Facial bruising is a common occurrence in small children, whose foreheads often connect with countertops or tables at face height. Toddlers often "take it on the chin" when they fall when learning to walk, while increased activity makes older children a prime target for falls off bikes or playground equipment or injuries from horseplay with friends. Facial bruising can panic parents, but watching for more serious injuries and applying basic first aid to bruises can help ease your concern.
Assessing the Injury
A bruise can develop almost instantaneously on some parts of the head after injury, such as the scalp, which contains many blood vessels and tightly adheres to the skull, says pediatrician Kelly Ross on Childrens MD. Check for loss of consciousness and make sure the child knows who he is and what happened, easy ways to assess whether he has a serious head injury. Concussions can occur even if little bruising occurs. Make sure the child can breathe normally if he has bruising on his face or neck.
Stopping the Swelling
Ice packs can help reduce swelling, if you can get your child to keep it on her face. Don't apply ice directly or you could injure the skin. Wrap the ice in a cloth or use prepackaged ice packs that mold to areas of the face. Apply for 20 minutes at a time every three to four hours, suggest KidsHealth from Nemours.
Watching for Complications
Depending on the site of injury, facial bruising can cause more serious injuries than what first appears. A blow to the eye can affect the interior of the eye by causing bleeding or retinal detachment, causing vision loss as well as a black eye. See an eye doctor if vision changes occur. A bruised cheek or nose can indicate a broken bone. If the child complains of severe pain or the area appears asymmetrical compared to the other side of the face, seek medical attention. A blow to the head can cause injury to the brain; watch for signs of lethargy, vomiting, breathing changes, confusion or loss of consciousness. If your child has bruising around the mouth, check his teeth to make sure they're all intact.
Treat the injury with ice for the first 24 to 48 hours and heat thereafter to help the tissue reabsorb the blood. Expect bruising to last one to two weeks. Bruises may start out blue and change to green, yellow and brown before fading away. Don't be alarmed if a bruise changes colors. Give acetaminophen to treat mild discomfort from a bruise and follow up with your pediatrician if pain increases or other signs of complications appear.
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.