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BRUISES

BRUISES COME IN ALL SHAPES and sizes and exhibit a spectrum of shifting colours - midnight blue, the purplish red of raw liver and olive green mottled with sickly yellow. Injury to the soft tissues of skin and muscle causes most bruises. Surgery, major or minor, can cause extensive bruising. Sometimes the injury that causes the bruise is serious; sometimes the trauma, especially as we get older, is so mild we don't even register the bump until there's a change in skin colour. If you habitually bruise without injury, see your doctor. This can be a sign of illness such as a platelet disorder, leukaemia or nutrient deficiency. If a snake bite produced your bruise, or you feel ill and break out in a rash of tiny bruises, get medical help immediately.

BRUISE CURES FROM YOUR FREEZER
Simple, old-fashioned and effective, a cold application right after an injury can help reduce swelling. Cold temperatures encourage blood vessels to narrow, thus stanching their flow and minimising swelling. Cover your skin with a thin cloth, then apply a bag of frozen vegetables (peas and sweetcorn conform nicely), a plastic bag of ice cubes or a commercial cold pack. Elevate the injured part and keep it cold for a mximum of 10 minutes. Repeat three to four times per day the first day of the injury.

OLDER PEOPLE WHO BRUISE EASILY
Have you ever seen a scattering of bruises on your forearms or shins and wondered how they got there? Older people sometimes develop capillary fragility. Capillaries are the smallest of blood vessels and the ones that tend to leak blood into tissues. Vitamin C and bioflavonoids, the nutrients that often accompany vitamin C in foods, help keep blood vessels strong and less likely to leak. You can either take a vitamin C supplement (at least 500 milligrams per day) or eat foods rich in vitamin C and bioflavonoids: peppers, guavas, parsley, dark-green leafy vegetables, broccoli, cabbage, citrus fruits and strawberries.

DRUG TREATMENT

Analgesics
Aspirin, paracetamol, ibuprofen.
Paracetamol and aspirin side effects:
heartburn, mild nausea or vomiting.
Ibuprofen side effects: dizziness, stomach ache, nausea, headache, diarrhoea.

HERBAL REMEDIES

Arnica (Arnica montana)
Pain-relieving, antiseptic and anti-inflammatory, arnica is most commonly used topically for traumatic injuries and is said to speed the disappearance of bruises. In fact, Germany's Commission E, that country's equivalent to the Medicines Control Agency, has approved arnica's external use for injuries. Many gels, creams, ointments and salves contain arnica. You can also make your own compress with arnica flowers you purchase in bulk. Just steep 2 teaspoons of dried flowers in 1/4 litre of hot water for 10 minutes, strain and cool; or add 1 dropperful of tincture to 1/4 litre of water. Wet a clean cloth with the solution and apply to the injured area for about half an hour three times per day, preferably beginning as soon as the injury occurs. With manufactured products, follow package directions.
Caution: do not apply products containing arnica to broken skin or open wounds.

Calendula (Calendula officinalis)
Anti-inflammatory, astringent, antiseptic and cooling: pretty calendula, or marigold, has all of these properties, plus it inhibits bleeding. A traditional remedy for wounds of all sorts, it can also be applied externally to bruises in the form of a compress, gel, cream or salve. Steep the dried flowers in the same way as for arnica to make a compress. Apply to the injured area three times per day.

Comfrey (Symphytum officinale)
This herb contains allantoin, a substance that helps 'knit' cells back together. It's also anti-inflammatory. Germany's Commission E endorses its external use in treating bruises, sprains and strains. You can make a poultice to apply to an injury by wrapping wet comfrey leaves in a clean cloth. Or make a tea of the roots or leaves (steep 4 tablespoons of dried roots or leaves in % litre of hot water for 15 minutes), cool, strain and use to moisten a cloth. Apply for about an hour at a time. Repeat four times per day or as needed. Comfrey is contained in many commercial first-aid salves; apply these as the manufacturer recommends.

Tea (Camellia sinensis)
Both green and black tea contain tannins, astringent compounds that help shrink swollen tissue and narrow blood vessels. Here's a simple remedy: take a tea bag (plain black or green tea), moisten it with water and put it on your bruise. Herbalist Sunny Mavor, co-author of Kids, Herbs, and Health, says she always keeps tea bags in her first-aid kit. She finds them a handy remedy for black eyes, among other mishaps.

St John's Wort (Hypericum perforatum)
This bright yellow flower is anti-inflammatory and can be used topically to reduce pain and speed healing. Germany's Commission E endorses its external use for bruises. The flowering tops tinge the infused oil a lovely red. To use such an oil, simply apply it as necessary.
Caution: may cause skin reactions to sun exposure, so cover your oil­anointed bruise if you're going out in the sun.

Cayenne (Capsicum annuum, C. frutescens)
These peppers contain a pain-reducing substance called capsaicin that also speeds wound healing. If your bruise aches, try massaging it with a commercial cream or ointment that contains cayenne. Again, apply according to manufacturer's directions.
Caution: wash your
hands immediately after applying cayenne products - it's just too easy to apply the ointment and then rub an eye, with predictable stinging results.

Bilberry (Vaccinium myrtillus)
These fruits have a great reputation for strengthening and protecting capillaries and improving circulation, making them a good choice for bruises.
Typical dosage: 240 to 480 milligrams of capsules standardised to 25 per cent anthocyanoside per day, divided into two doses.

Ginkgo (Ginkgo biloba)
While most famous for increasing blood flow to the brain, ginkgo also increases blood flow to the extremities. Typical dosage: 120 to 240 milligrams of extract standardised to 24 per cent ginkgo flavone glycosides and 6 per cent terpene lactones per day, divided into two or three doses.
Caution: don't use it with blood thinners, such as warfarin.

MEDICINAL GARNISH
Two common kitchen items can help heal bruises.

* Parsley. Its leaves can be crushed and applied repeatedly to a bruise. This remedy may help speed the disappearance of black-and-blue marks.

* Potato. Spud slices, raw and cool, are an old home remedy for bruises, including black eyes.

A SWEET SOURCE OF HEALING

Bromelain, the protein-digesting enzyme from pineapple, may be worth a try if you've suffered a serious injury accompanied by bruising. One study found that it reduced swelling, pain and tenderness in patients who had suffered blunt trauma.

The potency of bromelain is measured in milk clotting units, or MCUs; a typical dose might be one to four 2,400-MCU capsules two or three times per day between meals. Bromelain should be taken as soon as possible after the injury and continued for several days afterward.
Caution: if you have gastric or duodenal ulcers or gastritis, you should not take bromelain.