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How to Treat a Soft Tissue Hematoma

Updated on April 14, 2017
Bobski606 profile image

I've had experience with soft tissue hematomas as a result of regular injections I received for a medical condition.

What Is a Hematoma?

A hematoma forms when a blood vessel breaks and blood leaks out into the surrounding tissue. This can form a clot, or retain its fluid state, depending on how old the injury is. Blood can come from an artery, vein, or capillary depending on where the damage occurs, and then accumulate in the soft tissue forming a bruise. Alternatively, it can seep into joint sockets causing mobility problems, damage to the socket, and a lot of pain.

If a hematoma is causing a lot of problems, or continues to grow, it will need to be drained by your doctor. The ruptured vessel will need to be sealed to prevent the hematoma growing back.

Disclaimer

I am not a doctor. This information should not replace the advice of a qualified health care professional. If you have any worries, please consult your doctor.

What Causes a Soft Tissue (Subcutaneous) Hematoma

A subcutaneous hematoma occurs when a ruptured blood vessel leaks blood into the surrounding fatty tissue. This can cause a lump to form and a large bruise to appear on the affected area. You may find that if the hematoma is further away from the skin you may only feel a "fatty" or mobile lump without the bruise or only a light discoloration.

There are many ways a subcutaneous hematoma can form and the most common factors are blunt force trauma or through an injection. With a blunt force trauma injury, the symptoms will be very similar to that of an orthopedic hematoma (also known as a muscle contusion or bruise), but the blood sits in the fatty tissue rather than the muscle. People taking blood thinners are more at risk from this type of damage since their blood clotting is already restricted.

Injections can also be the cause of subcutaneous hematoma (which I get on a regular basis from my medication, Clexane). When an injection punctures the skin on the tummy or thigh it can graze, damage, or pierce straight through a blood vessel causing blood to seep out into the surrounding fatty tissue. If you're injecting Heparin or another type of blood thinner, this can make hematoma worse because your clotting is restricted and more blood can potentially enter the tissue.

My hematoma
My hematoma | Source

Symptoms of a Soft Tissue Hematoma

A subcutaneous hematoma can look very different each time you get one. The most common symptoms I have experienced are on my tummy and they start with a small lump about the size of 10p piece that starts on the surface of the skin and goes back towards my spine. The lump will be very tender and hard and on the surface of the skin will be a great big bruise that goes from black to purple to green to brown and then gone. Those are the symptoms of a hematoma caused by an injection.

Of course hematoma will vary each time depending on the severity of the injury and you may need to get the hematoma drained if it continues to grow or is incredibly painful or large. Basically, when in doubt see your doctor.

Scarring Update

It's been about 2 years since I've moved from Clexane injections to an anticoagulant called Warfarin, and I wanted to provide a quick update on my hematoma/scarring.

So, it's actually healed up really well. All of my hematoma have healed, and the scarring is so light that you can only see a few small dots of scar tissue if you know where to look.

The healing process was quite slow in the beginning, but after 4-6 weeks of no injections the bruising was clearing up and the hematomas began to shrink. It still took long time for the multiple hematoma to completely disappear, but the discomfort they caused was mostly gone within 6 months. I believe I haven't been bothered by them in over a year now.

Scarring From Hematoma

As you can see in the photo, I have a series of small white scars, and farther up I have some particularly nasty red scars too. These are all caused by an injection that I receive for a condition called Heterozygous Factor V Leiden. The problem of scarring arises when I inject and then develop a hematoma. It causes the tissue to stretch and scar some more which I'm obviously not happy about.

I took a look around the internet and found some great ways of removing or reducing scars and scar tissue, and making skin more supple. I discovered that if your skin is nice, healthy, and supple, you are at a decreased risk of scarring and hematoma: that's just one more reason to look after yourself. I made a habit of moisturizing with very gentle massage every night as it not only helped to keep my skin healthy but also helped in reducing some of the discomfort I felt as well.

Draining a Soft Tissue Hematoma

The video below is quite graphic, so if you wish to view it then go ahead. However, if you're squeamish or would simply prefer not to watch it, then feel free to carry on scrolling straight past it.

Graphic Video of a Hematoma Procedure

First Aid Treatment

Within the first couple of days you should be treating your injury with the RICE method where possible (Rest, Ice, Compression, Elevation). This method will help keep the swelling down and keep the size of the potential hematoma small, too.

