Ecchymosis is a scientific term for discoloration, which is more commonly known as a bruise.
Keep reading this blog to know about what is ecchymosis and causes, symptoms, and treatment.
What Is Ecchymosis?
Ecchymosis is the medical term or the common bruising or the purpura. Well, the term of ecchymosis describes as a flat, purple, or blue patch measuring 1 centimeter or more in the diameter.
Ecchymosis usually occurs when the blood vessels near the surface of the skin get damaged, usually by the impact of an injury. This will cause discoloration.
The force of the impact causes the blood vessels to burst open and also leak the blood. This blood will get trapped beneath the skin, where it forms into a little pool that will turn your skin blue, black, or purple.
After injuring the blood vessels, the platelets in the blood will come to help the clotting process. The clothing will help to prevent the injured blood vessels from leaking any more blood and making your bruise even bigger.
Some of the protein of the blood is called clotting factors, which will also help to stop the bleeding so that the tissue starts healing. Ecchymosis will typically treat between 1 and 3 weeks after the injury.
Areas of ecchymosis that are different from hematomas and bruises. The swollen patches which can form when the blood collects and clots outside of a blood vessel.
But the hematomas may appear raised, while the patches of the ecchymosis are flat.
Bruises are typically caused by an injury such as a knock or a fall, while the ecchymosis is not always a result of trauma. Diseases and other conditions also cause ecchymosis.
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What Are The Types Of Ecchymosis?
The signs and types of ecchymosis will depend on the part that will be affected.
Raccoon eyes cause the blue bruises or the dark purple skin under the eyes. The name of raccoon eyes comes from their remembrance to the dark circles under the raccoon’s eyes.
Sometimes doctors will call the raccoon eyes periorbital ecchymosis. Because periorbital means around the eyes, and ecchymosis means a change in color.
Raccoon eyes can occur after the injury or the illness that will cause the tiny blood vessels to bleed into the under-eye skin. But raccoon eyes are not the same as the dark circles that can cause when you tire.
These dark circles are much milder than the raccoon eyes, and they need any medical condition. Well, raccoon eyes are also symptoms, not any disease. They are also not dangerous themselves.
But raccoon eyes could be a sign of severe eye or head injury. So, consult with your doctor and do all the right things if you have recently had any injury.
2. Mastoid Region
Battle’s sign or the mastoid ecchymosis sign is a bruise that will appear after a person will break a bone at the base of their skill. This kind of break is known as a basilar skull fracture.
Basilar skull fractures can also lead to permanent brain injury, meningitis, or other complications. Battle’s sign is a crescent-shaped that will appear behind the one or both ears.
The battle’s sign was named after an English surgeon, DR. William Henry Battle, and it can be an indication of a serious head injury. Our skull made up of more than 20 different bones.
The basilar bones are associate at the base of the skull that can protect us by the following structures: eyes, nerves to the head and neck, ears, brain stem, cerebellum or coordination, and balance center.
When one of the basilar bones is broken, blood may pool behind the ear, which will create the battle’s sign bruise. While the battle’s sign may look like ordinary ecchymosis, it is not a result of direct injury behind the ear.
Instead, mastoid ecchymosis is a sign that one or more skull’s bones have been broken. The size of the battle’s sign can a very but it may also extend down the back of the neck.
The person who has a minor basilar factor can treat them easily by receiving immediate medical care and also following proper healthcare at home.
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3. Umbilical Region
Cullen’s sign characterize by edema swelling, bruising, and the discoloration of the fatty tissue surrounding the umbilicus navel area.
The Cullen sign can arise because of pancreatitides like inflammation of the pancreas, cancer or the pancreas, liver problem, thyroid cancer, ectopic pregnancy, or some other sources of the internal bleeding in the abdomen.
It was first identified by Dr. Thomas Steohen Cullen in 1918, this condition also often coexists with the grey turner’s sign of a bruising in the abdominal flanks or walls.
While the occurrence is relatively rare, it will seem in less than 1% of ectopic pregnancy and 1-3% of pancreatitis patients. When Cullen signs clinical view then it will mark as a serious health problem.
Cullen signs present as severe the discoloration and the bruising around the patient’s navel. It is also accompanied by the swelling in the umbilical region.
