Understanding the Basics of a Hematoma
Before diving into what can make a hematoma worse, it's helpful to understand what it is. A hematoma is a localized collection of blood outside of blood vessels, often caused by trauma that damages a vessel and causes blood to leak into surrounding tissues. While typically benign and resolving on its own, several factors can complicate the healing process and exacerbate the condition.
Medications That Aggravate Bleeding
One of the most significant factors that can worsen a hematoma is the use of certain medications, particularly those that interfere with the body's natural blood-clotting process. Patients must exercise caution and consult with their healthcare provider, especially if a hematoma develops while they are on these medications.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Over-the-counter pain relievers like ibuprofen (Advil) and aspirin are common NSAIDs that should be avoided with a fresh hematoma. These medications can inhibit blood clotting, potentially perpetuating internal bleeding and increasing the size of the hematoma. Acetaminophen (Tylenol) is often a safer alternative for pain relief, but always check with a doctor.
Blood Thinners (Anticoagulants)
Individuals taking prescription blood thinners, such as warfarin (Coumadin), apixaban (Eliquis), or rivaroxaban (Xarelto), are at a higher risk for more severe or expanding hematomas. These medications are designed to prevent dangerous blood clots, but as a side effect, they can also cause more pronounced bleeding after an injury. Any unusual or large hematoma in a person on anticoagulants warrants prompt medical attention.
Supplements and Vitamins
Certain supplements, including garlic, Ginkgo biloba, and high doses of vitamin E, are known to have blood-thinning properties and can contribute to bleeding issues. It is important to disclose all medications and supplements to your doctor, particularly after an injury.
Physical Activity and Pressure
Your actions immediately following an injury play a crucial role in preventing a hematoma from getting worse.
Premature Strenuous Activity
Returning to intense exercise, heavy lifting, or strenuous activity too soon can significantly worsen a hematoma. This increases blood flow and pressure to the injured area, which can cause the damaged blood vessels to leak more blood, enlarging the hematoma. Rest is critical in the initial stages of recovery.
Improper Application of Compression and Elevation
While proper compression and elevation are part of the R.I.C.E. method and can help, incorrect application can be counterproductive. Applying a bandage too tightly can restrict blood flow and cause other problems. Likewise, not elevating the injured limb above the heart level can allow blood to pool, increasing swelling and discomfort.
Improper First-Aid Techniques
Applying the wrong kind of treatment can be detrimental to the healing process.
Applying Heat to a Fresh Injury
Many people mistakenly believe heat helps all injuries. However, applying heat to a fresh hematoma is a major mistake. Heat increases blood flow and can cause more bleeding and swelling. Ice or cold therapy should be used immediately after the injury to constrict blood vessels and minimize bleeding.
Attempting to Drain the Hematoma Yourself
Never attempt to drain a hematoma at home with a needle or any other device. This carries a serious risk of introducing bacteria and causing a severe infection. Draining should only be performed by a healthcare professional in a sterile environment.
Underlying Health Conditions and Age
Certain medical conditions and physiological factors can predispose individuals to larger or more problematic hematomas.
Coagulation Disorders and Liver Disease
Conditions like hemophilia or liver disease can impair the body's ability to clot blood effectively. In these cases, a minor injury can result in a more severe hematoma that takes longer to resolve.
Hypertension (High Blood Pressure)
High blood pressure can weaken blood vessel walls, making them more susceptible to damage and leakage, which can worsen a hematoma.
Older Age and Fragile Vessels
As people age, their blood vessels can become more fragile and their skin thinner, making them more prone to hematomas from even minor bumps.
Comparison of Proper vs. Improper Hematoma Care
| Action | Proper Care (Recommended) | Improper Care (What to Avoid) |
|---|---|---|
| Medication | Use acetaminophen (Tylenol) for pain, if needed and approved by a doctor. | Take NSAIDs like aspirin or ibuprofen, which thin the blood. |
| Activity | Rest and elevate the injured area, especially in the first 24-48 hours. | Engage in strenuous exercise or heavy lifting prematurely. |
| Temperature | Apply ice or a cold pack wrapped in a towel for 15-20 minutes at a time. | Apply heat, which increases blood flow and bleeding. |
| Intervention | Seek professional medical advice for large, painful, or persistent hematomas. | Attempt to drain the hematoma at home, risking infection. |
| Compression | Use a compression bandage correctly to reduce swelling. | Apply compression that is too tight or constricts blood flow. |
Conclusion: Proactive Steps for Better Healing
Understanding what can worsen a hematoma is the first step toward effective management and a smoother recovery. By avoiding certain medications and premature activity, using proper cold therapy, and seeking professional help for concerning symptoms, you can significantly reduce the risk of complications. Always consult with a healthcare provider for diagnosis and treatment, especially if the hematoma is large, not improving, or accompanied by severe pain or other neurological symptoms. For more comprehensive information on this topic, refer to reputable sources like the Cleveland Clinic on Hematomas.
