By Dr Evelyn Lewin

A bruise is a discolouration of skin. It is often painful or tender. It occurs when blood vessels are damaged, allowing blood to leak out. The blood then pools underneath the skin, causing the change in skin colour. Bruises can happen after injury. They can also occur spontaneously (meaning, without injury beforehand). Children who bruise spontaneously, or bruise following minimal injury, may have a bleeding disorder. Spontaneous bruises are also a feature of leukaemia (a form of cancer). Spontaneous bruises that occur in an unwell child (with symptoms such as fever and headache) may be a sign of meningitis and requires urgent medical care.


Bruises come in a variety of shapes and sizes. A bruise changes colour over time. It initially starts off red or reddish brown, and then becomes purple before fading into a more yellow colour as the blood gets resorbed. It fades a couple of weeks later.

  • Bacterial meningitis: If your child is unwell with a fever, neck stiffness or headache and then she develops a rash that resembles a bruise, call an ambulance immediately. Urgent medical care is required.
  • Bleeding disorder: If a child bruises easily, bleeds from the gum when brushing her teeth, or has cuts that bleed for a long time, consider a bleeding disorder.
  • Leukaemia: Spontaneous bruising can also be a symptom of leukaemia. Your child may also have extreme tiredness or weakness, get more infections than expected, feel short of breath or have a fever.


If your child hurts herself and you think she may bruise, apply ice to the affected area. Ice helps prevent too much blood pooling under the skin and can minimise the severity of the bruise. If a bruise does not go away on its own, or if a hard firm lump forms underneath the skin, your child may need further treatment. See your GP for advice. If your child is unwell and you notice new bruises appearing, consider the possibility of meningitis and call an ambulance immediately. If your child bruises spontaneously, has bruises she can’t account for, or bruises easily, or you are concerned at all, see your doctor. While there is no exact number of spontaneous bruises a child needs to have to be classified as ‘worrying,’ if you are concerned, speak to your doctor.

Reviewed by Dr Evelyn Lewin 25 February 2015 references
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This document has been developed and peer reviewed by a KIDS HEALTH Advisory Board Representative and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

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