The color of the bruise varies based on the severity of the condition that will range from the yellow/green or in more moderate cases. In severe cases, it will become purple.
Some of the patients also feel discomfort and pain in the affected area. While in the cases of acute pancreatitis, the symptoms of Cullen sign tend to emerge 24 to 72 hours after the onset of the condition.
The treatment of the Cullen sign ultimately means taking on the disease or the disorder that will cause it.
Pancreatitis for instance taken on by directing the fasting, medication for pain, fluid replacement via IV, or the surgery of the pancreas or the gallbladder.
4. Lateral Abdominal Wall
Grey turner’s sign refers to the bruising of the flanks and also the part of the body between the alt rib and also the tops of the hip.
Classically it associates with the severe acute necrotizing pancreatitis and also often in the association with the periumbilical ecchymosis. It can also be seen in the many other conditions that will result in the intra-abdominal or retroperitoneal hemorrhage.
The discoloration of this condition may be yellow, green, or purple because it depends on the degree of the red blood cell that gets breakdown in the abdominal wall tissues.
The Grey turner’s sign will take 24-48 hours to develop and it can predict a severe attack of acute pancreatitis. The grey turner’s sign name after the British surgeon George Grey Turner.
6. Lower Abdomen
The seat belt sign that will presence of bruising in the distribution of a seatbelt across the abdomen chest and the sometimes neck resulting from a motor vehicle accident.
Well, seat belt syndrome collective term of injury that contains all injury of profiles, that can associate with the use of seat belts. It is defined classically as a seat belt sign plus an intra-abdominal organ injury and thoracolumbar vertebral fractures.
The seat-belt sign was described by Garrett and Braunstein in 1962 as linear ecchymoses the abdominal wall following a motor vehicle accident.
This injury is also indicative of an internal injury in as many as 30% of cases seen in the emergency department. The disruption of the abdominal wall musculature can also occur in this but it is relatively uncommon.
The symptoms of seat belt signs are associated with this syndrome that will depend on the injured organ. In the case of hollow organ injuries then the peritoneal signs may appear.
While in some other cases of parenchymal or vascular injuries, the hypovolemic signs dominate the clinical picture.
Seat belt syndrome usually caused by the hyperflexion of the spine that around the lap strap in a sudden declaration which can lead to the crushing of intra-abdominal contents between the seatbelt and also the spine.
The fixed portions of the bowel such as proximal jejunum and the distal ileum are more susceptible to injury than the mobile portion since the mobile segments that can escape the high pressures and resultant damage.
5. Inguinal Pubic Area
Bryant’s sign and the stabler’s sign that occurs in the Inguino pubic area due to the ruptured ectopic pregnancy. The scrotal ecchymosis is also associated with the ruptured abdominal aortic aneurysm.
Extravasation of the blood in the retroperitoneum may lead to the non-traumatic discoloration in the beneath that will intact the penile or the scrotal epithelium.
Ecchymoses symptoms typically appear within three to six days after the AAA rupture. In order to be observed, the blood must transverse the inguinal canal and spermatic cord down to the subcutaneous scrotal tissue.
It will also require a close retroperitoneal hematoma or the sealed surrounding retroperitoneal and the aortic tissue rupture. And also the slow rate of leakage and a prolonged interval prior to the final rupture.
The Bryant’s sign is named on the JH Bryant because he describes the scrotal ecchymosis is associate with the rupture AAA.
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Some Other Types Of Ecchymosis
Purpura has been characterized by the small purple spots on the skin, typically 4-10 millimeters in diameter. In some cases, people develop larger patches of 1 centimeter or greater.
These patches are called ecchymoses. Purpura is also known as blood spots or hemorrhages that can signal a number of medical problems that range from minor injuries to life-threatening infections.
Sometimes these spots can also appear on the mucous membranes, for the instance inside the mouth of the patient. The purpura tends to occur in the clusters that are found in a single area or cover a large portion of the body.
The larger the rash is one of the greater the bleeding will be often. Unlike some other rashes of the purpura will not change the color or blanch when pressed.
The rash can also look a lot like the tiny clusters or the bruises, but the skin should not be irritated or itchy. This would suggest a cause other than purpura. Because purpura itself is a symptom rather than a condition.