Have you ever had a soft tissue hematoma?

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What Causes A Hematoma To Rupture?

A ruptured hematoma is going to need some medical attention. A soft-tissue hematoma is likely to rupture when it needed to be drained in the first place and it has either:

  • Had an excess of fluid build up and the pressure has become to great for the surrounding tissue;
  • Suffered further injury causing more damage to the already weakened artery/vein

When in doubt please seek medical attention to have your injury evaluated.

Longer-Term Treatment

The most effective treatment for a subcutaneous hematoma is, simply, time. However, if you have a large hematoma that is causing a lot of pain and inhibiting mobility you may have to get it drained by your doctor.

To drain a hematoma your doctor will make a small incision to gain access and then insert a syringe to relieve the area of built-up blood, clots, and fluid. This procedure only takes a few minutes are there is instant relief. Recovery from this procedure is fairly quick and there should be minimal problems in healing assuming everything went well in the procedure.

If your hematoma does not require draining then I would recommend wearing loose clothing to avoid irritation and to use arnica cream or gel a couple of times a day (morning and night) to help the body dissolve it.

How Long Does A Hematoma Take To Heal?

The answer to this question is entirely down to the size of the hematoma but I'll provide some guidelines for you to work with.

The smaller hematoma I have experienced (see picture above) usually lasted for a week to 10 days as they were caused by injections. However, my ability to heal is slowed due to my Heterozygous Factor V Leiden so if you have no previous or conflicting medical complaints then I would put the recovery time between 5-7 days.

A larger hematoma caused by blunt force will take longer to heal simply due to their size. Most people should find that their bruising reduces within 10 days and that the lump left behind should be gone within 6 weeks. Be aware that larger injuries and your body's natural ability to heal will impact this healing time though. If you have not seen any reduction in size after 10 days and it is still sore and generating heat then you should see you primary care provider for an assessment. Of course if are worried before the 10 days have passed then please don't hesitate to speak to them before as you may need treatment earlier.

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    • Bobski606 profile image
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      Bobby 6 weeks ago from U.K

      @Angie, yes this can happen after an injury. It may be an inflammatory response to the trauma, if it doubt see your doctor.

      @Adrian, if the hematoma is still there in a couple of months then yes, you can opt to have it drained if it is still causing you concern. Your doctor will be able to provide a better diagnosis after an examination though.

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      Angie Pollitt 6 weeks ago

      I have a soft tissue injury in my left wrist that happened 2 days ago from blunt force trauma. Today I have had more pain, lump and bruising show up on up my arm from my wrist that is pretty painful. Is that normal for pain and bruising to continue to show up 2 days after the injury?

    • profile image

      Adrian 6 weeks ago

      Can I opt for drain the hematoma after few months which I have never been done before. Could this eliminate the hematoma bump ? What is your advice ?

    • Bobski606 profile image
      Author

      Bobby 7 weeks ago from U.K

      Hi Adrian, I still have a couple of small bumps where the hematoma developed over the years. To me they feel like a callous that you can move around and generally don't give any pain. I have spoken to my doctor about these and she said that it's just the body's way of trying to deal with the lump and that eventually it will go away, I just have to be patient. As long as the lump is not bothering you on a daily basis or causing any pain then it will eventually disappear but if in doubt have a doctor check it out just to be safe.

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      Adrian 7 weeks ago

      It almost 4 months since hematoma developed in my ankle and I felt very small lump and skin is little rough although my condition has improved over time. My question is can hematoma actually would not go away completely after few years ? Please share your thought base on your experience.

    • Bobski606 profile image
      Author

      Bobby 7 weeks ago from U.K

      @Adrian: yes this can sometimes happen although not as often. The blood vessels in the ankle and feet are quite small and therefore at a greater risk for other complications. Make sure your doctors are keeping an eye on this.

      @Marley Rose: this sounds like it could be a hematoma and if the lump is causing pain then draining it could be the cure you are looking for especially as they have not found a solution yet.

      @Julie: you should get this looked at with a doctor who will need to examine this and see if it needs draining. It may seem more pronounced now because any lingering swelling from your fall would have cleared by now revealing more of this knot.

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      Julie 7 weeks ago

      I had a hard fall on my metal stairs almost a month ago which resulted in several injuries. One being a bruised bone in my lower arm bone with a firm knot on it. Today, I noticed the knot has now gotten a more pronounced softer swelling on it about the size of a ping pong ball. What could be going on and should I be concerned about this?

