Ecchymosis: Signs, Symptoms, Causes, Types, Diagnosis and Treatment

It is one of those skin conditions that can confuse you and make you feel uncomfortable, either because of the pain or appearance.

For inexperienced people, distinguishing the type of ecchymosis is not easy. Many people are confused about ecchymosis based on appearance and size.

Many medical conditions can seem very dangerous and scary to sufferers while being easy to diagnose and harmless with proper treatment.

We present you the following article to understand what it means and how it can be treated. A skin condition develops because blood circulates in the skinny layer of the skin.

The visual of such a skin condition comes in a discolored spot but is much larger, about 1 centimeter or more extensive. It is often a flat spot with colors mixed between blue and purple. Sometimes you may feel a slight pain depending on the severity of your site.

It is a subcutaneous bleeding spot (from extravasation of blood) with a diameter greater than 1 centimeter (0.39 inches).

It is similar to (and sometimes indistinguishable from) a bruise, although the terms are not interchangeable in careful use.


Specifically, bruises are caused by trauma, while ecchymoses, which are the same as purpura spots except that they are larger, are not necessarily caused by trauma; they are often caused by cells’ pathophysiological function in some diseases such as Marburg virus disease.

A broader definition of ecchymosis is the leakage of blood into tissues from broken blood vessels. The term also applies to subcutaneous discoloration resulting from the leakage of blood into the affected tissue.

Signs and symptoms of ecchymosis

Ecchymosis is described as a bruising since, like a normal bruise, it is the circulation of blood outside the blood vessels. Different medical terms are given according to the size of the discolored spot.

Hematomas can be subdivided by size. By definition, ecchymoses are 1 centimeter or more in length and therefore larger than petechiae (less than 2 millimeters in diameter) or purpura (2 millimeters to 1 centimeter in diameter). Ecchymoses also have a more diffuse border than other purples.

Ecchymosis is typically a harmless condition. The causes behind this can be a significant threat to your health. You should consult with your doctor if you do not know the reason behind your spots. The doctor can discover a hazardous disease behind it and help you treat it.

Associated symptoms can appear in the form of reddish, blue, and purple spots that can differ in size. The discoloration may be noticeable as the ecchymosis may be prominent on your body.

It is exciting to know that ecchymosis in different regions receives different names:

  • Raccoon Eye Sign: Ecchymosis common with injury or trauma to the eyeball results in periorbital ecchymosis (bruising around the eye).
  • Battle Sign: In cases of basilar skull fracture, ecchymosis is commonly seen behind the ear, also known as retro auricular/mastoid ecchymosis.
  • Cullen’s sign: ecchymosis surrounding the navel. In some cases of acute pancreatitis, ecchymosis may be seen on the lateral side of the abdomen.
  • Crescent sign: bony projections on either side of the ankles (Malleoli) may show ecchymosis.
  • Stabler’s sign: the groin-pubic area is showing ecchymosis.
  • Fox sign: outer side of upper thigh showing ecchymosis.
  • Bryant’s blue scrotum sign: scrotal ecchymosis.

You may also experience a type of pain but not a vital one. The pain depends on the severity of the stain; some people do not even feel pain.

Possible inflammation due to tissue damage at the level of the thin skin. The swelling can be mild or severe depending on the severity of the discolored spot.

Aside from these signs, you won’t know what ecchymosis is until you see a doctor. Because you’d think it’s just a bruise that you didn’t realize how you got it from.


There are many causes of subcutaneous bruising, including ecchymosis. Coagulopathies such as hemophilia A can cause bruising in children. Betamethasone medication can have the adverse effect of causing ecchymosis.

The first thing people think of when they see an ecchymosis spot is a bruise caused by a punch or a fight.

However, other reasons, such as internal health conditions and diseases, could cause bruising. Here is a list that includes other causes:

Liver disease

Since the liver is a vital organ that monitors the circulation, storage, and filtration of blood in the body, clotting factor deficiency can occur due to liver disease.

Your liver can cause ecchymosis spots if it is affected or not working correctly, which will cause a disturbance in the circulation, filtration, and distribution of the blood.


Bulimia is associated with vomiting most of the time. Therefore, if you tend to put your hand in your mouth to vomit deliberately, you run the risk of ecchymosis at the level of the nails.

When you put your hand in your mouth, your fingers will automatically touch the back of your throat, and your knuckles brush your teeth. After doing this for an extended period and clenching your fist afterward, you begin to develop ecchymosis.


Leukemia occurs due to the excessive production of white blood cells. When there is a blood-forming cell cancer, the normal cells decrease.

This can result in effortless weight loss, loss of appetite, etc. This condition makes the human body or skin venerable to bruises. This means that bruises appear quickly and can also turn into ecchymoses.

Lack of vitamin C

Vitamin deficiency is another factor that causes ecchymosis; this case mainly affects children under five years of age.

Children are usually very picky when it comes to eating, so you have to feed them foods that contain different types of vitamins without neglecting their nutrition program.

It occurs with adults who are dieting and sometimes on strict diets. Dieting does not mean depriving yourself of foods that are high in vitamins. If you do not know how your body would react to such a diet, consult a nutritionist for advice.

Multiple myeloma

This type of factor occurs due to a disorder in the level of plasma growth in the human bone marrow. Ecchymosis occurs when the number of plasma cells increases over time until it develops and causes ecchymosis as it reaches advanced stages.

Renal failure Acute

This condition refers to a lack of kidney function. It occurs when the kidney fails to do a proper job of sorting waste.

The more kidney dysfunctions you have, the more significant the increase in waste in your blood, leading to the development of bruising.


Aging is a natural factor that can cause bruising. Aging means that your health does not stay the same and that specific organs could start to malfunction.