To determine the cause of purpura doctors must run a range of the test. These tests will assess the patient’s nutrition, inflammation, platelet levels, blood vessel health, and potential for infection.
Treatment of the purpura usually requires testing the rash’s underlying causes. The purpura spots are generally benign but may indicate a more serious medical condition such as the blood clotting disorder.
Sometimes, low platelet levels that cause excessive bleeding and bruising. The platelet is the cell that can help your blood clot. Low platelet levels may be inherited or genetic, but they may also be related to it.
Pinpoint is the flat round red spots that occur under the skin surface caused by intradermal hemorrhage or bleeding into the skin. Petechiae are red because they also contain red blood that leaks from the capillaries into the skin.
Petechiae are quite tiny or less than the 3 millimeters in the diameter and they also do not turn white after applying gentle pressure. There are also many health conditions in which the petechiae may also be seen.
Well, these conditions are range from very minor to very severe health conditions. One of the common causes of petechiae which include trauma and injury.
Some others cause autoimmune diseases, viral infections, and allergies that impair blood coagulation and thrombocythemia needs a certain medical treatment.
Some medical treatments are radiation, leukemia, idiopathic thrombocytopenic purpura, radiation, and other bone marrow malignancies that may help to lower the number of platelets and sepsis.
Petechiae ecchymosis is commonly seen right after birth in the newborn, coughing, and after violent vomiting. Some drugs such as heparin, cortisone, aspirin, and anticoagulants warfarin can also are the causes of the petechiae.
3. Senile Purpura
Senile purpura is also known as the Bateman’s purpura or the actinic purpura is a condition that will commonly affect aging skin. Fair-skinned older people are more likely to develop these conditions.
These discolored spots of senile purpura had also been called the blood spots or the skin hemorrhages. The initial signs of the senile purpura are the purple or the red bruises that have an irregular shape.
The bruises are not the result of a bleeding disorder, the lack of minerals, or the vitamins or it is the sign of a significant injury.
These small bruises on the skin are also known as the petechiae and the larger ones are called the ecchymoses. The colors of smile purpura will usually not be that much dark or a lighter as the spots progress.
After healing the bruise there’s still a yellow or the brown stain might remain on the skin. Usually, senile purpura is harmless, but it may be a sign of underlying conditions.
One of the most common factors that can most directly affect the development of the senile purpura is thin that can easily damage the skin.
Sun damage over a long period of time also plays an important role in developing the signs of senile purpura. Because it will weaken the connective of the tissues over time.
Vascular disease or the medications that can affect the blood vessels and it can also contribute to the development of the senile purpura.
Lupus, rheumatoid arthritis, and diabetes may also increase the likelihood of developing the lesions. Certain drugs such as the aspirin and the corticosteroid may also increase the lesions.
What Are The Symptoms Of Ecchymosis?
One of the main symptoms of ecchymosis is an area of the skin discoloration larger than 1 centimeter. The area of ecchymosis may also be painful and sensitive to touch.
The color of the patch corresponds to how old and also the severe injury is. If the leakage is recent then the area of ecchymosis may appear purple, black, or dark blue, but it will fade over time and become green or yellow.
Ecchymosis will also disappear as your body that reabsorbs the blood that was pooling under the skin. Ecchymoses most commonly occur on your legs and arms since they are most likely to be injured.
The bruising can also happen when the sprain or strain a bone especially in the wrist or ankle. Typically ecchymosis alone does not cause any concern.
The ecchymoses also appear in those areas where the skin is thin such as the lips and eyelids. Ecchymotic and bruising are commonly shown in the highly active children and in older adults because their skin is thin.
The older adults may notice the painful bruises in the back of their arms and their forearms. When you have thin skin then the blood vessels burn more easily, bursting these blood vessels more frequently bruising.
These injuries are so small, that’s why these ecchymotic usually don’t hurt you. The skin around the eyes is also very thin, which can make it likely to bruise. The ecchymotic around the eye socket is more commonly known as the black eyes.
