In adults, which bruise color generally indicates a recent injury?

• A. Yellow
• B. Green
• C. Red or blue
• D. Brown

Answer: (C)

Bruise color changes as blood and its breakdown products are processed in the tissue after an injury. Immediately after bleeding begins, the trapped blood is still oxygenated, which gives a red hue. As the blood ages and loses oxygen, it appears blue or purple because of how light penetrates and scatters through tissue. This red-to-blue/purple phase is typical in the first day or two and signals a recent injury.

Over the next several days, the body breaks down the blood, producing greenish biliverdin and then yellowish bilrubin, followed by iron-containing pigments that give brown tones. These colors indicate that the bruise is healing and several days old or older.

So red or blue is the color most associated with a recent injury, while green, yellow, or brown colors reflect a bruise that has been there longer and is in the healing process.