Acupuncturist

If you bruise easily, you might have an illness that has depleted the body over time, or your digestive organs may not be working together to properly control blood flow. Usually an herbal therapy can help, though treatment depends on the person.

Most of the herbal formulas for bruising work to keep the body's energy (qi, pronounced “chee”) or blood circulating. For fresh bruises, I use cooling herbs that dilate the blood vessels and move energy through the area in order to clear a bruise. I don't recommend ice on a swelling bruise because rather than moving the blood, ice congeals blood in a local space, which can work against healing.

Externally, you can heal bruising with an herbal formula called San Huang San or “herbal ice.” The main herbs in the formula are huang bai, huang qin, and da huang, which you can find in Chinese herb stores. Grind about 20 grams of each herb into a fine powder and then mix with egg whites until it is the consistency of thick mud. Spread the paste on the bruised area, cover with a bandage, and leave it on for 24 to 48 hours to reduce the inflammation.
-Tom Bisio, Lac, author, A Tooth From the Tiger's Mouth (Simon & Schuster, 2004), New York

Naturopathic doctor

Bruises can be a symptom of numerous conditions, so the first thing we want to do is identify the cause of the problem by doing blood work to rule out blood clotting, liver disease, platelet or bone marrow disorder, or hemophilia. If everything is fine, then we look at nutritional imbalances and identify if the person is taking aspirin, other blood thinning medications, or steroids, which can cause bruising as a side effect.

In general, people who bruise really easily may have a clotting disorder. Vitamin K applied topically and vitamin E taken internally coagulate seeping blood and help clear bleeding from bruises. Vitamin C is also important for strengthening capillaries. Acerola berries, available in frozen acerola juice concentrate, as well as oranges, grapefruits, and peppers, are great sources. Bioflavonoids, the plant substances that bring color to fruits and vegetables, also increase vitamin C's ability to protect capillary walls. Try to get these vitamins from your food because food sources provide a broad range of essential minerals and antioxidants that you need. Also, look for topical ointments or salves with arnica, comfrey, or sweet clover to minimize inflammation and alleviate pain.
-Angela Lambert, ND, MSOM, Lac, owner, A Healing Path holistic health clinic, Portland, Oregon

Vascular surgeon

A bruise represents the red blood cells leaking into the tissues underneath the skin when direct injury breaks the small blood vessels, or capillaries. The elderly and those with significant malnutrition are at increased risk of bruising because they don't have as much structural integrity in the skin and underlying tissues. People who are on steroids or blood thinners, including everyday aspirin, are also at increased risk because these factors make the capillaries more fragile.

For most bruises you don't need to see a physician. The black-and-blueness may take several weeks to go away, but that is not a concern. During the first 24 hours, put a cold compress on the area several times a day to decrease the pain and inflammation and to help close the capillaries and decrease further bleeding. For the first day or two take 325 mg Tylenol three times a day, which does not exacerbate bleeding or thin the blood like aspirin. After a few days, you can use aspirin because it has anti-inflammatory and analgesic components. Elderly patients could also wear long-sleeved shirts and pants to provide a little protection against everyday bumps and bruises.
-John Blebea, MD, professor of surgery and chief of vascular surgery and endovascular therapy division, Case Medical Center, Cleveland