Bruises can be painful and unsightly. When we get a bruise, our first instinct is often to put ice on it. But does ice actually help bruises heal faster? Let’s take a look at the evidence.
What is a bruise?
A bruise, also called a contusion, occurs when an impact causes tiny blood vessels under the skin to break. Blood leaks into the surrounding tissues, causing discoloration. The injured area initially turns reddish as blood pools, then changes to a blue or purplish color as the blood breaks down. Finally it turns greenish or yellowish as the bruise fades. This whole process can take 1-4 weeks depending on the severity of the injury.
How does ice help with bruises?
Applying something cold, like ice, to a new bruise can provide several benefits:
- The cold causes the blood vessels to constrict, reducing internal bleeding into the tissues. This may limit the size of the bruise.
- The cold helps numb the pain and provides comfort.
- It decreases cellular metabolism and inflammation.
Doctors often recommend applying ice for 20 minutes at a time in the first 24-48 hours after an injury. The cold temperature causes vasoconstriction (narrowing of the blood vessels), which reduces blood flow to the area and inflammation. With less blood pooling in the region, there is less bruising and swelling.
Does ice actually speed up healing?
Despite being commonly used for bruises, evidence that ice speeds up the healing process is lacking. A few key points:
- Most studies find that ice does not actually alter the natural progression of a bruise or shorten healing time.
- One study found it took bruised tissue exposed to cold temperatures longer to regain normal metabolism compared to tissue not exposed to cold.
- Applying ice may temporarily provide pain relief but does not impact underlying tissue damage.
The body will heal a bruise through its natural inflammatory and regenerative processes regardless of whether ice is applied. How quickly you heal mainly depends on your age, genetics, nutrition, and severity of the injury.
When is icing counterproductive?
While generally safe, icing does come with some risks and downsides:
- Applying ice directly to the skin can cause frostbite in some cases.
- Extreme cold may damage cell membranes and delay healing.
- It may reduce delivery of nutrients and oxygen to the area.
- Ice can temporarily dampen pain but lead to more swelling once removed.
Doctors advise against icing a new injury for more than 20 minutes at a time. Allow the skin to return to normal temperature before reapplying ice. Icing too aggressively or for too long can be counterproductive.
Other evidence-based treatments
Some other remedies may supplement icing when treating a bruise:
- Compression: Wrapping the area applies pressure to stop internal bleeding and swelling. This helps prevent bruising from spreading.
- Elevation: Keeping the bruised area raised above heart level aids gravity in reducing blood pooling and inflammation.
- Pain relievers: Over-the-counter meds like acetaminophen or NSAIDs can relieve pain and discomfort.
- Arnica: Arnica supplements may minimize bruising when taken immediately after an injury, research indicates.
- Bromelain: This enzyme found in pineapples shows promise for reducing bruising.
When to see a doctor
Seek medical care if:
- A bruise does not fade after 4 weeks
- Pain or swelling worsens over time
- Bruising spreads to other areas
- Bruising occurs with only minor impacts
These signs may indicate an underlying medical condition requires treatment or that the injury is more serious than a typical bruise.
The bottom line
Icing is unlikely to make a bruise heal faster. But it can temporarily minimize pain and swelling. Apply ice for no more than 20 minutes at a time during the first 1-2 days after an injury. Combine icing with other remedies like compression or OTC pain relievers as needed. Seek medical care if bruising seems severe or spreads.
Frequently Asked Questions
How long should you ice a bruise?
It’s generally recommended to ice a new bruise for 10-20 minutes at a time, a few times per day, during the first 48 hours after injury. Icing for longer periods can damage skin tissue.
Can you ice a bruise too much?
Yes, it’s possible to over-ice a bruise. Applying ice for over 20 consecutive minutes can cause frostbite. Allow the skin to warm up between icing sessions. Excessive icing can also impede blood flow needed for healing.
Is heat or ice better for a bruise?
Ice is considered better than heat for new bruises. Cold temperatures constrict blood vessels, reducing bleeding under the skin. Heat promotes blood flow and can increase swelling and inflammation.
How do you treat a bad bruise?
To treat a severe bruise:
- Apply ice for 10-20 minutes several times daily to minimize swelling.
- Compress the area with an elastic bandage to prevent spread.
- Elevate the bruised area above heart level when possible.
- Take over-the-counter pain medications as needed.
- Consider arnica or bromelain supplements to reduce bruising.
When should you go to the doctor for a bruise?
See a doctor if:
- Bruising worsens or spreads days later.
- The bruised area becomes warm, red, or inflamed
- The region remains painful to touch after 2 weeks.
- Bruising results from minor bumps.
- You develop a fever or flu-like symptoms.
These can indicate an infection, blood-clotting problem, or underlying medical condition requiring treatment.
Can you drain a bruise?
It’s not recommended to drain a bruise, as this can introduce bacteria and cause infection. Most bruises will heal on their own through the body’s inflammatory and reparative processes. A doctor can drain pooled blood from a bruise only in rare cases.
Conclusion
Icing is helpful for relieving bruise pain and limiting initial swelling. But evidence does not show it quickens healing. More important is treating the injury appropriately and letting the body’s natural processes resolve any bleeding and tissue damage. Combine icing with other remedies like compression or OTC pain relievers as needed. See a doctor if excessive bruising or complications develop.
