatologist.

Reply Date: 2016/12/14

More Info

When it comes to understanding bruises under the skin, it's essential to recognize that they can arise from various causes, including trauma, blood disorders, or even certain medications. Bruises, or contusions, occur when small blood vessels break, allowing blood to leak into the surrounding tissue. This can lead to discoloration, swelling, and tenderness in the affected area.
In your case, you mentioned noticing a small bruise on your waist that has a "water-like" feeling and causes mild pain when pressed. While many bruises will resolve on their own without medical intervention, there are specific signs that indicate when it is prudent to seek professional help. If the bruise does not improve over time, becomes increasingly painful, or if you notice other concerning symptoms such as swelling, redness, or warmth in the area, it is advisable to consult a healthcare provider.

Given that you are experiencing a sensation of fluid beneath the skin, this could suggest the possibility of a hematoma, which is a localized collection of blood outside of blood vessels. Hematomas can occur after an injury and may take longer to resolve than a typical bruise. If the area is tender and the fluid sensation persists, it may warrant further evaluation.

In terms of which specialist to see, a dermatologist is indeed a suitable choice, especially since you are concerned about a skin-related issue. Dermatologists are trained to assess and treat various skin conditions, including bruises and hematomas. However, if you have a history of bleeding disorders, or if you are taking medications that affect blood clotting (like anticoagulants), it may also be beneficial to consult a hematologist or your primary care physician for a comprehensive evaluation.

In the meantime, here are some general recommendations for managing bruises:
1. Rest and Protect the Area: Avoid activities that may aggravate the bruise. Protect the area from further injury.

2. Ice Therapy: Applying ice to the bruise for 15-20 minutes at a time can help reduce swelling and pain. Make sure to wrap the ice in a cloth to avoid direct contact with the skin.

3. Elevation: If possible, elevate the bruised area to reduce swelling.

4. Pain Relief: Over-the-counter pain relievers such as acetaminophen can help alleviate discomfort. However, avoid NSAIDs like ibuprofen or aspirin, as they can increase bleeding.

5. Monitor Symptoms: Keep an eye on the bruise for changes. If it worsens or if you develop new symptoms, seek medical attention.

6. Hydration and Nutrition: Staying hydrated and maintaining a balanced diet rich in vitamins C and K can support skin health and healing.

In conclusion, while many bruises will heal naturally, your symptoms suggest that it may be wise to consult a dermatologist, especially if the bruise does not improve or if you have any additional concerns. Early evaluation can help rule out any underlying issues and provide peace of mind.

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