One of the most commonly discussed topics in any procedural consultation is the management of bruising – both prevention and treatment. Bruising is distressing to patient and surgeon alike, as it can prevent the post-procedure anonymity and privacy a patient would otherwise enjoy.
To understand how to best avoid bruising, one needs to know how a bruise occurs. Underneath the human skin is a fine network of vessels that supplies blood to the skin and muscles. Any intervention that then disrupts this network can leak blood, temporarily “staining” the surrounding skin and adipose tissue. If the injury is significant enough, a collection can develop that becomes apparent on the skin surface and can be difficult to cover up with make-up.
As each person has a different propensity towards bruising, it is helpful to review options with anecdotal evidence of either preventing or treating bruises.
Supplements – Two of the most commonly discussed over-the-counter supplements thought to reduce swelling and bruising include Arnica Montana and Bromelain. Arnica is a naturally occurring herb that is found in multiple forms, including topical gels and oral pills; it is thought to dilate local blood vessels, speeding clearance of bruises through increased blood flow. Bromelain, a protein found in pineapples, is thought to naturally reduce inflammation, limiting swelling and the duration of bruising.
Medications – There are a number of medications that can increase the fragility of blood vessels, predisposing patients to bruises: Aspirin, Ibuprofen, and blood thinners such as Coumadin and Lovenox. These medications should be stopped at least a week or more before treatments, with timing of cessation and resumption dictated by your surgeon.
Diet – There are certain foods that can predispose patients to bruising, due to certain chemical compounds found within them: garlic, ginger, green tea, cayenne pepper, and red wine. Other foods can help prevent bleeding and include leafy green vegetables – kale, spinach, and cabbage – while the papain found within papaya can help break up and clear bruises.
Herbals – Given the recent increased interest in Eastern medicine, there are a number of herbal remedies that must be avoided prior to any injection or procedure. The more common ones include Echinacea, Ginkgo Biloba, Ginseng, and St. John’s Wort.
Despite all good intentions, if a bruise begins to materialize, what are the best maneuvers to mitigate its severity?
Apply Pressure – Pressure on the area of concern will slow blood flow through the surrounding tissues, limiting the amount of blood that leaks through the source of injury before your body’s natural responses plug the injury with a small clot.
Icing/Heat Therapy – For the first 1-2 days after treatment, ice and cool compresses will help limit swelling in the skin — and the amount of skin staining that can result from any injury. Once the bruise has developed and stabilized in size, use warm compresses to increase blood flow and help clear the bruise.
Supplements – In addition to the aforementioned products, taking a multivitamin daily can assist bruise clearance by supplying your body with the Vitamin A, C, zinc, selenium, and B complex medications that help promote tissue repair. Witch Hazel compresses can also help reduce skin’s irritation post-injury and is also thought to help clear bruises.
Makeup – It is okay to apply makeup to a bruise in order to minimize its appearance. Try using a yellow-tinted concealer on darker bruises (purple in color) for better camouflage.
As an Emory, Harvard, and University of Pittsburgh-trained, ASPS board-certified plastic surgeon, Dr. Castillo aims for each patient to receive the outcomes they deserve, and although bruising is a possibility with any intervention, he prioritizes limiting patient distress — both visible and internal.
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