    • profile image

      Marley Rose 7 weeks ago

      Hi there,

      May 2015 I was passenger in car accident, broken pelvis, had surgery 5 days later, was on blood thinners for a month afterward. On my right upper thigh (localized below butt near the back on thigh) for 2 years now no doctors have any idea but said they would stick a needle and drain it. It's a 10cmX5cm raised lump and I've gotten no answers.

    • profile image

      Adrian 2 months ago

      Hi Booby,

      Do you know about post hematoma symptom and treatment ?

      The accident trauma not just cause hematoma but it may cause other effect. Such as trauma just above the ankle may cause damage blood vein and nerve in the feet. I had a blood pool in my feet although the hematoma just above my ankle.

    • Bobski606 profile image
      Author

      Bobby 2 months ago from U.K

      @kingkeith: I would advise seeing a medical professional after a hit to the head to rule out any concussion or other serious injury. Bumps to the head can take longer to heal and based on previous experience it's likely to be at least a few weeks depending on your body's healing time.

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      kingkeith 2 months ago

      i have a bump on my head after hitting it on a pole and it’s moving down from my forehead to my eyelids when will it go away?

    • profile image

      ann pomeroy 2 months ago

      Hi, I had a fall in december last yr. and had a football size bruise and alot of swelling on my thigh. after a few weeks the bruise went away but the swelling never did. i still cany sleep on that side and today it was burning when i woke up. i do have to go to therapy to try to get it to absorb back into the skin. i just got a feeling this is not going to work

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      Adrian 3 months ago

      Thanks for your reply. I have another question, can the accident trauma which cause the hematoma in the lower limb affect the blood circulation in the feet ?

    • Bobski606 profile image
      Author

      Bobby 3 months ago from U.K

      @ Adrian, in my experience the lump is normal and will eventually disappear and the skin will return to normal. Just keep an eye on it and speak to your doctor if it changes or starts causing discomfort.

      @ Lisa, you're welcome.

      @ Karen, this can happen with hematoma so carry on with the drain until your health care provider says so and report anything unusual or painful to them asap.

    • profile image

      Adrian 3 months ago

      I had hematoma just above the ankle and is already 2 months had passed. The hematoma had reduced in size it does not cause any disconfort. However I can still feel tiny small hard lump which does not goes away. My question is can this lump absorbed back to the body, how long it will take. Is it possible to take years for the skin to return in original condition ?

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      Lisa 3 months ago

      Thanks for your article Bobby - so good to have someone explain this with personal experience. My Mum has regular blood tests on warfarin and has developed a hematoma on her arm, which comes and goes with the ongoing tests and gets enlarged if she knocks it. So good to have some tips to help alleviate it.

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      karen bond 3 months ago

      I have just had a hematoma drained that was caused by a accident I had many years ago, The Radiologist drained 2 litres of fluid off ( yes it was very big) the pigtail drain has been left in now for 3 weeks and is still draining, the problem I have is no fluid drains throughout the daytime then every morning there is a lump back again and then about a 100 mls is drained gradually through the morning, is seems to be filling again,, this happens daily ?????

    • Bobski606 profile image
      Author

      Bobby 7 months ago from U.K

      Thanks for stopping by Anand. If you are at all worried about the hematoma then please get it checked out by your health care provider so they can assess if it does need to be drained.

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      Anand 7 months ago

      Hi,

      My husband has a fall and now has a huge hematoma in his knee. First aid was done and pain has been resolved. But the hematoma continues to exist. It has gone down a bit but still remains. It has been 10 days. Should we wait and see if it goes down, or should we get it drained!?

      Thanks in advance.

    • Bobski606 profile image
      Author

      Bobby 8 months ago from U.K

      Hi, thanks for stopping by. I'm not a medical professional however in my experience a clot healing in this manner is normal. It sounds like your daughter is healing well.

    • Artavazd Minasyan profile image

      Artavazd Minasyan 8 months ago

      Hi. Great post.

      We discovered a hematoma in my 2 year old girl 6 months ago. It is in her leg in form of a clot(about 5cm). Doctors advised just to wait to heal itself. We measured few times in last months and it reduced in size up to 3cm. Yesterday we went to doctor for measurement and discovered that it now does not have emphasized edges. Is it the usual way of hematoma healing?