An interesting question dermatologists sometimes get from their patients is whether bruises can actually lead to scars. The answer to this question is nuanced and depends on the type of bruising and the associated injuries to the skin. In general, most bruising can heal without scarring. However, there are important exceptions.  

If the injury that leads to bruising caused a break in the skin, a deep cut, or a gash, it may result in not only a bruise but also a scar. The depth and width of the injury and the body part which was injured are some factors that determine whether a permanent scar develops. Also, if that injury results in a skin infection, scarring is much more likely to occur.  

One additional consideration is that while certain bruises don't heal with scarring, they may heal with increased pigmentation in the skin.  This is called post-inflammatory hyperpigmentation or post-inflammatory pigment alteration (PIPA). This is the result of increased melanin (pigment) synthesis in response to skin injury or trauma.

This increase in pigment (PIPA) most often occurs in individuals with darker skin types and can be permanent in some cases while can be treated with certain cosmetic interventions in others.

While some pigmentation changes from bruising may eventually fade, some bruises can heal with permanent hyperpigmentation, especially if the bruises occur on the lower leg area. This results due to delayed clearance of the hemosiderin under the skin and/or hyperpigmentation. This is more common in areas with decreased blood circulation like the lower legs.  

Disclaimer:The content in this article is not medical advice, but rather informational content.  As a service to our readers, Skintensive provides access to our library of archived blog content. Please note the date of last review or update on all articles.  No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other medical professional.

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