Late internal operations cause the blood circulation to suffer from a disorder. Getting older can contribute to ecchymosis more often the older a person gets.

Von Willebrand disease

Von Willebrand factor is an essential component of the coagulation cascade. Factor deficiency or defect affects blood clotting and can present as nosebleeds, bleeding gums, excessive bleeding from cuts, etc.


When they become cancerous, cells of the immune system, such as lymphocytes, are called lymphoma. Weight loss associated with chills and rigors and swollen lymph nodes may be the presentation in such a case.

Gaucher disease

An autosomal recessive disorder that affects fat metabolism. They can be characterized by hepatosplenomegaly (enlarged liver and spleen), weak bones, and bleeding disorders.

Síndrome de Wiskott Aldrich

It is an X-linked recessive disorder in which there is a decrease in the platelet count leading to a bleeding disorder. It can also manifest itself with eczema and recurring infections.

Vitamin K deficiency

Vitamin K-dependent clotting factors will be absent or decreased in vitamin K deficiency. This can lead to a bleeding disorder.

Clotting factor deficiency

Deficiency can occur due to many causes, such as liver disease. Usually, there may be a family history present. Clotting factor deficiency is characterized by bleeding from various sites, including the nose, gums, wounds, skin, etc.

Ecchymosis area

There is no specific area where ecchymosis can appear on your body. There is some speculation about what makes it appear in a particular area different from the other.

Supposedly the disease or health condition that causes your ecchymosis is the contributing factor where the spot appears.

Ecchymosis can develop on the eyes, neck, elbows, thighs, and stomach; you can detect it immediately due to the noticeable discoloration.


There are many types of ecchymoses, so we chose the most famous types; these types can appear similar in appearance. However, the reasons behind them are different from one to another. You need to read carefully to discover the reason behind yours.

Periorbitaria equimosis

They are also known as raccoon eyes. This condition usually occurs when blood vessels leak from the brain to the area under the eyes, causing discoloration and pain.

Sometimes brain fracture is the cause of such a condition, so you need to consult a doctor as soon as possible.

Traumatic ecchymosis

This type of ecchymosis occurs due to a sudden trauma directed towards a specific body point. You can get traumatic ecchymosis from a fistfight or a sudden hard blow. It often occurs on the face and under the eye area as it is the most exposed during a fight.

You can also get it from tripping or tripping on something stiff, such as a survey or a wooden object. This type produces swelling and pain as it happens suddenly, so you may want to add a cold compress to ease it.

Equimosis mastoid

A condition caused by a head injury is a blow or an accident. This type is similar to the raccoon eye; it happens in a short time, so it is easy to notice. You may want to see a doctor if you have any concerns or ask your doctor to check your brain for severe issues.


In cases of bruising, a detailed history, including family and medical history, is of the utmost importance. In addition, a physical examination should be performed to emphasize the relevant suspicious causes.

In general, a complete blood count (CBC), prothrombin time (PT), and activated partial thromboplastin time (PTT) should be performed. Other detailed investigations will vary from person to person based on the suspected cause. Tests can be done to confirm one diagnosis or to exclude some others.

Differences between ecchymosis and other skin conditions

Many times people tend to Google their symptoms on the Internet. If you are inexperienced with skin infection conditions, you have a high chance of misdiagnosing your condition.

We have provided the following table that distinguishes between ecchymosis-like conditions to make it easier for you.

Ecchymosis vs. bruise

The difference between the two is not visible. The difference is that a bruise is caused by simple causes such as trauma such as a punch or blow. At the same time, ecchymosis occurs due to severe health conditions such as kidney disease or liver disease.

Equimosis vs Púrpura de Schönlein-Henoch

The only difference is the size; the size of the ecchymosis ranges from 1 centimeter and more, while the purple ranges from 3 millimeters but not more than 1 centimeter.

Equimosis vs hematoma

In the same case with purpura, the difference between ecchymosis and hematoma is the size. The hematoma size does not go beyond 3 millimeters; it is 1 centimeter, unlike ecchymosis.

Ecchymosis vs contusion

The difference between bruising and bruising is the wound. Ecchymosis is a hematoma due to internal bleeding so that the skin does not break. However, a bruise means that the skin or blood vessels are damaged.


Ecchymosis treatment can vary from person to person. Doctors consider the reason behind it and treat you based on it. However, some medicines can help you alleviate some of the uncomfortable symptoms.

Ice bags

This treatment can help soothe your area and help regulate blood circulation. This solution helps prevent the spread of ecchymosis by easing the blood vessels and returning them to normal.


When you see a doctor, there is a high chance that they will prescribe the right pain relievers for you. These medications help relieve pain around the affected area until you discover a treatment for the actual cause. Do not take any painkillers that you find in your medicine cabinet; you must first consult a doctor.


If you want to heal ecchymosis quickly:

  1. Avoid any trauma.
  2. Don’t get into fights; you must be careful while exercising.
  3. Prevent boxing while training.

Let the area rest, and don’t work too hard until the pain goes away. After that, you are allowed to stretch it little by little to regulate your blood circulation.


The word ecchymosis (/ ˌɛkɪˈmoʊsɪs /; plural ecchymosis, / ˌɛkɪˈmoʊsis /), comes to the English of the new Latin, based on the Greek ἐκχύμωσις ekchymōsis, from ἐκχυμοῦσθαι ekchymousthai «to extravasate the blood,» from ἐκ- to ekἐ e-) and χυμός chymosin «juice.»

Compare enchyma, “tissue infused with organic juice,”; elaboration from chyme, the formative juice of the tissues.

This skin condition is not harmless and can be cured with a simple solution. Could you not take it lightly? The reasons behind this can cause risks to your health. It would help if you had a complete medical check-up to ensure you don’t have a severe illness.

You need to review your medical history with your doctor to discover any possible signs that you have neglected.