Some common symptoms of the ecchymotic are:
- Pain over the ecchymosis
- Tenderness when your press the ecchymotic
- Occasional inflammation of the skin surrounding the site
Some signs and symptoms that mean bruises can be from a bleeding disorder rather than an injury. These symptoms are:
- Heavy or very long periods
- Frequent nosebleeds
- Trouble to stopping the bleeding when you cut yourself
- Red or purple spots on the skin.
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What Is The Cause Of Ecchymoses
If you ever bumped your leg or the arm with enough force on the hard surface, then you know the ecchymosis very well. Because the ecchymosis is usually caused by an injury, such as a bump, fall, or blow.
These hit or fall breaks blood vessels under the skin’s surface. If the injury causes a cut on the skin then it causes bleeding. If there is no cut then the blood can’t get out, so it pools underneath in the skin.
These blood cells called platelets rush to the injury. They combine with the proteins called clotting factors to form a clot. The clot plug can break the blood vessel and stops it from the bleeding.
The single ecchymosis or bruise on the skin then is often a symptom of a minor injury. Up to half of the Americans can easily get the bruises in fact sometimes without any obvious cause.
Ecchymosis is very common and it can affect everyone, but women tend to bruise more as compared to men, so do older adults.
As you can get older, then your skin will become thin and it loses its fatty protective layer as well as the collagen and the elastin that will support the blood vessels.
This will lead to you more bruises. The problems with the blood vessels, blood clotting, or platelets can cause more ecchymoses too.
Easy bruising is also a sign of a bleeding disorder such as the Von Willebrand or hemophilia disease.
If you regularly find the ecchymoses on your body, but you can not remember when you get injured, then there could be a sign of an underlying cause.
You may also notice more bruises more usually if you take the medicine that can thin your blood or it will affect its ability to clot.
These medications are:
- NSAIDs like naproxen, ibuprofen, aspiring
- Taking supplements such as ginseng, vitamin E, fish oil, garlic, and ginkgo.
- Blood thinners, like warfarin, clopidogrel, heparin.
If you are taking one of these medications and also notice bruises, then consult with you. But don’t stop taking any medicine before consulting with the doctor.
Because there are also a few other causes of bruises. Usually, ecchymoses have two types of causes these are:
1. Underlying Disease Conditions
Multiple disease conditions can also result in ecchymosis.
- Kidney or liver disease
- Alcohol misuse
- Problems with the bone marrow, which can make new blood cells.
- Connective tissue disease such as lupus and Ehlers-Danlos syndrome.
- Not getting enough vitamins like Vitamin B12, C, or K
- HIV and also other infections
- Aplastic anemia
- Acute renal failure
Trauma is a secondary cause of ecchymosis but it is not that much of a common cause of ecchymosis. A blunt injury, excess pressure, or sudden forceful pressure on any part of the body can cause ecchymoses.
The underlying tissues like asphyxiation or even fractures will cause rupturing of the minor blood vessels and capillaries on the affecting and surrounding areas can cause ecchymosis.
This will result in the leakage of blood into the underlying skin, mucus membrane and it will appear as a bluish discoloration on the surface of the skin.
Frequent bruising of the skin for nor reason will require a health check-up to reveal any underlying disease conditions that might be life-threatening, for example, Marburg virus disease.
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How Is Ecchymosis Diagnose?
Ecchymoses will be diagnosed primarily through the physical examination, during this doctor will assess the area of discolored skin.
The doctor will also ask for your medical history, medications that you currently take, and also ask for the injuries that you may have sustained recently.
If the ecchymosis injury is severe enough then your doctor will ask for the blood test to measure the body’s healing responses, level of inflammation, and blood cell count.
This information will assist your doctor to determine the cause of ecchymosis if the mechanism is still unknown and also providing treatment.
The color of your skin with the ecchymosis assists a doctor to determine the age and also the depth of the injury. A red, purple, or blue hue typically indicates the fresh spots of ecchymosis.
If several days have passed and the healing process has begun, then the areas of the skin typically turn brown, green, or yellow.
A research study analyzed the photographs of the ecchymoses to determine their age and concluded that yellow spots of the skin were the ecchymoses that had received more than 18 hours prior.
If the injury is also more severe than your doctor will also order an X-ray to make sure that there are not any broken bones.
How To Treat Ecchymosis Treatment?
Ecchymosis usually heals on their own within two or three weeks. But the injury that will cause by the bruise may take a longer time to heal, especially if it involves the broken bone.
If you will also experience the frequent pain that results from ecchymotic then the doctor will also complete the more tests and evaluation to know what is the exact reason for it.
After the examination doctor will be able to treat the ecchymotic condition to prevent any serious issues from evolving. Another course of action may be to stop taking certain medications that will cause ecchymosis.
The most minor or moderate ecchymosis injury treat with the NSAIDs which includes ibuprofen, it will reduce the swelling and pain.
Doctors typically also recommend evaluating the bruise by applying the ice to reduce the symptoms of swelling and pain. You can also speed up the healing process with these healing treatments.
Taking rest can help to repair tissue repair and healing especially if it occurs due to trauma.
If it is present in a place where the bodyweight falls frequently on it due to the movement, like the lower extremities or the folds of the skin.
2. Treatment Of Underlying Disease
If the ecchymosis will cause by a reason other than injury, then these underlying conditions should be examined carefully and treated by the physician.
3. Cold Fomentation
If your skin gets inflame after the injury then applying an ice pack will help reduce the swelling. An ice pack can also make by wrapping ice cubes in a piece of a soft cloth.
Applying an ice cube on a big sting or insect but it also aids the healing by reducing irritation and also decreases the inflammation. Just apply the ice pack for 15 minutes, repeat this twice a day.
One of the best methods of applying an ice pack is to move it continuously around the bruised area in a circular motion. So, as not to freeze a vein or increase the pain of injury.
If the ecchymosis causes by a fractured bone then bone needs to be surgically treated.
Surgery can help to put in place with a cast to let it heal completely.
Taking medication to treat ecchymosis such as painkillers like Epinephrine can help in contracting the blood vessels when used along with and anesthetic locally.
And analgesics like then Ibuprofen and local ointments such as arnica gels or taking vitamin K ointments.
Gently elevate the affected area to reduce the swelling and also improve the circulation.
Prop the area on pillows to keep it elevated above the level of your heart. Do elevate as often as possible.
7. Vitamin Supplements
Repeated and the easy bruising may be the result of aging or the physical abuse or the lack of vitamin K, so a healthy diet rich in vitamin C and K supplements that will need to be recommended.
8. NSAIDs Medicines
NSAIDs medicines such as ibuprofen can help reduce pain and swelling. These medications are available without a prescription.
Then ask your healthcare provider which medicine is correct for you. Also, ask your healthcare provider how much to take it and how often to take it.
You can also follow the directions of NSAIDs. Because the NSAIDs can cause stomach bleeding and kidney damage if it is not taken correctly.
If you also take the blood thinner medicine, then always ask doctors before taking NSAIDs.
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What Are The Complications Of Ecchymosis?
Usually, ecchymosis might not have the major complications because it presents itself as the complication of some underlying disease condition like a liver disorder, trauma, ectopic pregnancy.
However, sometimes it might also have some common complications are the areas affecting the mucous membrane or the skin folds.
Hence, one of the most common complications of ecchymosis is an infection of the affected area which includes the following symptoms.
- Pus formation
- Chills and fever
- Increased pain and tenderness
- It will increase the swelling and reddishness of the affected area and also the area surrounding it.
Can I Prevent Ecchymosis?
Well, bruising is normal and it is impossible to avoid, but there are things that you can do to lower your risk of bruising.
These tips are also especially important if the condition that will makes you more likely to bruise:
- Keep floors and walkways clear of debris to prevent falls.
- Never leave items on a stairway
- Wear protective equipment while playing sports.
- Arrange the furniture in a way that will reduce the likelihood of bumps
- Keep a nightlight on in your bathroom and bedroom to avoid any bumps
- Use the flashlight on your cell phone or attach the small light to your keyring so you can easily see in poorly lit areas.
- Consume enough vitamins
- Checking for blood clotting disorders
- Avoid injuries especially in children.
- Avoid consuming anticoagulants or aspirin for a long period of time.
What Is The Difference Between Bruise And Ecchymosis?
An ecchymosis is an under skin spot of bleeding with a diameter larger than 1 centimeter. Ecchymosis similar to a hematoma and it also commonly called a bruise, though the terms of the ecchymosis are not interchangeable in careful usage.
Specifically, the bruise cause by the trauma whereas the ecchymosis.
Ecchymosis is the same as the spots of purpura except larger, but it does not necessarily cause by the trauma. It often causes the pathophysiologic cell function and also disease.
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A contusion is commonly known as a bruise. It is a type of hematoma of the tissue in which the capillaries and also sometimes the venules get damaged by the trauma.
It will allow the blood to seep, hemorrhage, or extravasate into the surrounding of the interstitial tissues.
The bruises remain visible until the blood either absorbed by the tissue or cleared by the immune system’s actions.
Bruises that not blunt easily under the pressure that can involve the capillaries at the level of the skin and subcutaneous tissues, bone, or muscle.
Bruises are also not to confuse with the other similar-looking lesions that primarily distinguish by their diameter or causation. It often induces pain, but all the small bruises are not normally dangerous alone.
Sometimes bruises can be serious that can be leading to the more life-threatening forms of the hematoma, such as it associates with serious injuries, including features and more severe internal bleeding.
Ecchymosis vs Hematoma
A hematoma characterizes as a solid swelling of clotted blood within the body’s tissues.
While ecchymosis is a skin discoloration that can result from the bleeding underneath of the skin and it is usually larger than 1 cm or 3 inches.
Sometimes, hematoma and ecchymosis that can use interchangeably leading to the some of the confusion between the two-term and also the other like:
Both the ecchymosis and hematoma may be caused by the traumatic injury, but the hematomas are usually due to the more severe trauma that will result in the larger blood vessel breakage, and also it can be complications that will occur after the surgery.
Ecchymosis is unlike bruises and hematomas that will often have many other causes that can cause trauma.
For example, ecchymosis that may be caused by the problems with the blood vessels, blood thinners, and other reasons
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Prognosis of Ecchymosis
Well, the prognosis for the ecchymoses is very good. In most of the cases, the ecchymoses are minor and it will resolve quickly in healthy individuals.
So, once the doctor will identify the cause of the ecchymoses, then the doctor can instruct the patient to take steps to prevent it from occurring again.
Then immediately contact with your doctor if you experience the development of new symptoms of ecchymosis after being treated.
Also, consult with the doctor your bruise is growing the size or you are not seeing healthy progress after the 2 weeks. Most of the cases the ecchymosis is minor and causes a little swelling and pain.
Most individuals who are experiencing minor ecchymosis, that can must cope with the temporary cosmetic changes due to discolored skin and bruises.
These all bruises usually resolve entirely once the ecchymosis will heal and the blood also redistributes under the skin. Ecchymosis typically takes around two weeks to recover.
When To See A Doctor?
Ecchymosis usually does not need any treatment, it will heal on its own within a few weeks. If you feel your bruising is more than you will usually or notice unexplained bruises then immediately talk with your doctor.
Because it may be an underlying condition that will need medical attention. Sometimes easy bruising is also a sign of a more serious medical condition such as bleeding disorder.
There are at least 28 conditions that will cause easy bruising. Immediately consult with your doctor if you have:
- Having several bruises on the body with no obvious cause
- The bruise that doesn’t go away within a week or two
- Having possible injuries like a broken bone that can cause the bruise
- Signs of too much blood loss such as nausea, dizziness, extreme thirst, or weakness.
- Bleeding that will not stop after a few minutes.
Also, consult with your doctor immediately if you recently had any surgery or you have a birth and you will notice bleeding or bruises.
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Some Word For Ecchymosis?
Ecchymoses are the most common condition that can occur independently of an overlying medical condition. In most of the cases, ecchymoses are not the cause for concern.
Ecchymosis symptoms resolve in time and are often due to minor soft tissue injuries. Most of the instances of ecchymosis occur due to soft tissue injuries, such as sprains, falls, and other impact-related injuries.
If you are healthy, then one of the best ways to prevent ecchymotic is to avoid soft tissue injuries.
But if you are older than the best precautionary measure that you can take to avoid the ecchymosis is preventing falls or some other injuries in the home.
If you are concerned about the medication that you will take or the condition that you are living with that may cause the ecchymoses. Then consult with your doctor for more information.